Question 10362 — health establishments

Summary

Mrs. Aurélie Trouvé alerts the Minister of Health, Families, Autonomy and People with Disabilities of the announced closure of the Lilas maternity ward, located for 61 years in Seine-Saint-Denis. The Lilas maternity ward, a historic place of health and struggle for women's rights, will close its doors on October 31, 2025. For decades, it has embodied a strong commitment to respectful, feminist and accessible medicine. This closure, a symptomatic example also part of a broader context of medical desertification in the country, is not only due to dilapidation and financial difficulties, but also to the inability of the regional health agency to support a long-term project and its successive reversals. It must be remembered: the health system is not intended to be profitable, it cannot be managed as a business would be. private. However, today, France no longer has a health policy, because it has been reduced to its budgetary dimension alone. Without long-term strategic thinking, the only objective was to make savings, in particular via the national health insurance expenditure objective (ONDAM): a closed annual envelope fixed in advance. Since its creation, this has been lower than the real needs for health spending, strangling a little each year plus establishments. What were the repercussions of this policy? Difficulties in accessing care with extended appointment times, shortages of specialists, ever more medical deserts, closures of hospitals, chain removals of beds, a lack of staff leading to the exhaustion of the remaining caregivers and leading to an increase in sick leave, resignations and the impossibility of good patient care. Even from a purely financial point of view, the calculation is not good: forgoing care increases treatment costs with pathologies detected too late. For Seine-Saint-Denis, already identified as the first medical desert in France, the closure of the Lilas maternity ward represents a further setback in access to care. The department only has 116 general practitioners per 100,000 inhabitants, compared to a national average of 126. The problem of medical deserts is not limited to Seine-Saint-Denis, but affects 87% of French territory, since successive governments over the past ten years seem to be pursuing a systematic policy of abandoning local health centers. The figures are alarming: 6,000 hospital beds have closed in the country since 2017, 40 maternity closed in France, 130 places practicing abortions (voluntary terminations of pregnancy) closed in 15 years. Nearly 6 million French people do not have a primary care doctor and 8 million live in a medical desert. Even Paris is in the middle of a medical desert. In Les Lilas, although union delegates and local elected officials succeeded in obtaining a memorandum of understanding to create a care center for women's and maternal health on the site, this did not does not replace the loss of motherhood. This is why she questions him about the guarantees provided to ensure the reclassification and enhancement of the skills of maternity staff as well as the means and infrastructure that will be put in place to meet the health needs of the inhabitants of Seine-Saint-Denis, particularly in terms of gynecology and maternity.

Machine translation from French. The official text remains authoritative.

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