FILE. Medical desert: in La Bastide Puylaurent, in Lozère, “it's fine if you're not sick”

Mobisanté 48 allows people without a primary care physician to access care. Midi Libre – MICHAEL ESDOURRUBAILH

What does the health world expect from the new government?? In La Bastide Puylaurent, a village in Lozère with 170 inhabitants, the problem of “access to care”, declared as a priority by the new Minister of Health, is not an empty phrase. The visit of a mobile medical office once a month is a small relief on a gaping wound.

A medical centre, a pharmacy, restaurants, a café, a butcher, a school, a station with daily trains to Nîmes, Mende, Clermont-Ferrand, the passage of many hiking trails and the Stevenson trail… On paper, the town of La Bastide Puylaurent, 170 inhabitants, on the border of Lozère and Ardèche, is not a desert. In any case, not a medical desert.

However, Geneviève Darrieussecq would have there reason to reflect on her mantra, "access to care", now attached to her title of Minister of Health. "The major axis" of her policy, she says. "If she wants to come and see how the problem is posed, we welcome her!", suggest those who fight to provide care. “Here, we are doing palliative work, but it is not the solution. The solution is for a doctor to be able to set up shop”, projects Dr. Daniel Durand, who is providing consultations this Tuesday, September 24, three days after the appointment of the new government, in a mobile medical office, the Mobisanté 48, parked in front of the medical center.

On the glass facade of the building installed in the center of the town, next to the town hall, the word of Dr. Durand's predecessor has been frozen for almost two years in an announced end of activity, starting December 31, 2022. With a number for "advice or guidance". But "no consultation". An emergency doctor was ready to take over, by putting on the coat of a family doctor, but the proposal fizzled out, “it is forbidden by law”, regret Daniel Durand and Annie Blanchet, a volunteer at the Red Cross who rents Mobisanté 48 from the Lozère avenir santé association. In the medical center, today, only one osteopath and one “energy therapist, magnetizer, sophrologist…"

"We go out to others, it starts with kindness"

Dr Durand is only here in passing, accompanied by a private nurse, and, for a while, by Shazia Patel, an intern at the Perpignan hospital, who is writing her thesis on the difficulty of accessing care, and the Mobisanté 48. A mini-waiting room, a blood pressure monitor, a stethoscope, the converted vehicle was put into service on March 5. In an area populated by medical deserts, it provides access to a few hours of care for the people of Lozère, on Tuesdays, from 9 a.m. to 6 p.m., with the help of retired doctors. “In a medical practice, you pay, here, with the bus, there is no advance payment, it is third party payment”, specifies Annie Blanchet.

The first Tuesday of the month, the bus stops in Serverette, in northern Lozère. The following Tuesday, in Châteauneuf de Randon, and the following, in Chastel-Nouvel.

Annie Blanchet counts:“In March, 37 appointments were made for patients aged 15 to 84, in April, 31, in May, 40 and in June, 42”. “We would like the system to be continued next year”, hopes the volunteer, who offers coffee, tea, a glass of water, at the reception, whether or not you have an appointment: “We go out and reach out, it starts with kindness”.

“When there's panic, I call the 15"

"It's fine if you're not sick", explains without irony Françoise, 79, who is worried about "the age that is coming" : "I'm scared". She doesn't hesitate to drive three quarters of an hour from Saint-Amans to be followed by a doctor she “known since 2005”. Like her dentist, who has been treating her for “nineteen years”, but who “didn't want to do it for my partner”: “No one is taking on new patients”, the retiree notes fatalistically.

Another Françoise, aged 62, arrives with the report of an imaging scan carried out five months ago: “I don't know what to do with it, I don't have a GP anymore, every time, they can't take", explains this neo-Lozérienne, who has lived in the hamlet of L’Estevenes for fifteen years. With "significant health problems", she does what she can, with a bit of teleconsultation, the help of the pharmacy, her shrink who "sometimes acts as a treating physician", and “When there's panic, I call 15”.

Régine, 53, moved here in 2017. Before, she “would get taken to Villefort”, a half-hour drive away and “sometimes four hours of waiting”. “It's clear, we're in a medical desert”, notes without pretense the former Nimes resident, who gave up on seeing a rheumatologist and having the tests prescribed at the Mende hospital, after the Social Security refused her a VSL three times. “The bus drops you off two kilometers away, and it's like that”, explains, raising her hand at 45°, Dr. Durand's patient, asthmatic, smoker, who “doesn't see what the new government will be able to do". She, has "dropped the case".

The doctor confirms: "I don't see all the patients who should be here, some have dropped out".

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