MPs must examine, on Tuesday evening, a bill establishing “direct access” to certain health professions, in particular nurses in advanced practice. Liberal practitioners already fear a “two -speed medicine”.
by Mattea Battaglia and Minh Dréan
“Direct access”, “Delegation of tasks”: these expressions do not speak, or very little, to the neophyte. However, they are at the heart of the debates that agitate – and sometimes oppose – the health actors, between them and with their supervisory authorities; At the heart of the tensions that have been going through the medical and paramedical world in recent weeks.
It is necessary, to respond to the stake of a demography at half mast – for at least ten years – among the doctors, and therefore to resolve the difficulties of exercise and access to care, to move the lines and perimeters of health professions? If yes, how to do, how far, what type of missions today assumed by doctors to delegate, and for the benefit of which other nursing (s)?
These questions promise to bounce back with the start of discussions in the National Assembly, probably this Tuesday, January 17 in the evening, in public session, of the bill “improving access to care by confidence in professionals health “. The context gives this text a particular echo: city medicine and health insurance are engaged in harsh conventional negotiations before achieving, by the end of February, to redefine for five years the contract which links them.
carried by a whole fringe of Renaissance (and related) deputies grouped around the deputy of the Loiret Stéphanie Rist, the bill intends to establish a “direct access” of patients to the nurses in advanced practice (IPA) – graduates in baccalaureate + 5, and not at Bac + 3 like nurses of state graduates -, as well as to masseurs -physiotherapists and speech therapists. His supporters make it a lever to “free medical time”, at a time when health supply is not always enough to meet needs, when its detractors, that is, almost all of the spokespersons for liberal practitioners, Already denounce a “two-speed medicine”, a “low-cost medicine” or even a “medicine without doctors”.
“Coordinated exercise”
If the text was voted, patients could consult these three professions “in first intention” (in other words, without visit to a doctor upstream), on the condition of a “coordinated exercise” or an exercise in a “coordinated care structure”. In the Social Affairs Committee, where the bill was adopted on January 10, M Rist, rheumatologist by profession, has given details in the face of opposition deputies claiming guarantees in The material. “These are primary care teams, health homes, health centers or even territorial health communities [CPTS]”, she explained.
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