Question 16994 — health professions

Summary

Mr. Nicolas Ray draws the attention of the Minister of Health, Families, Autonomy and Disabled People to the place given to occupational therapy in the organization of the health system. In a context marked by the aging of the population and the increase in needs linked to loss of autonomy, occupational therapists occupy a strategic place. Their intervention makes it possible to facilitate daily activities, to analyze needs and the environment, to prevent loss of autonomy and to support rehabilitation, rehabilitation and home support. However, in the organization of the health system, occupational therapy remains dependent on scattered systems, which vary according to pathologies and territories. This situation weakens equal access to care, complicates procedures for patients and limits the capacity of public authorities to manage in a clear and efficient manner a discipline that is nevertheless essential to policies of prevention, autonomy and compensation for disability. If the State recognizes occupational therapy as a profession regulated by the public health code and mobilizes it in essential health and medico-social policies, the absence of a national conventional framework deprives this profession of the conditions necessary for intervention. structured, accessible and coordinated. The structuring of occupational therapy responds to the challenge of organizing the health system, controlling pathways and making good use of public spending. A national conventional framework would in fact make it possible to define actions, conditions of recourse and terms of care, while giving health insurance and the State the means for more coherent management. This structure must also be accompanied by the creation of a national order of occupational therapists. The development of liberal practice, the progressive broadening of the missions entrusted to these professionals, particularly in terms of evaluation, recommendation of technical aids and adaptation of the environment, as well as the issues of quality and independence of practices make it essential the creation of a national body responsible for guaranteeing the ethics, safety of interventions and protection of patients. This structuring appears all the more necessary as the demographics of the profession, although increasing, remain insufficient in relation to needs. France thus remains among the least endowed European countries, with a density much lower than that observed in neighboring countries. This discrepancy underlines the need for a more readable national policy, both to guarantee patients' access to this support and to strengthen the attractiveness of a profession called to play an increasing role in autonomy and prevention policies. The reform of wheelchair financing concretely illustrates this difficulty. While it is based on the legitimate objective of “zero out-of-pocket expenses” for users, it does not finance the interventions of occupational therapists, however essential for assessing needs, recommending suitable equipment and securing its use. This inconsistency can lead to the cost of these interventions being transferred to patients and slowing down access to this equipment. Also, he asks if the Government intends to initiate consultation with representatives of the profession, health insurance and autonomy stakeholders in order to examine the conditions for implementing establishment of a national conventional framework for occupational therapists and the creation of a national order. He also wishes to know what measures the Government intends to take to better structure the demographics of this profession, strengthen its attractiveness and guarantee, throughout the territory, effective access to occupational therapy.

Machine translation from French. The official text remains authoritative.

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