The French health system is efficient but inequitable, which is why it is essential to restructure the system. Marisol Touraine has presented the broad guidelines for the Health Act. The project is based around the main issues of prevention, education, care pathways, innovation and patients' rights.
Why reform our health system?
The national health strategy (SNS - stratégie nationale de santé), presented by Marisol Touraine in September 2013, aims to define a framework for public action for the coming years. The challenge is to restructure our health system in order to overcome the challenges it is facing. This involves simultaneously combating the inequities and inequalities in health care and access to the care system, adapting the French health system to the needs of patients and to current changes such as the ageing population, the development of chronic illnesses, the need for information, territorial proximity, etc.
The bill will change French people's relation to their health, will provide them with the means to protect and guard themselves and will give them the arms to face illness. From November 2013 to February 2014, 160 debates took place in the regions. More than 25,000 people were thus able to participate in the discussion on the guidelines of the Health Act. These exchanges fuelled the discussion on the new national health strategy.
The health bill will give priority to prevention. Our health system has essentially developed around care while the main objective should be to avoid the appearance of illnesses: this means placing the emphasis on clear priorities and developing more targeted tools.
Health education will be strengthened by the development of training programmes for young people (nutrition, attending physicians, national smoking reduction programme, fight against alcoholism, access to emergency contraception, etc.).
Prevention concerns all of the ministries. That is why an inter-ministerial committee for health was created on 19 June 2014. And to reinforce the efficiency of our administrative structures, France will create an Institute for prevention, observation and intervention in public health.
The mobilising of local and social actors to notably promote health in the work place.
The aim of this focus is to offer all French people the same care. In order to do so:
The territorial public health service will reinforce access to care for all French people by establishing an accessible, legible and understandable organisation. It will facilitate the territorial structuring of primary care. To support this process, the role of Regional Health Agencies (ARS - agences régionales de santé) will be strengthened.
Removing financial barriers. To guarantee access to care, we need to combat financial barriers and all forms of discrimination.
By 2017, the third-party payment system will be extended to all insured persons.
The bill will guarantee individuals with low-incomes accessible prices for health products, such as glasses.
Guaranteeing access to care everywhere
To enable all French people to find a health professional in their area, a single 3-digit phone number will be set up in each department.
The law will suggest establishing a dedicated internet portal for the public health service, like a "health sat nav".
Implementing an organised pathway
Better coordinate professionals and facilitate cooperation (set up a newsletter, set up a personalised care programme, etc.).
- To help health professionals in this effort, territorial support platforms should be created.
- Medical records will also be revived.
- The development of pathways will lead to a gradual and negotiated evolution of methods of remuneration for health professionals.
An updated hospital service: the law will make territorial hospital groupings obligatory. This will notably allow the pooling of certain activities. Establishments will thus undertake a shared medical project and the coherence of their executive will be strengthened.
Scientific and technological advances are revolutionising daily care. They are also decisive factors for French growth and for the future of our care system. Capitalising on innovation means:
Guaranteeing an innovation-friendly ecosystem. Time frames regarding clinical trials will be reduced from 18 months to 2 months as of now. The bill will generalise the single agreement measure among all categories of health establishments.
Advance health professions. The bill will recognise new professions and will reassess the role and place of some professions. A discussion is currently under way with Geneviève Fioraso on the reorganisation of the third cycle of medical studies.
Be ready for Open data. We need to extend the move towards open health data.
A more efficient health policy
This bill will strongly emphasise the unity of public health.
The law will provide the means to better coordinate interventions on the part of the State and health insurance. There is only one health policy and everyone should contribute, national, local, public and private actors alike.
- The law will also embark on the reform of agreements.
The law will bolster social dialogue. It will suggest the creation of a High Council of hospital medical staff.
The vitality of our health democracy calls for:
The future law will enable patients to co-construct health policies to a greater extent and to be involved and engaged in building a system according to their vision.
- The proposals aim to better represent users. These will be largely taken up in the bill: the extension of the requirement of representation for users in all national health agencies and the creation of the user commission.
- The strengthening of public debate on health.
- The simplification of patient's relations to the health system. Starting by instituting the same rights for all. Thanks to the bill, the cohabiting partner or civil partner of a deceased person will have access to their medical record.
- The strengthening of patient power when they are victims of damage. Faced with serial health damage, a new right could be considered: the establishment of group action.
Presentation of the SNS: 23 September 2013
Regional debates: November 2013 to February 2014
Presentation of the guidelines for the Health Act: 19 June 2014
Presentation of the bill to the Council of Ministers: September 2014
Review in the National Assembly: early 2015