the essential
The mayor of Sallèles-d’Aude had been negotiating for many months with a specialist in rheumatology, so that he would come and practice weekly in the town. The Regional health Agency has just said no.
The lack of a treating doctor in the department, particularly in rural areas (but not only that, see the current situation in Carcassonne), is already known to everyone, as is the delay in obtaining an appointment with many specialists. In this context, the municipality of Sallèles-d’Aude wanted to welcome a rheumatologist: question of “service to the population”says Mayor Yves Bastié. “When we know the time it takes to have a consultation if we contact a specialist based in town…” The doctor in question currently practices in Toulouse but “has a house in Sallèles”and he was in favor of weekly consultations. “At first every Tuesday, then we considered increasing to two or three days a week, with a view to a total transfer of his office to Sallèles.” As such, the practitioner had to be “hired as an employee” by the community.
Proof that the municipality had made good progress on the project: a start date for activity had been set. “Monday May 13”, specifies Yves Bastié. The professional had already started to bring equipment to the site, and the municipality to settle the technical considerations (payment by credit card, etc.). Even more, no less than two months of appointments had already been made. “Everyone was informed of our approach since January”, says Yves Bastié. But a few days ago, it was a cold shower.
Rules
“The ARS had to validate the arrival of this specialist with a number finesse, explains the chosen one. This number is essential to enter into an agreement with the Primary Health Insurance Fund, and allow patients to be reimbursed. However, the Health Agency informs us that the finesse will not be issued to us because we must have salaried general practitioners, not independent ones.” Yves Bastié recalls that two private GPs, a dermatologist, a speech therapist and nurses are already grouped together in a single location, in Sallèles-d’Aude. The move near the town’s dentists has also been launched, and the installation of physiotherapists is planned. “We are fighting to bring in experienced people. There, we manage to attract a rheumatic patient, and we are refused”plagues the councilor. “We are really walking on our heads in this country!”
Above all, there are rules to respect, replies the Health Agency, which responded to our title via a press release summarizing the situation in Halle. To summarize, the municipality is criticized for wanting to put the cart before the horse. “The regulations relating to health centers require that these coordinated exercise structures primarily provide primary care, guarantee accessibility and continuity of care, as well as the coordination of health professionals within the center with health actors”, we specify. Fact, “the center must operate with at least two health professionals, in order to ensure continuity of care”.
The ARS thus indicates that “the main obstacle is the absence of a treating doctor to provide consultations”adding that “the town hall had first considered employing a doctor with the specialty of surgeon but, despite the support of the ARS, he did not wish to embark on a course of change of specialty aimed at becoming a general practitioner”. Therefore, the Agency “cannot assign a number finesse At this stage of the project, operation with a single rheumatologist doctor is not compatible with the primary missions of a health center which are to provide primary care and guarantee continuity of care..
Explanations which still have difficulty getting through at the town hall. “The doctor is devastated, and we will have to contact all the people who had already made an appointment in May and June”deplores Yves Bastié, determined to seizer “the prefect and the regional management of the ARS”. The Aude representatives of the latter, however, emphasize that “the door remains open” for Salleles d’Aude: “The ARS, particularly attentive to the problem of access to care, continues to follow the file carefully”we add, stipulating the “project mentioned by the director of the CCAS to employ part-time employees of the two general practitioners established on a freelance basis in the municipality”.
