A diagnosis well posed. Good intentions deployed in 54 measures that it has not yet been implemented. But to those who were asking for more resources, the president Macron has, from the outset, cut the grass under the feet : “Our system does not suffer from a problem of under-funding. He displays a true disability organization. “In short, it will almost make means constant : the comprehensive plan will be equipped by 2022 with a budget of 3.4 billion euros, compared with annual health expenditures approaching $ 200 billion per year. The Point has chosen the tracks of reform, the most promising of the health plan presented by Emmanuel Macron on Tuesday.

Labelling of 400 to 600 hospitals of the vicinity. Create and convert the local hospitals to strengthen “the first action” from new hospitals so-called ” proximity. “The first settlements will be labelled from 2020, between 400 and 600 will be here in 2022. A law shall determine their status. They will have a biology laboratory, an imaging center, equipment for telemedicine. They practice general medicine, elderly care, follow up care and rehabilitation, consultations to specialty and small emergencies. On the way, small hospitals with maternity wards and surgical services to low-activity and who have, for years, opposed their closure will join the park facilities.

The facelift and upgrading, including financial support, of these institutions today undervalued and often located in medical deserts will be sufficient to attract sustained competent doctors and their families ?

Creation of 1 000 business communities and territorial health (CPTS) by the year 2022. It is professional associations isolated or working in small groups able to provide, on a territory of 20 000 to 100 000 inhabitants, access to a physician capable of responding to emergencies, and to propose prevention actions, and to cooperate with physicians of all specialties between them. A bargaining conventional between the health clinic and the unions medical to begin in 2019 to ensure the financing of these new communities. It will be crucial to the success of this key point of the reform, as it has proved difficult up to now to bring together physicians viscerally attached to their independence.

Creation of 4 000 jobs of medical assistants to return to the medical time by 2022 under the condition, for doctors, to practice in a group. These medical assistants will be responsible for the reception of patients, collection of data, verification of immunizations, and screenings, the update of the folder and the support of appointments with specialists or in institutions of care. To be eligible, it must be that the doctor is part of a CPTS, follow more patients, and practicing in a group practice.

generally speaking, Emmanuel Macron wants to exercise “isolated” the medicine city “disappears” by the end of his five-year term and he hopes that the negotiations between the social Security and the unions medical manage to ” find a smart solution so that they can organize collectively in order to receive the emergency patient all day up to 20 hours or 22 hours. Two promises that will be particularly hard to take. Be enough to stem the nomadism medical and engorgement of the emergency services ?

Creation of 400 posts of general practitioners to exercise shared between the city and the hospital to address the most serious situations in the medical deserts.

A package will be introduced, for the hospital care of diabetes and kidney failure as early as 2019. We will not pay in the act or in the review, but a lump sum in respect of the course of care. This type of support will be extended to other pathologies, and then to the care of the city. It is not only to pay the care institutions according to their activity alone, but to inject a portion of financing related to the quality.

medical Record to be shared. It will be deployed and generalized from November 2018. This announcement was made for the first time in 2004. To date, the DMP still does not exist.

In 2022, all the requirements are dematerialised between physicians and pharmacists.

a Generalization of the thresholds of activity. All the institutions of medicine, geriatrics, rehabilitation will be organized in three levels : level 1 corresponds to the proximity, the 2 to specialized care in hospitals, the 3 acts ultra-specialized in the CHU.

Removal of the numerus clausus and the recast of the first cycle of studies health as soon as 2020, and deleting, at the end of the studies, tests and trials national classantes. Also removed the entrance exam for the institutes of nursing as early as 2019. Admission will be by Parcoursup.

Quality of care. Guides the support to be relevant and of quality for physicians are going to be defined for the main chronic disease by 2022. The first, concerning heart failure and osteoporosis, will be defined by the end of the year.

Revaluation allowances of presidents of CME (medical committee), heads of division, managers of health and creation of an allowance for heads of service, creation of a system of profit-sharing collective in services.

On the same subject Agnès Buzyn confirms the end of the numerus clausus ” as early as 2020 “