“Every euro spent must be useful” asks Frédéric Valletoux, Minister for Health expected in Montpellier on Friday

Frédéric Valletoux, ministre délégué à la santé et à la prévention : “Il faut mieux dépenser”. MAXPPP – Luc Nobout

The Minister for Health Frédéric Valletoux is traveling this Friday, March 22 to Hérault, on the occasion of the national congress of multi-professional health centers organized in Montpellier. Beforehand, he visited the Cancer Institute-Val d’Aurelle. In the afternoon, discussions are planned with members of the Professional Territorial Health Community (CPTS) of Lunel and the health center of the Lemasson district, in Montpellier.

Access to care, general practitioner agreement, deficits of public and private hospitals, savings… Frédéric Valletoux speaks on the "hot" of his ministry.

Multi-professional health centers, which bring together primary care health professionals in the same place, are holding their national congress in Montpellier on March 22 and 23. Will it open with the observation that the objective set by the government of 4000 MSP has been met??

C’is an objective for 2027. The model works well, firstly because it responds to the aspiration of a number increasingly important for professionals, particularly younger generations, to work in teams.

MSP also makes it possible to anchor healthcare provision in the territories, and the subject of access to healthcare is essential today.

It doesn't matter the number. What is needed is for these projects to be carried out by a real team medical project. Things will go at their own pace. Behind, these MSPs are part of a larger territorial project linked to the hospital and the rest of community medicine. See the emergence of territorial care organizations that make it possible to break down barriers and make the public, the private sector, the hospital, the city, specialists, general practitioners, paramedics, etc. work together. is one of my priorities, it is one of the major challenges of the years to come.

At the congress, these MSPs are asking for a "Marshall Plan" to "go faster and further, with more resources", you subscribe ?

I am wary of big expressions that make you happy when you say them and that don't correspond to reality. The reality is that today, we are in a constrained context of public finances. We don't need to announce the moon to implement concrete solutions.

In 2017, France devoted 200 billion euros to health. In 2024, it is 255 billion euros, more than 30% additional. We must manage to spend better and better allocate what is useful, necessary, and which serves the health of the French, rather than giving the impression that health is a bottomless well in which we must, each year, inject billions.

France does not underfund its health system. On the other hand, there are tensions: we need to pay better salaries at the hospital, we need to better promote and support systems like health homes…hellip; The subject is to spend better rather than spending more.

"I am optimistic about the ability of private doctors to understand that there must be reciprocal commitments"

General practitioners are asking for an increase in their prices, discussions have resumed with the national health insurance fund to bring about the agreement which sets them. Are you in favor of sticking to 30 euros per consultation and up to 60 euros for certain complex consultations?

Everything will depend on the ongoing negotiations. Many things have been put on the table and are under discussion between the unions and health insurance. I understood that the state of mind is rather positive and constructive even if we still hear that "the account is still not there". I am optimistic about the ability to find an agreement. From the moment when health insurance, that is to say the State, is ready to financially support an evolution of consultation, I am optimistic about the capacity of private doctors to understand that ;rsquo;there must be reciprocal commitments. For the liberal world, this will be a commitment to taking into account a certain number of objectives of general interest which are close to the government's heart and which express the expectations of the French: better permanence of care, care for patients who do not have a treating doctor…hellip;

When the State funds medical assistants to relieve private doctors of administrative tasks, it is to allow doctors to devote more time to patients. 6000 medical assistants deployed. The goal is 10,000 by the end of the year.

It will be signed by summer ?

Yes, I hope, they meet again at the beginning of April.

You know well that positions are tense on the permanence of care, particularly on the obligations imposed, you are optimistic ?

Today, liberals are not absent from permanent care: 40% of general practitioners participate. They take patients in the evening after 8 p.m., on weekends and on public holidays. It’s a lot, 40%, but it’s not the majority. We undoubtedly have room for progress, with attractive measures, especially since it is not a question of re-establishing 24/7 guards.< /p>

I also recall that in the bill that I had proposed, and which was adopted last December, we made permanent care compulsory for private clinics to relieve the hospital emergencies.

Over the course of the year, we will accelerate the territorialization of the health system. The territories will make the demarcations themselves, with local elected officials, the regional health agency, prefects, representatives of hospitals, clinics, liberals… Perhaps, gradually, they will feel led by the collective.

"L’Hérault will have an SAS in April"

The model of permanent care is the SAS, the access to care service that Gabriel Attal would like to see deployed throughout the territory, which will make it possible to find an appointment in town medicine within 48 hours, excluding life-threatening emergencies, thanks to a collaboration between town medicine and emergency professionals?

SAS is regulation. When you call 15 and the regulator sees that the subject is less a vital emergency than obtaining an appointment with a practitioner, he directs you to a platform run by city doctors with the ability to direct colleagues who have appointment slots available in the short term.

The SAS is deployed today in 67 departments…

L’Occitanie was a pilot…

Yes. Hérault finalizes its project during the month of April. Aude and the Pyrénées-Orientales are working, Lozère is soon ready.

Since we launched the first SAS in July 2022, 900,000 French people have been referred to a town doctor. All departments will be covered in September.

"In our health system, there are also rents, useless or redundant acts"

For that, money is needed, in a context where the deficit of public hospitals reached a record level last year, where one in two private establishments is in deficit. They are waiting the announcement of hospital rates, there is a lot of work to be done…

On the pricing campaign, we must not panic, decisions are coming. They are complex. My goal is that every euro spent is useful to the health of the French.

I say this, because we have to be honest, in our health system, there are also rents, useless or redundant acts, expenses that we could incur more relevant way.

Where are these "rents" ?

On certain acts that we do out of habit, for comfort or for financial motivation.

Reimbursement by Social Security of thermal cures ?

I have no taboos. The essential thing is that we perpetuate our universal system of care adapted to needs, of which we must be proud. If one day we have to raise the subject of thermal cures, let's look at it. Some would like us to look at the subject of long-term conditions. This does not mean that we are going to reduce support for the French, that is not the objective.

"We are not going to close a hospital because’it is in deficit"

The deficits displayed by health establishments, public hospitals and private clinics, are worrying ?

The State has been running a deficit for almost fifty years and things are still turning around. We are not going to close a hospital because it is in deficit. We know that today, hospitals are ready to reopen services and beds as soon as they are able to recruit. We are not in an approach of violent closure of hospital services under the pretext of savings. We can survive a year of deficit, as long as it is not ad vitam aeternam.

Caregivers say they are exhausted, how to respond to this situation ?

Yes, caregivers are exhausted. In the hospital and even the general practitioners who are fewer and fewer in number and who do an enormous job. We must actually restore meaning, we must better finance what needs to be financed, we must make an effort on hospital salaries, on small salaries, why not on liberal consultation…

But the subject is not only financial. It’s also a question of the meaning we give to our work, the conditions in which it is done. We need to make careers in hospitals more attractive, and I also think in nursing homes where the rhythms are often very difficult.

What are you going to tell the doctors you are going to meet in Montpellier on Friday?

That we all need to roll up our sleeves and stick together. My job is to tell them that I have confidence in the mobilization of all stakeholders, and above all I want to give them the means to improve the situation in the territories, by bringing out projects that will be different in Montpellier than in Montpellier. ;elsewhere. We want to release energies.

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