French health service is falling apart, say doctors

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The Independent Online

The French health service, regarded as the world's best, is falling apart, a petition signed by 286 of its most senior hospital doctors claims. Waiting lists, almost unknown in France five years ago, are becoming common, and there is a severe shortage of doctors and nurses.

The French health service, regarded as the world's best, is falling apart, a petition signed by 286 of its most senior hospital doctors claims. Waiting lists, almost unknown in France five years ago, are becoming common, and there is a severe shortage of doctors and nurses.

"In casualty units, sick people have to wait for hours, sometimes even days, on stretchers, because there are no beds for them in the hospital," said the doctors' petition, sent to the newspaper Le Monde.

The recently appointed Health Minister, Philippe Douste-Blazy, has said the public health service budget would be €12bn (£8bn) in the red this year, €1bn more than the previous forecast.

The two events are closely connected. The doctors' petition was a shot across the bows of the unpopular centre-right French government, which is expected to announce plans next month for the most radical reform of the health service in more than 50 years.

Battle-lines are being drawn for what is likely to be the most bitterly contested domestic political issue in France this year, the future of a €130bn-a-year health service which is regularly named by the World Health Organisation as the world's finest.

A committee of inquiry reported in January that the "health insurance" section of the nation's social security system faces a €66bn deficit by 2020 unless something is done to increase its revenues or reduce its spending, or both. Half of public spending on health goes on the state hospital service, which was originally to be excluded from the reforms.

There have been reports recently that M. Douste-Blazy, a former GP, intends to bring the public hospitals into the scope of his reform plans, to be announced next month. Hence the indignant petition from 286 heads of departments in hospitals across the country.

The doctors accused the government of wanting to abandon the principle that excellent health care should be available to everyone in France "whatever their resources". They predicted that the reforms would introduce the principle of choix (priorities), favouring the private sector and "destroying" the "best public hospital system in the world".

The petition also said successive French governments had saved money by placing draconian limits on the number of training places for doctors and nurses. As a result, especially with the introduction of the 35-hour working week, there was a crippling shortage of trained medical staff, forcing the permanent or temporary closure of many wards.

The petition offered no alternative solution, other than more spending, to the crisis. The committee of inquiry suggested there was vast waste and duplication in the system.

The committee, a cross-section of society, including the medical professions, said France uses proportionally four times more pain-killing, antidepressant and tranquillising drugs than its European neighbours. French doctors and French patients have come to expect a system which asks few questions and imposes few rules.

Loopholes even allow even some types of cosmetic surgery on the Secu (health service). Doctors are reluctant to prescribe cheaper, generic medicines, which account for 3 per cent of the total drugs bill in France, compared with 60 per cent in the UK.

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