With a deficit of €13bn, the French health system is in crisis. GPs strike, specialists get special treatment, a two-speed system is coming and the public doesn't careby Tim King / March 17, 2005 / Leave a comment
In France, every new year kicks off with public sector strikes. They affect schools, hospitals, railways, postal and power services. Yet, despite this year’s honourably robust turnout, the country is neither “in the grip of” the strikers, nor being “held to ransom” by them. Far from the regime-changing chants which brought down Alain Juppé’s government in 1997, this year’s strikes seem overcome with weariness: tired of Jean-Pierre Raffarin’s government, certainly, but cynical about the chances of it being changed. And this seems to be not so much resignation to the powers that be than to their own lassitude. “The French no longer believe in anything,” claim the country’s préfets in their annual report to the government. “That’s why everything is relatively calm: [people] see no point in expressing an opinion or making themselves heard.” “The French are having to restructure the way they see themselves,” says Dominique Reynié, director of the Observatoire Interrégional du Politique. “Nobody believes that our country is an exception any more, nor that a specific French model exists. For the first time it’s not us defining the rules of the game.” This systemic pessimism has been given a name: la sinistrose. Like any psychosomatic illness, no sooner was this announced than everyone discovered they had it, but if they seek medical advice for “sinistrosis” they’ll be out of luck—GPs are on strike too, for the unlikely reason that the reforms being introduced by the health minister Phillipe Douste-Blazy are not radical enough.
French GPs don’t have a monopoly on frontline healthcare as they do in Britain—the patient has the right to see as many GPs or specialists as he likes, for all the diseases he may or may not have. This fundamental liberté results in nomadisme médical, with no doctor knowing how many patients he has—they come once, but will they come again? “If I want to keep my patients, I have to give them whatever they want: sick note, bagful of medicines,” one of the three GPs in my area tells me. “I can’t tell them unpleasant truths: stop smoking, cut down on alcohol, lose weight—they’d simply go to my colleague.” The word “colleague” is a euphemism. Off the record he spits venom imagining what his rival is offering to lure his customers. The patient loves having doctors who pamper him, but nomadisme médical is good for neither the country’s health, nor its finances.