Question 16991 — health professions

Summary

Mr. Jérôme End draws the attention of the Minister of Health, Families, Autonomy and People with Disabilities to the current blockage of the conventional framework for midwives and to the risk of disruption in women's access to care. In recent years, Parliament has voted for several changes to the midwifery profession. The law of January 25, 2023, known as the “Chapeler law”, notably established the state diploma of doctor in midwifery, the third cycle of midwifery studies and the strengthening of the university sector. However, the absence of effective opening of conventional negotiations prevents the implementation of these developments. The long consultation dedicated to menopause, created by article 64 of the social security financing law for 2026 and which aims to strengthen support for women at the time of menopause, remains also in practice without effect for the profession in the absence of rating and conventional framework applicable to midwives. However, it is essential to concretely translate the decisions taken by the legislator in favor of women's health and true recognition of the skills and place of midwives in the health system. In general, it is clear that there is an inconsistency in the exercise framework, also visible in the question of remuneration. Thus, since the 2024-2029 medical convention, certain gynecological follow-up consultations have been upgraded for doctors, while comparable procedures carried out by midwives remain at different price levels. The commitments made from amendment no. 4 to the 2018 national convention of midwives provided for a convergence of prices for competent acts. shared. It is important to emphasize that the midwifery profession currently represents only around 0.3% of health insurance healthcare expenditure. But no conventional negotiations can be initiated today in the absence of the framework letter that the Minister of Health must send to the National Health Insurance Fund (CNAM), a letter which has not been published to date. Midwives do not ask for new skills but would like those already recognized by the legislator to be able to be exercised within a conventional framework consistent with their responsibilities. This would both strengthen the attractiveness of the profession and demonstrate the capacity of public authorities to concretely translate the ambitions stated for women's health. He therefore asks the Government if it intends to quickly begin negotiations expected in order to re-establish coherence between the skills recognized for midwives, the missions they carry out and their conditions of practice.

Machine translation from French. The official text remains authoritative.

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