Question 7851 — health professions

Summary

The “My health 2022” strategy, announced on September 18, 2018 by the President of the Republic, proposes an in-depth modification of the health system to better meet local care needs and by rethinking the professions and training of health professionals. The rehabilitation professions are affected by this transformation project and certain measures announced in “My Health 2022” will have consequences on the initial training for rehabilitation professions and the number of professionals in practice. The profession of masseur-physiotherapist is experiencing very sustained growth in its workforce and according to the department of research, studies, evaluation and statistics, it is expected to increase by 57% between 2016 and 2040. “My health 2022” aims to create a real care collective in the territories which brings together health professionals. health of all professions, hospitals, city professionals and the medico-social sector through the territorial professional health communities and which will have a positive impact on patients' access to health professionals in the rehabilitation sector, in particular by improving the coordination and organization of local care. Measures have also already been taken to facilitate patient access to health care providers. rehabilitation. At the same time, the action plan to strengthen the attractiveness of the hospital exercise launched in 2016 continues. This plan concerns speech therapists, but also masseurs-physiotherapists, psychomotor therapists, occupational therapists or chiropodists-podiatrists who have been reclassified in category A of the hospital civil service by decree no. 2017-1259 of August 9, 2017. A first reclassification in September 1, 2017 allowed an increase in the basic salary of professionals in these bodies since they now begin their careers in a scale increased by 40 index points compared to the category B index scale (around €187 gross per month). A second reclassification should amplify this revaluation on January 1, then a third increase will make it possible to reach the final scale on January 1, 2020. At the end of this development, the overall remuneration (including basic salary and indexed bonuses) of a speech therapist, for example, will have increased by more than €300 per month at the start of their career, and by more than €500 at the end of their career.  In order to promote the attractiveness of certain professions whose role is essential to the quality of care for hospitalized patients, a specific bonus was created by Decree No. 2017-981 of May 9, 2017. This bonus, amounting to €9,000, can benefit rehabilitation personnel belonging to the bodies of masseurs-physiotherapists or speech therapists who will commit for three years after their tenure to positions prioritized by shared care projects within regional hospital groups (GHT) or the AP-HP. Rebalancing the provision of care across the entire territory is one of the objectives of agreements concluded with health insurance organizations. Amendment No. 5 to the national convention of masseurs-physiotherapists approved by notice published in the Official Journal of February 8, 2018 thus defined five zones according to the care offered by masseurs-physiotherapists: very over-endowed, over-endowed, intermediate, under-endowed and very under-endowed. The amendment thus reinforces demographic rebalancing in the form of incentives to the installation or maintenance of activity in under-endowed or very under-endowed areas and selective agreements in over-endowed areas. Finally, if the doctor remains and must remain through his prescription the privileged coordinator of the treatment course, the public health code has provided that masseurs-physiotherapists can prescribe, unless otherwise indicated by the doctor, medical devices necessary for the exercise of this occupation. An expansion of these prerogatives can only be examined in the light of the effects of the overall transformation of the health system, relating in particular to skills and professions and subject to guaranteeing the highest quality of care for patients.

Machine translation from French. The official text remains authoritative.

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