Question 20822 — overseas

Summary

Mr. Jean-Philippe Nilor questions the Minister of Solidarity and Health on the bill relating to the organization and transformation of the health system. During the examination of this text in the Senate, amendment no. 604 by Senator Dominique Théophile on Practitioners with a diploma outside the European Union (PADHUE) was adopted on June 7, 2019, thus modifying article L. 4131-5 of the public health code to authorize the arrival in the Antilles of Cuban doctors, in particular in order to combat the shortage of health professionals in these territories. After having worked a lot upstream of this question as evidenced by the number of his interventions devoted to this subject, he is delighted to note the favorable opinion of the Government which miraculously ended up evolving on this point from the National Assembly to the Senate! With the removal of the numerus clausus, the effects of which will be perceptible that after ten years, this measure of welcoming foreign doctors is a unanimously defended palliative. However, in order to sustainably combat medical desertification and offer doctors more opportunities to practice in the country, the creation of a full-service Antilles-Guyana medical faculty providing trilingual teaching (French, English and Spanish) and allowing equivalences with the Caribbean and Central America is essential. Indeed, for the moment, West Indian students cannot continue their courses at the University of the Antilles beyond the first cycle and must then leave for the second cycle, which in fact reduces their chance in the third cycle of being able to practice the specialty of their choice in the region of their choice and particularly their region of origin. This is why, within the framework of the examination of this same bill relating to the organization and transformation of the health system, it carried amendments to article 2. The latter provides for the disappearance of the much-maligned national ranking examination and for the conditions and modalities of access to the 3rd cycle to be set by decree in order to better assess the profiles of admitted students. The new conditions and modalities will focus more on clinical knowledge and skills and relationships of students and the modalities of distribution and assignment of positions will take into account the training capacities, the forecast needs of the health system, the training paths and the professional projects of the candidates. In the overseas communities governed by article 73 of the Constitution hit by the shortage of certain specialties and faced with specific demographic problems, particularly given the worrying phenomenon of brain drain, it seems crucial to encourage the return of trained specialist doctors, especially since the human and cultural dimension in patient care is significant in these territories. In these communities, this allocation should be made as a priority for the benefit of those who completed their first cycle there. This was the meaning of the amendment unfortunately rejected at first reading in the National Assembly despite the valuable assistance of deputies Gabriel Serville and Ericka Bareigts. To this end, it is absolutely essential to consider that access to boarding schools for overseas residents is regionalized with an Antilles Guyana subdivision and a Réunion subdivision or that the classification at the end of the second cycle with a view to the choice of specialty and boarding school subdivision be separate for overseas based on the results of the tests, the training course and the professional project linked to these territories; this last point relating to the territorial dimension must benefit from a decisive weighting. The Government having demonstrated on the question of welcoming foreign doctors its ability to evolve from one room to another, this same state of mind of openness should prevail on this question. He asks him what his position is on the creation of a full-service faculty at the University of the Antilles based on two centers Guadeloupe and Martinique and on measures aimed at offering students who began their cycle in an overseas community governed by article 73 of the Constitution better chances of practicing their profession there in response to the proven lack of doctors and the brain drain.

Machine translation from French. The official text remains authoritative.

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