French Assembly Approves Regulation To Combat Medical Deserts

On April 2, 2025, the French National Assembly made a significant step towards addressing the growing issue of medical deserts in the country by adopting a key article of a transpartisan bill aimed at regulating the installation of doctors across the territory. This move, championed by Socialist deputy Guillaume Garot, received a comfortable majority of 155 votes in favor, with 85 against and 3 abstentions, despite opposition from the government.

The bill, which has garnered support from over 250 deputies across various political lines, seeks to create a framework for the authorization of medical practitioners' installations, particularly in areas experiencing a shortage of healthcare providers. Under the proposed regulation, physicians—both generalists and specialists—will need to obtain approval from regional health agencies (ARS) to set up practice in designated areas. If a region is identified as lacking sufficient healthcare services, the authorization will be granted automatically. Conversely, in regions that are already well-served, a new doctor can only establish practice if another physician in the same specialty vacates their position.

Garot expressed his satisfaction following the vote, stating, "A decisive step has been taken in the fight against medical deserts." He emphasized the urgency of the situation, noting that "six million French people are without a treating physician, and eight million live in a medical desert." This alarming statistic highlights the stark disparities in healthcare access across the country. According to a report from the Drees, the statistical arm of the Ministry of Health, the top 10% of the population has access to an average of 5.6 consultations per year, while the bottom 10% averages only 1.4 consultations annually. This gap has widened by 5% between 2022 and 2023.

The article had previously been removed during a committee review on March 26, but was reinstated after a heated debate in the Assembly chamber. Garot, who has been advocating for this regulation since 2022, argued that previous measures aimed at improving healthcare access have not yielded the desired results. "We have tried everything, from incentives to training programs, but the inequalities continue to grow between territories and among citizens," he lamented.

Despite the support for the bill, Health Minister Yannick Neuder voiced strong opposition, arguing that "a shortage of doctors, even potentially regulated, remains a shortage." He expressed concerns that the regulation could lead to disaffiliation of healthcare providers, increased emigration of doctors to other countries, and a general decline in the attractiveness of the medical profession. Neuder highlighted the importance of fostering the engagement of healthcare professionals in any reform efforts, stating, "We cannot manage medical human resources without considering the professionals' adherence to the proposed measures."

Critics of the regulation, including Neuder and Deputy Joëlle Mélin from the National Rally, described the initiative as a "false good idea" that could exacerbate the very issues it seeks to solve. Mélin stated, "This will only worsen the core of the shortage: the lack of attractiveness of the profession." Moreover, a coalition of fifteen organizations representing liberal doctors issued a statement opposing the measure, warning that a coercive regulation would have counterproductive effects on access to care.

In defense of the bill, supporters pointed out that the regulation would not impede the freedom of installation for doctors in 87% of the territory. Philippe Vigier from the MoDem party emphasized this point, asserting that the regulation is necessary to ensure a more equitable distribution of healthcare resources. He noted that other healthcare professions have already adopted similar regulatory measures without detrimental effects.

The Prime Minister, François Bayrou, had previously indicated support for some form of regulation during a speech on April 1, stating the need to move beyond stagnation and impasse in healthcare access. He called for a collaborative approach involving all stakeholders to develop a comprehensive solution by the end of April.

As the debate continues, the National Assembly will reconvene on May 6 and 7, 2025, to further discuss the bill and its remaining articles. These include provisions to eliminate increased consultation fees for patients without a designated family doctor and to establish a minimum training requirement for medical students in each department. The Assembly also adopted an amendment creating a "territorial indicator of the supply of care," which will be updated annually to reflect the medical resources available in different regions.

Garot's initiative represents a critical attempt to rectify the disparities in healthcare access that have developed over the years. As he noted, "When medical deserts advance, the Republic retreats." The urgency of this situation cannot be overstated, as millions of French citizens continue to grapple with inadequate access to essential medical services.

In summary, the adoption of this article marks a pivotal moment in the ongoing struggle to ensure equitable healthcare access for all French citizens. As discussions resume in May, the outcome will be closely watched by both supporters and detractors of the proposed regulation.