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EXPLAINED: Why are French doctors on strike?

The Local France
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EXPLAINED: Why are French doctors on strike?
A patient receives care from a doctor in France (Photo by SEBASTIEN BOZON / AFP)

Unions representing French general practitioners have called for 'unlimited' walkouts, leaving many doctor's offices closed. Here is why doctors are on strike.

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Your French GP's office might be closed this week, as primary care physicians walk out and close their practices in order to protest the 'lack of attractiveness' in the field.

Unions representing GPs on Friday called for an unlimited strike, which means closures could continue for several days or even weeks.

Unions estimate that approximately 60 to 70 percent of généralistes had closed their offices on Friday to join strike action, according to La Depeche.

This latest strike has reportedly seen a stronger uptake in participation from doctors across rural France, according to Philippe Cuq, the president of Bloc (a surgeon's union) in an interview with 20 Minutes, with the movement being "not very well supported in Paris."

This is the most recent example strike action after a series of previous walkouts during the winter of 2022 and spring of 2023, as primary care physicians in France call for consultation fees to be increased.

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Increased fees

Unions have been for several months calling for consultancy fees to be raised to €30 for standard appointments. Originally, unions representing doctors were calling for fees to be raised to €50 (some, like the UFML union, were still calling for this price increase as of October 2023).

In response, the French public health system (Assurance Maladie) announced in April their plans to bring up basic consultation fees by €1.50, coming into effect on November 1st.

As such, a regular consultation with a GP would cost €26.50, instead of the current €25. In France, patients pay upfront for medical appointments and then - if they are registered in the French public health system with a carte vitale - the government reimburses 70 percent of the cost. The rest can be covered by the optional top-up insurance known as a mutuelle.

However, unions representing GPs say this is not enough, with the strike called in hopes of resuming negotiations with French public health authorities. 

Luc Duquesnel, a general practiioner in Mayenne and President of the Confédération des syndicats médicaux français told Franceinfo that doctors see the €1.50 increase as "a humiliation, given the investment doctors make in their patients."

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Another demand from unions has been to push back against some of the proposals in the proposed 'Valletoux bill against medical deserts', which is set to be debated in France's senate at the end of October.

The bill aims to improve access to care, but some doctors are worried that they will be forced to offer 'on-call services' or be forced to work 'on-call' at public hospitals. 

Currently, French GPs take on-call hours on a voluntary basis. Obligatory on-call time for primary care doctors was scrapped in the early 2000s after GPs mobilised against the requirement.

However, representatives from the Hospital Federation have called for it to be reinstated in order to help relieve emergency services.

How bad are 'medical deserts' in France?

Around a third of France has a shortage of doctors, dentists or other medical services, in areas known as 'medical deserts'.

It affects mainly rural areas with an ageing population – though they’re also developing in some towns and cities (including some Paris suburbs) as retiring doctors are not replaced and younger medics establish themselves in more dynamic zones, both in terms of economy and activities.

READ MORE: ANALYSIS: How sick is the French health system?

The French government has taken some steps to solve the 'medical desert' problem, including ending the cap on the number of medical students who can be taken on each year, a measure that has been in place since 1971. That was scrapped in 2019.

Why increase fees for patients?

Many striking généralistes say that an increase in fees would help make the field more appealing to new candidates, as well as help physicians better manage their administrative workload.

Benoît Coulon, a primary doctor in Besançon, located in eastern France, told France 3 in November 2022 that currently at the end of a consultation, when swiping a patient's medical card (carte vitale), the doctor must then log all of the medical acts performed, according to the social security code. "It's getting more and more complex," Coulon explained to France 3.

"There are always new procedures and you almost need to have a dictionary next to you to be sure of what you are doing," he said.

Doctors like, Christèle Audigier, a general practitioner near Lyon, have told French media that an increased consultation could help GPs hire administrative assistants to help decrease their time spent on administrative tasks, which in turn would help doctors spend more time with patients.

Find more info here on getting medical care if your doctor is on strike - Urgent care: How to get non-emergency medical treatment in France

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