Tuesday, the National Council of the Order of Physicians (CNOM) presented 10 proposals to lead to the construction of a more regional health reform.
Of the great consultation depressing to optimistic proposals … Following the results of a large-scale survey (35,000 practitioners interviewed) which had shown the deep discomfort of doctors, the National Council of the Order of Physicians (CNOM) presented on Tuesday the 10 proposals of his Libre blanc “In response to the many dysfunctions of our health system, both for patients and for physicians and other health professionals,” he writes.
They are therefore the result of the major consultation initiated by the CNOM with all the players in the health system and of numerous meetings with professionals in the field. A “political” program which surprised many, and which gives pride of place to a more regionalized health system.
Simplify the territorial organization of care
To begin with, the CNOM calls for the establishment of a single territorial level in order to improve the coordination of care. “To get out of the current administrative millefeuille and to thoroughly rationalize the territorial organization of care, it is essential to define a single area of health action”. The Order wishes to name it the “Health Proximity Pool” (BPS).
If one day the measure is adopted by a government, it will be the smallest geographical entity. The CNOM wants it to have the capacity for independent outpatient care for its population, “including care, prevention, screening, health education, medico-social, prevention at work and in school”, adds. he. Doctors isolated in private practice as well as hospital structures must be part of it
But the reorganization around the BPS, will have to be done from the existing (means and skills) “and on a voluntary basis”, specifies the Order.
For a regional numerus clausus
This regionalization of health, the CNOM also wants it for medical studies. This is how it wants to reform the numerus clausus (number of admissions in the second year) according to local needs by specialty, the training capacities of universities and the possibilities of organizing internships during schooling in the territories. .
In addition, it calls for “thinking” about a preselection system before the year of the “extended” First Common Year for Health Studies (Paces), in the interest of students and universities, in order to limit the rates of ‘failure. “Extended” because the Order also wants to set up a common base for all health professions in the first year, some health professions still not being “university-based” (midwives, physiotherapists, radiology technicians, etc.).
“This absence of specific university courses reduces the number of openings and early gateways”, he thinks.
Increase fee-for-service
Finally, the Order makes more consensual proposals but a little far from its usual field of competence. He therefore calls for a reassessment of the remuneration of doctors. For liberal doctors in particular: “we must pave the way for the diversification of remuneration, in particular by simplifying the lump sum payment of certain missions, and revalorize the fee-for-service payment, frozen for many years,” he deplores.
And for salaried physicians (hospitals, school physicians, occupational physicians, and others): “early career salaries must be upgraded (especially for the first levels of hospital practitioners, as recommended by the Le Menn report)”. The medical unions will appreciate, the health insurance less than one imagines …
“These 10 proposals aim to feed the public debate and the political programs of the next electoral events with the perspective of leading to the construction of a broad and shared health reform”, concludes the CNOM.
10 recommendations @order_medicins to develop the system of #health https://t.co/Ln3zDWEmix #Tomorrow’s Health pic.twitter.com/Z63cv1uPoE
– Pourquoidocteur (@Pourquoidocteur) January 27, 2016
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