"Society pays for their studies": she is the only doctor and MP who wants to regulate the establishment of doctors

She is a particularly dissenting voice within her own constituency. Green Party MP Dominique Voynet voted in favor of the bill "aimed at combating medical deserts," adopted at first reading in the National Assembly on Wednesday, May 7. Its contentious first article, which provides for regulating the establishment of doctors to smooth their distribution and eliminate disparities across the country, is included.

In a depleted chamber, 99 MPs voted in favor of the bill, while 9 voted against, out of the 577 elected members for this legislative term. Of the 12 doctors serving as MPs, 11 were present for the vote. Only one MP voted in favor of the bill: Dominique Voynet.

The Doubs elected official, an anesthesiologist by training and former director of the Mayotte Regional Health Agency (ARS), is an anomaly. Speaking to BFMTV, she justified this conscious decision, drawing on her knowledge as a local elected official and former cog in the medical profession.

"I was the director of an ARS in a region that is a real medical desert, in Mayotte. Before, during, and after Covid-19, I had discussions with my fellow ARS directors general who were all ultimately faced with the same problems: the unequal distribution of health professionals across their territory," she explains.

But there's no need to go to Mayotte, where the situation is particularly critical, to see these problems. As the former mayor of Montreuil (Seine-Saint-Denis), she observed a desertification "of certain neighborhoods three or four kilometers from the Paris ring road."

His observation: "in city districts, in rural areas as well as in overseas departments, I noted that there was a mismatch between young doctors" and the concrete needs for general practitioners.

This observation is broadly shared by all stakeholders in the debate. But the solutions being considered are not the same. Unions and lobbies are more likely to advocate a form of self-regulation, or the implementation of financial incentives to encourage professionals to set up in less well-endowed areas.

"Self-regulation hasn't worked. They've been saying that for ten years," notes Dominique Voynet sourly, noting some progress, but an insufficient response.

This is not the path that has caught the attention of legislators. In response, the profession has launched a strike movement to protest this change, led by interns and junior doctors.

The parliamentarian acknowledges that these young people "provide a service to society," emphasizing that "hospitals would struggle to function without interns and externs." But she insists on the need for a return on investment from these healthcare professionals, who operate thanks to national solidarity, including in private practice.

"What we officially call private practice isn't really what it is. There's no major risk; it's very regulated and protected. It's society that reimburses their services through social security. It's society that pays for their studies," Dominique Voynet reminds us. Speaking to BFMTV, the elected official also highlights the fact that doctors wouldn't be the first to see their practice restricted; quite the contrary.

"On the one hand, I understand (the doctors, editor's note), because it's a major upheaval. On the other hand, the same parliamentarians did not agree to give in to pressure when it was proposed for other professions. My two parents are teachers, they did not choose the place where they were appointed , but they went there," she argues, emphasizing that it will still be necessary to take into account the specificities of the profession.

Dominique Voynet acknowledges that this bill "doesn't solve everything," but she believes it has the merit of "opening up the debate." "It was necessary to kick things off and get things moving, to say that the status quo is no longer possible, no longer tenable," she asserts.

According to her, proof of the operation's success is the hasty announcement of another plan by François Bayrou's government . Instead of regulating the installation, the executive - which opposed the MPs' text - is asking doctors to spend two days a month away from their place of practice to carry out shifts in a medical desert.

"This bill doesn't solve everything," she admits. But she hopes that this debate, now open, will lead to progress for patients. While the text is due to be presented to the Senate this Monday, the Green Party member believes that the text voted on in the first reading risks being "shaken up." "I'm not sure the bill that was adopted by the Assembly will pass the Senate test. But I see that the debate is finally open. Finally!"