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Liberal medicine on the way to an “arbitral settlement”


Treaty negotiations have failed, what next? A month almost to the day after the unanimous rejection by the six representative unions of city medicine of the “medical convention” proposed by the Health Insurance (this “contract” supposed to redefine their conditions of exercise and remuneration for the next five years), the stakeholders replayed their disagreements on Saturday March 24, not at the CNAM headquarters, Porte de Montreuil, as was the case this winter, but inside the Palais des Congrès, Porte Maillot, where the College of General Medicine held its congress.

On the third – and last – day of this 16e edition punctuated by dozens of workshops, conferences and round tables, some of the actors (or their representatives) of the aborted conventional round – Thomas Fatôme, for Health Insurance, Agnès Giannotti, for the MG France union, Luc Duquesnel, for the CSMF-Généralistes, or Claude Bronner, for the generalist branch of the Fédération des médecins de France – came to sit down side by side, in front of an audience of doctors asking for perspectives.

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The opportunity to display shared objectives: re-engage ” quickly “ negotiations to restore the attractiveness of the profession and meet the health needs of the French. It is also an opportunity to recall some of the “red lines” who led the last round to an impasse: means “insufficient”a framing letter “unclear”bases for negotiations ” to review “, listed the union spokespersons. “The method used is not working, it must be changed”, said Agnès Giannotti. Opposite, the Director General of Health Insurance responded to criticism in the form of a question: “Do you want to be players in the transformation [du métier], co-construct the devices that will trigger the movement, and which are not only tariffs? »

“Territorial commitment contract”

In hollow, even if the expression was not – or little – mentioned on Saturday, it is indeed the “territorial commitment contract” which continues to get stuck, a translation of the principle of “rights and duties” defended by the government, and rejected, at the end of February, by all the unions. Rendered obsolete by the failure of the negotiations, it provided, for the general practitioners who would have initialed it, to raise the price of the basic consultation to 30 euros, against 25 euros today, on condition that they undertake to rewards – seeing more patients, participating in on-call duty, working in a medical desert, consulting on Saturdays, etc.

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