Just five months after taking office, Aurélien Rousseau resigned from his role as health minister in protest against France’s recently adopted immigration law. Interim replacement Agnès Firmin Le Bodo, the sixth health minister since 2017, is not expected to stay long after accusations relating to gifts she obtained from pharma companies. For healthcare professionals this ongoing instability and lack of a steady point of contact is especially exasperating at a time when France’s healthcare system is already under considerable pressure.
We need stability, we’re at a time in our history when the healthcare system is suffering more than ever, with caregivers exhausted, and patients experiencing difficulties accessing care
Jérôme Marty, UFML
Heated Resignation
As a part of the more left-leaning contingent of president Emmanuelle Macron’s government, the Minister for Health and Prevention, Aurélien Rousseau, resigned in protest against the immigration law adopted on Tuesday December 19, 2023 in the French Parliament.
Rousseau was particularly opposed to the proposed abolition of state medical aid (AME), which offers access to healthcare for illegal immigrants. Despite a report previously commissioned by the government that demonstrated the “health benefits” of the AME while indicating the “limits and risks” of replacing it, the French right argued for a more restrictive “emergency medical assistance” programme.
The elimination of the AME was originally voted by the Senate as part of the new immigration bill. Although the repeal was finally abandoned, the state aid mechanism still faces review in 2024.
Concern from Healthcare Professionals
While the country’s principal medical associations and doctors’ unions appear to be in alignment with Rousseau’s views, they worry about the instability of the position of Minister of Health at a time when the French healthcare system is already under considerable pressure, reported the Agence France-Presse (AFP).
“A man who puts the values of the Republic and honor above his personal career can only have our admiration,” read a statement from the doctors’ union UFML after Rousseau’s resignation. The nation’s main GP union, MG France, was also behind Rousseau with respect to his stand on AME, an aid mechanism that if eliminated stands to put further strain on the public health system. “We were in agreement with Aurélien Rousseau on … maintaining state medical aid (AME) for undocumented immigrants, said Agnès Gianotti, President of MG France.
French healthcare professionals were nonetheless taken aback by yet another change in the health ministry. “We’d like to see a lasting relationship with a minister who has the time to implement all the measures planned,” said Agnès Ricard-Hibon, spokesperson for the French Society of Emergency Medicine (SFMU). “It’s complicated to have such frequent ministerial changes, because it hampers the continuity of the policies,” she added, regretting that no forthcoming measures to relieve emergency room congestion are in view.
“We change ministers every four mornings,” Patrick Gasser, president of the leading specialist doctors’ union Avenir Spé, complained in reaction to the departure of yet another health minister. Agnès Firmin Le Bodo will be the sixth to fill the position in so many years.
“We need stability, we’re at a time in our history when the healthcare system is suffering more than ever, with caregivers exhausted, and patients experiencing difficulties accessing care,” Jérôme Marty of the UFML asserted.
“The healthcare system is in deep crisis, so it’s very important that we have someone who is genuinely concerned about the subject,” said Gianotti.
Plagued with issues such as staffing difficulties at public hospitals, a dearth of medical personnel in rural areas and smaller towns, and long-disputed low consultation fees for doctors, the French healthcare system is indeed at a critical juncture.
The former minister had renewed dialogue with independent doctors, with a view to relaunching consultation fee negotiations between them and the social security system. “[The discussions begun with Aurélien Rousseau] enabled us to resume negotiations on consultation fees in a calm climate, and to re-engage liberal medicine in a dynamic, so that it can participate in a better structuring of care,” Gasser claimed. It is now unclear what will become of any headway made during these negotiations.
An Uncertain Replacement
Agnès Firmin Le Bodo, former Minister Delegate for Territorial Organization and Health Professions to the Minister of Health, who has taken over on an interim basis, does not look like she will have the possibility of sticking around.
“I will continue to pursue the work undertaken alongside Aurélien Rousseau,” the former pharmacist wrote on X (ex-Twitter), and as someone who is already in the healthcare reform orbit, having led work on a much-disputed end-of-life bill, she is well placed to do so.
However, “conflict of interest” accusations have been levelled at Firmin Le Bodo stemming from a legal investigation relating to the pricey gifts she received from Urgo laboratories, valued at EUR 20,000, between 2015 and 2020 when she was a pharmacist in Le Havre. While the new minister has admitted to being under investigation for the gifts, she has denied any conflict of interest, Mediapart reported.
Amid speculations about who will be the next health minister to take over and for how long, the duress of France’s healthcare system persists.
