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STRIKES

Doctors surgeries close in France as GPs stage new strike

General practitioners in France staged another strike on Tuesday that led to doctors surgeries closing as they call for better investment in community healthcare.

Published: 1 February 2023 10:13 CET
Updated: 14 February 2023 09:57 CET
Doctors surgeries close in France as GPs stage new strike
(Photo by JEFF PACHOUD / AFP)

GP doctors in France walked out again on Tuesday, just a few weeks ahead of a key deadline in which France’s social security apparatus, Assurance Maladie, must reach an agreement to a structure for fees for GPs for the next five years.

A protest march was also due to take place from the Ministry of health to the French Senate in Paris.

Le Figaro reported that Tuesday’s strike action could be larger than previous mobilisations by general practitioners, and that this time SOS Médecins doctors will also walk out, as they call for the rates for home consultations to be upgraded.

READ MORE: Urgent care: How to access non-emergency medical care in France

Previously, general practitioners staged walkouts in December and over the Christmas-New Year holidays in early January.

Hospital doctors in France are largely barred from striking, but community healthcare workers such as GPs are self-employed and therefore can walk out. 

Their walk-out comes amid mass strike actions in February over the French government’s proposed pension reform. You can find updated information on pensions strikes HERE.

Previous industrial action led to widespread closures of primary care medical offices across the country. In December, strike action saw between 50 to 70 percent of doctor’s surgeries closed.

New concerns among GPs

Doctors are concerned about the possibility of compulsory ‘on-call’ hours.

Currently, French GPs take on-call hours on a voluntary basis. Obligatory on-call time for primary care doctors was scrapped in the early 2000s after GPs mobilised against the requirement.

However, representatives from the Hospital Federation have called for it to be reinstated in order to help relieve emergency services.

Additionally, GPs are calling for Saturday shifts to considered as part of their standard working week, in order to allow for a two-day weekend.

Striking primary care doctors are more broadly calling for actions by the government and Assurance Maladie to help make the field more appealing to younger physicians entering the profession, as the country faces more “medical deserts” – parts of the country without GPs – and for working conditions to be improved.

Those walking out hope to see administrative procedures to be simplified and for the basic consultation fee – typically capped to €25 – to be doubled to €50.

In France patients pay the doctor upfront for a visit, and then a portion of the fee is reimbursed by the government via the carte vitale health card. The remainder, or part of it, is reimbursed via mutuelle insurance schemes.

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JOHN LICHFIELD

OPINION: In France even riots used to have rules, now political violence is spiralling

After a week of increasingly violent and chaotic protests in France, John Lichfield looks at why protests in France so often involve violence and whether the problem is getting worse.

Published: 29 March 2023 13:39 CEST
OPINION: In France even riots used to have rules, now political violence is spiralling

France has a problem with violence. It is not, on the whole, a violent country. And yet it has a strange tolerance of – even a taste for – political violence.

Even after 26 years reporting on France, I find this phenomenon hard to explain or define.

There used to be a kind of theatrical violence by farmers and other serial protesters which had informal rules of engagement. I have attended riots by wine-producers in Languedoc which were scheduled weeks in advance, like rugby matches or a bull-fights.

That kind of low-level, political violence has been supplanted in recent years by a new type of insurrectionary violence without clear rules or limits – mostly coming from the extreme Left but also from the extreme Right and from the brutal part of the Gilets Jaunes movement in 2018-9.

The issue is complicated by the inconsistent behaviour of the French riot police, which ranges from stoical professionalism under vicious assault to unprovoked attacks and arrests in relatively peaceful sections of the crowd.

Parts of the French political classes and the French media have a strangely ambivalent – even hypocritical – attitude to the kind of extreme violence seen in Paris and other French cities last Thursday (and to a lesser extent on Tuesday night).

The smashing of shops and banks, the burning of bins and news kiosks – over 900 small acts of arson on one night in Paris alone – were mostly the work of 1,500 or so self-appointed, middle-class revolutionaries of the ultra-Left (the so-called Black Blocs).  

They have no interest in pension-reform. They hate the trades unions and radical Left parties as much as they hate President Emmanuel Macron.

Middle-class young men (and it is mostly men) were bombarding working-class riot cops (now including many women) with bottles, stones, acid, pétanque balls and agricultural bird-scaring rockets in the name of a people’s revolution against capitalism and the bourgeoisie.

And yet this violence is reported in the media as “débordements” (excesses) or “tensions” (tensions), as if it was somehow a regrettable but understandable expression of the genuine popular anger against President Macron’s modest plan to raise the official French retirement age from 62 to 64.

Is there a connection? Maybe there is. The Black Blocs never demonstrate on their own. They latch on to any expression of popular discontent from the amorphous, rural and outer-suburban Yellow Vest movement to the union-led demonstrations against pension reform. They know when they can best ratchet up the mood of crisis and create and sense of chaos.

Much the same is true of the apocalyptic battle scenes fought out around an agricultural reservoir in Deux-Sèvres in central France last weekend. There may well be a good ecological case against these “méga-bassins” but many of the thousands of people who flocked to the banned demonstration came armed to attack the state and injure policemen and women.

Left-wing and green politicians, including Jean-Luc Mélenchon, leader of La France Insoumise, suggested that the police had brutalised a family picnic in the countryside. It is not normal to bring Molotov cocktails and baseball bats to a picnic.

In truth radical left-wing politicians and unions have an ambivalent attitude to street violence. They weakly condemn it and then blame the police. They enjoy the increased sense of national crisis that the violence creates.

At the same time, they fear that the violence will undermine support for their movement and reduce peaceful turn-out on the streets (as it did with the Yellow Vests and maybe on the tenth day of union marches on Tuesday).

The government also has secretly mixed feelings about political violence. The rampages in Paris and elsewhere have embarrassed the country in the international media. The cancellation of King Charles III’s visit was humiliating for Macron – and for France.

At the same time, the “débordements”  give the government the opportunity to pose as the defender of democracy and Republican law against intolerance and extremism.

That does not mean that the government has instructed the police to provoke the violence as Jean-Luc Mélenchon and others cynically claim.

There are examples of bad police behaviour. Many of the arrests are “soft arrests” to boost numbers. Some of the police weapons are unnecessarily dangerous.

But there have been ten days of mostly peaceful demonstrations since early January. A suppression of the right to protest? Hardly. The relative lack of violence in the earlier marches was partly thanks to police tactics, which kept the demonstrators and violent minority part.   

If the mood has turned more violent in recent days, that is partly the fault of Mélenchon and others who have been using the language of violence for weeks. Mélenchon said earlier  this month that it might be necessary to block pension reform “by force”.   

There has also been a kind of low-level terrorism at the radical end of the union protests, ranging from strategic vandalism of signalling systems on the railways to attacks on the constituency offices of pro-Macron or pro-reform deputies.

What to make a country where someone can send a message to Aurore Bergé, the impressive leader of Macron’s group in the National Assembly, threatening to murder her four-month-old baby because she supported a pension age of 64 instead of 62?

Where is all this going? I have the impression that we are heading into a long period of sullen stand-off, rather than increasing violence. The Black Blocs are, fundamentally, dilettante revolutionaries. They don’t have the stamina or resources to create mayhem indefinitely.

But France’s bizarre willingness to toy with political violence is disturbing. There used to be unspoken rules. They no longer seem to apply.

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