Question 13985 — health

Summary

Mr. Marc Chavent alerts the Minister of Health, Families, Autonomy and People with Disabilities to the particularly worrying situation of the association “Liberal Health Action in Team” (ASALEE), currently in the process of stopping payment following the interruption of its funding by the National Health Insurance Fund (CNAM). This system, recognized for more than twenty years, is based on cooperation between general practitioners and nurses within medical practices to improve the monitoring of patients with chronic illnesses, develop prevention and therapeutic education and support the organization of primary care. In a context of growing tension over access to care, particularly in rural and under-resourced areas, ASALEE concretely contributes to maintaining effective local medicine. THE network mobilizes around 2,000 nurses alongside 8,000 general practitioners, supporting nearly a million patients in more than 2,500 reception centers across the country, with a demonstrated impact on the quality of care for diabetes, cardiovascular risks or chronic respiratory diseases. However, the CNAM suspended its funding at the end of 2025, despite the recommendations of an IGAS report from July 2025 which, while emphasizing governance weaknesses, would validate the health usefulness of the model. The association disputes the assertions of the general director of the CNAM and affirms that it would have fully responded to these recommendations. This financial impasse, resulting from administrative blockages, payment delays and elimination of financing such as rents, places the association in a critical situation. The immediate consequences would be dramatic: breakdown of structured monitoring of many chronic patients, loss of jobs for 2,000 specialized nurses, worsening of the workload on already strained general practitioners, decline in prevention and therapeutic education actions. This situation arouses deep incomprehension among professionals, especially since public policies encourage coordinated work. In this context, he would like to know the precise reasons of the cessation of funding for the ASALEE system, the anticipated consequences for the organization of primary care and the measures envisaged by the Government to guarantee the continuity and sustainability of this essential interprofessional cooperation.

Machine translation from French. The official text remains authoritative.

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