French health minster: 'We must rebuild our health system to reflect the France of today'

The Local
The Local - [email protected] • 23 Feb, 2023 Updated Thu 23 Feb 2023 10:22 CEST
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French Health Minister Francois Braun. Photo by Ludovic MARIN / AFP

Widely regarded as one of the best in the world, the French health system is facing major challenges including funding shortfalls, a severe shortage of doctors and furious and exhausted healthcare workers - The Local spoke to French health minister François Braun about his plan to tackle the problems.


In common with many European countries, France's health service is facing a growing number of problems, with the difficulty of finding a GP or primary care doctor top at the list for many people.

The Local attended a briefing with health minister François Braun, organised by the Anglo American Press Association, to ask him what he intends to do about these issues.

He told us: "The health system in France is under strain for the same reasons as other countries; people are living longer and there are more people with chronic illnesses.


"I talk to my counterparts in Europe, in the UK, in Canada and we're all seeing similar issues. In most of these countries, as in France, the health system as we know it is largely a creation of the post-war period.

"Things have changed, and so we need to rebuild the health system to reflect the needs of France today."

You can hear the team at The Local discussing France's health system with politics expert John Lichfield in the latest episode of our Talking France podcast. Download it HERE or listen on the link below.


He outlined three main methods of change; addressing the needs and problems of the hospital system, reorganising healthcare in the community particularly addressing the shortage of GPs and shifting the focus to more preventative medicine.

The structural changes are those outlined by president Emmanuel Macron in January, who promised to begin the reorganisation by June.

Community healthcare

The biggest worry for many people in France is registering with a médecin traitant - a GP or primary care doctor - since there is a major shortage of 'généralistes' in France.

READ ALSO How to register with a doctor in France

GPs are self-employed and set up their offices wherever they like and increasingly there are shortages in certain areas - made worse as older doctors retire and younger doctors are increasingly reluctant to take on the speciality of general medicine. These 'deserts médicaux' (medical deserts) are mostly to be found in rural areas, but there are increasingly problems with a shortage of GPs in cities too, especially certain areas of Paris and Marseille.

Braun said: "What we want to do here is give more power to health authorities at a local level - a GP shortage in Paris and a GP shortage in [the sparsely populated area of] Lozère is not the same problem, the causes are not the same and so the solutions should not be the same.

READ ALSO What to do if you live in one of France's 'medical deserts'

"What we want is for local health authorities to become more involved in coming up with tailored solutions for their area - for example one thing that généralistes tell us is that they don't like to work alone, they prefer to work as part of a team, so local authorities could look at setting up offices in which several doctors can work together and share the administrative burden.


"We have a good example in Marseille, in the Nord area of the city there were no GPs practising so the hospital set up a medical centre, staffed by généralistes who are salaried employees of the hospital, rather than self-employed as is usual for GPs."  

The French government has already increased the number of doctors in training and removed caps on certain types of training.

However a suggestion from GPs themselves that the standard consultation fee be raised from €25 to €50 has not been taken up by the government.

Hospital doctors and nurses

When it comes to hospital medicine, plans are already underway to increase salaries and overtime payments, and to increase the number of doctors in training, as well as the number of nurses.

Braun said: "We have increased by 30 percent the number of training places for nurses, and even so these courses are over-subscribed.


"However there is a major problem with nursing students dropping out - more than 20 percent do not finish their course.

"They tell us that there are two major reasons; student poverty and the fact that the nursing training no longer matches the reality of the job. For the first of these we are changing the nursing courses to become university courses - so that students can benefit from grants - and for the second we are changing the structure of the training programme." 

Prevention is better than cure

As the French healthcare system grapples with an increasing number of people living with chronic illnesses, Braun is keen for the focus to shift much more heavily onto preventative medicine.

When he was appointed health minister in July 2022, the health ministry changed its name to Ministère de la santé et de la Prévention (ministry of health and prevention).

Exact details on the type of preventative healthcare still seem somewhat vague, with the exception of the rollout of free health checks for everyone at the ages of 25, 45 and 65 in order to screen for any potential problems. 

Braun said: "France has historically not been good at preventative healthcare, and this has to change.

"I am a big advocate of sport as a method of preventative healthcare and we have two great opportunities to expand sports provision with the Rugby World Cup and the Paris 2024 Olympics.

"Sport is good for both physical and mental health, but I think we need to change the messaging around taking part in sport and physical activity - less 'do it because it's good for you' and more 'do it because it feels good'.

"For example with high blood pressure, the symptoms can be reduced by up to 70 percent through exercise - but we need to get better at making rapid interventions for patients so that their conditions can be prevented rather than treated."



The Local 2023/02/23 10:22

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Schoencarol 2023/02/22 20:59
Unless this is some weird jeu de mot that I didn't quite get, I think you mean medical desert/ désert médical (one "s" in both languages) not "dessert" !

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