In a significant development for healthcare in France, the National Assembly has adopted the Garot law aimed at regulating the installation of doctors to combat the growing issue of medical deserts. This legislation, passed on the evening of May 7, 2025, has garnered support from a transpartisan group of over 250 deputies, despite opposition from the government and many medical professionals.
The law, which was approved by a substantial margin of 99 votes in favor to 9 against, seeks to address the critical shortage of healthcare providers in rural and underserved areas. As emphasized by Guillaume Garot, the socialist deputy who sponsored the bill, "when medical deserts advance, the Republic recedes." He stressed that health should not be determined by one's postal code, highlighting the urgent need for equitable access to healthcare across the country.
Currently, the commune of Saulnot, located near Héricourt in Haute-Saône, is emblematic of the challenges faced by many rural areas in France. For the past four years, Saulnot has struggled to attract doctors, with only one practitioner serving its 766 residents. Mayor Jean-François Ribiere has expressed his concerns about the situation, acknowledging the dire need for more healthcare professionals while also criticizing the new law. "It's a very bad idea. Taking someone and saying, 'You come here,' is not very pleasant," he remarked, indicating his belief that a more diplomatic approach would be preferable.
The Garot law stipulates that a doctor may only establish a practice in an area that is already well-served by practitioners if they are replacing a departing colleague. In areas that are underserved, however, installation remains free and facilitated. This regulatory framework aims to ensure that medical resources are allocated where they are most needed.
Despite the good intentions behind the legislation, critics like Ribiere question its effectiveness. He wonders, "If we implement this law tomorrow, can we fill all the vacancies? I doubt it. I would like to know how many are currently available." His skepticism reflects a broader concern among local officials and healthcare providers about the law's ability to attract new doctors to areas like Saulnot.
Anne-Laure Guillemain, a nurse in Saulnot, corroborates this sentiment, pointing out that the current doctor cannot meet the healthcare needs of the entire community, especially with several nearby villages also relying on limited medical resources. "Every day, there’s something; there are needs," she noted, emphasizing the ongoing demand for medical attention in the region.
The situation is further complicated by transportation issues, as many residents lack access to vehicles, making it difficult for them to travel to other towns for medical care. Ribiere himself has to visit a doctor in Héricourt, a reminder that even those with means can struggle to access healthcare in rural areas.
In an effort to address the shortage, former general practitioner Patrick Laine, who retired in 2021, left his building, which includes two fully equipped medical offices and two apartments, to the commune in hopes of attracting new doctors. "The doctor who wishes to settle could use these premises without even paying the costs for a certain time," he explained, highlighting the community’s commitment to finding solutions.
Despite these efforts, the question remains: why is Saulnot not attracting new doctors? Local officials and residents are baffled, having made numerous attempts to reach out to potential candidates without success. "We don’t know why; we’ve tried everything. The mayor has called everywhere, and everything is being done, but we still don’t have answers," Guillemain lamented.
As the Garot law moves forward, it is set to face scrutiny in the Senate, where lawmakers are expected to examine their own proposal aimed at addressing the same issues. This proposal, supported by the government, suggests that doctors in well-supplied areas should also work part-time in underserved regions as a condition for establishing their practices. The government has activated an accelerated procedure to expedite the legislative process, indicating the urgency of the situation.
The debate surrounding the Garot law underscores a broader national crisis: approximately 87% of France is affected by medical deserts, with over six million people lacking a primary care physician and eight million living in areas with particularly limited access to healthcare. This widespread issue highlights the need for comprehensive solutions that address both the regulatory and systemic challenges facing the healthcare sector.
As the legislative process unfolds, it remains to be seen whether the Garot law will lead to meaningful changes in the healthcare landscape or if alternative approaches will emerge from the Senate's discussions. For now, communities like Saulnot continue to grapple with the pressing need for medical professionals, hoping that new policies will ultimately lead to improved access to care for all residents.
