The measure aims to improve access to health care and combat medical merit. The National Assembly passed on Wednesday night the opening of “direct access” for patients to advanced practice nurses (IPA). Article 1 of this text, adopted on first reading by the deputies by 62 votes to 3, also provides for the possibility for these nurses to give certain prescriptions.
The IPA status, created by the Touraine law of 2016 and the decree of 2018, with a bachelor’s degree + 5, aims, among other things, to reduce the burden on doctors by expanding the skills of some nurses in relation to target pathologies. But the measure, taken from the Health Care Access Bill, continues to be heavily criticized by some doctors.
Direct access to physiotherapists, speech therapists, etc.
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The use of these “specialized nurses” is still limited, in part due to insufficient number of patients referred by physicians and unattractive remuneration. The article, adopted on Wednesday, aims to raise that status by giving patients the ability to go directly to these paramedics, bypassing a higher-ranking doctor, but as part of a “concerted action” with the latter.
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The deputies also passed an amendment by the LFI group, supported by the government, stipulating that the decree defining the conditions for the “first prescription” of these APIs should be adopted by the Council of State after consultation with the Higher Directorate of Health.
Renaissance MP Stephanie Rist’s bill, due to continue this Thursday, also plans to establish “direct access” to physiotherapists and speech therapists. “This text serves two purposes: to combat medical deficiencies and improve access to medical care,” the MP said.
The Socialists and Communists have announced they will abstain in the general vote on a text deemed too ambitious to combat medical desertification. Environmentalists said they were voting for their side, despite reservations.
“We condition our final vote on the attention you give to our proposals,” said LFI MP Farida Amrani during the general discussion. The LR group “will behave constructively,” MP Justine Gruet said, warning, however, that a positive final vote on the text would depend on the deletion of the IPA article.
For their part, physicians’ organizations are alarmed by some of the text’s measures, which they see as circumventing the prerogatives of liberal practitioners. The text is “dangerous and inappropriate,” the general practitioners’ union MG France said on Wednesday, warning against “a drug in which medical professionals are interchangeable without any consideration for quality of service.”