In the French government’s recent cabinet reshuffle, prime minister Elisabeth Borne’s former chief of staff, Aurélien Rousseau was appointed as the new minister of health. Rousseau, having piloted the Île-de-France Regional Health Agency during the COVID-19 pandemic, is more than familiar with both the French healthcare system and dealing with crisis situations. Nonetheless, the new minister has his work cut out for him as he begins to pilot a healthcare system in crisis.


We are facing an emergency. The challenges are immense, in terms of funding, attractiveness, and loyalty in public hospitals. We are waiting for a complete reform of the [French] healthcare system

Arnaud Robinet, president, French Hospital Federation


Rousseau, a former history and geography professor was named as the successor of emergency doctor François Braun in this summer’s French cabinet reshuffle that saw 11 ministries change hands. A technocrat who has served as the prime minister’s head of staff for over a year, the new health minister is also well acquainted with the complexities of French healthcare and saw the Paris region through the pandemic. Despite these impressive credentials, Rousseau will be inheriting a number of ongoing issues and challenges from his predecessors, namely a widespread and long-standing staffing crisis in the French healthcare sector and the growing needs of an ageing population.


Staffing Crisis

The first issue Rousseau will have to confront is the staffing crisis at French public hospitals as they struggle to attract caregivers due to low salaries and a generalised lack of motivation.

While these staffing shortages became even more critical during the COVID-19 pandemic, the lack of sufficient personnel and complaints among existing staff predate the health crisis. Nurses are particularly in short supply and at the end of 2021, 1,400 nursing positions in the Paris public hospital system went unfilled. The shortage has led to the elimination of a large number of hospital beds and the cancellation of medical procedures that are not considered urgent.


“Medical Deserts”

Meanwhile, the dearth of medical personnel in France’s rural areas and smaller towns and cities, a phenomenon known as “Medical Deserts” that forces patients in less populated areas to travel to big cities for treatment and has caused emergency services to be overrun with non-emergency patients is another issue plaguing French healthcare.

The new minister will have to confront the staggering fact that 30.2 percent of the French population lives in a medical desert and as many as 1.6 million people forego healthcare each year as waiting times for appointments get longer.


Further Concerns

In addition, Rousseau will have to face the anger of the trade unions representing city doctors who are demanding an increase in their consultation fees. General practitioners, for example, have not seen their fees augmented since 2017 when they went from EUR 23 to EUR 25 per consultation.

The newly appointed minister will also inherit the polemical “End of Life” bill handled by the outgoing delegate minister in charge of Territorial Organization and Health Professions, Agnès Firmin-Le Bodo, which includes measures for access to active assistance in dying.


Mixed Reactions 

Certain healthcare stakeholders have also expressed their misgivings about the appointment. Arnaud Robinet, president of the French Hospital Federation pressured the new minister to take immediate action, calling for widespread reform. “We are facing an emergency. The challenges are immense, in terms of funding, attractiveness, and loyalty in public hospitals. We are waiting for a complete reform of the [French] healthcare system.”

Christophe Prudhomme, spokesperson for the Association of Emergency Physicians of France (AMUF) also expressed his concern about Rousseau’s appointment. “We risk the acceleration of policies that will destroy the public hospital,” he declared, claiming that “during his visit to the Regional Health Agency of Île-de-France, (the new minister) did nothing done to develop the public sector.”