Health system transformation strategy

The Health Act adopted by Parliament on 16 July 2019 aims to establish a better-organised regional healthcare system, and in particular to introduce new local healthcare structures.


Debated in the French National Assembly on 25 March, the Bill was definitively adopted on 16 July 2019. Partly reflecting the measures contained in the "Ma santé 2022" plan presented in September 2018, the law on "the organisation and transformation of the health system" aims at a better organisation of health professionals, putting patients back at the centre of the system and guaranteeing access to healthcare nationwide, against a backdrop of attempts to eliminate medical deserts.

modernisation of career paths and careers within the medical professions

The cap on the number of students admitted into the 2nd year — the numerus clauses — has been abolished. The selection process at the end of the first year remains in place; however this will no longer be based solely on multiple choice questions, and will include the testing of human and social skills. Indeed, one of the components of the reform is the diversification of student sociology. It is expected that 30 to 40 % of students will have access to these studies, whatever qualification they hold. The aim is to abolish the numerus clausus as from the start of the academic year 2020.

The aim is to increase the number of doctors trained (+20 % of doctors trained each year). Why? Because training more doctors is one of the keys to ensuring access to healthcare nationwide, thereby addressing the problem of medical deserts.

Improving access to local healthcare, including the creation of regional professional health organisations (“Communautés professionnelles territoriales de santé” - CPTS)

The idea is to start with a given population’s sociological and epidemiological data (elderly population, addiction phenomena, prevalence of pathologies, etc.) and give the initiative to health professionals (doctors, pharmacists, paramedics, etc.) in the formulation of appropriate healthcare solutions for the population concerned. The goal is to deploy a minimum of 1,000 of these by the year 2022.

In the area of human resources, the Government plans to create 4,000 medical assistants between 2019 and 2022; they are to be deployed to general practitioners and private specialists who will work together and coordinate their efforts within a given region. These medical assistants will be given reception and secretarial duties (making appointments, compiling records and checking that vaccinations and screenings have been carried out). They will assist doctors at the pre-consultation stage (receiving, weighing and measuring patients and taking their blood pressure). The aim is to free doctors from procedures that can be delegated so that they can devote more time to medical procedures.

Existing CPTS solutions include multidisciplinary healthcare centres (Maisons de santé pluridisciplinaires – MSP). These bring together a number of primary healthcare private professionals under the same roof: general practitioners, nurses, pharmacists, physiotherapists, dentists, speech therapists, chiropodists, dieticians, occupational therapists, psychomotor therapists, etc. who are united by a common health project. France currently has 910 MSPs, and over 300 are in the process of being created.

This model was praised by the Prime Minister on 11 February 2019, during his trip to Avoine in the Indre-et-Loire département: "the initiative seen here — and other initiatives throughout France — are showing us the way forward. The goal of this Bill is to ensure that these initiatives can be duplicated, multiplied nationwide, in order that the collective exercise of medicine becomes the norm", he said.

Another local structure that the law promotes: local hospitals. Structures with facilities for providing daily healthcare (geriatrics, general medicine and rehabilitation). These hospitals are geared towards working in close connection with local health centres, to enable private doctors to provide their patients with follow-up care. The law provides for "the transformation of certain hospitals that are currently experiencing difficulties into local hospitals", said Agnès Buzyn. This will allow reinvestment in institutions that are currently experiencing difficulties and suffering from a lack of attractiveness. Its objective is to designate 500 to 600 hospitals by the year 2022.

The development of telemedicine

The law also promotes the development of digital healthcare, including increased opportunities to use health data (via the creation of a Health Data Hub) and the creation of a digital health space for each patient; it also authorises nurses to provide telecare.

Ironing out regional disparities in healthcare: this is the aim of the law on the organisation and transformation of the health system.


16 July 2019: the law was passed by Parliament
25 March 2019: the Bill was debated at its first reading at the French National Assembly
13 February 2019: presentation of the Bill to the Council of Ministers
18 September 2018: presentation of the overall strategy for the transformation of healthcare


National Health Strategy 2018-2022

France - National Health Strategy - 2018-2022


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