A few months ago I wrote in this blog about the extreme shortage of doctors in rural France and junior doctors’ general disinterest in working out here. That provoked an interesting series of comments from a young French doctor who, believing that rural France has no back-up medical facilities, wanted to know more about the free housing etc rural mayors are offering.  Until now I haven’t been able to answer her questions, but on Saturday I talked to my GP. He agrees the situation in rural France is frankly terrible and rapidy getting owrse, but only as far as front-line GP’s are concerned – medical back-up exists. Mayors of small towns are offering inducements to halt the slide into ghost towns. These include a help buying the practice (interest-free loans), free housing, someone to clean the surgery, free school canteen, stuff like that. But the main inducement, and this is where we delve into the arcane world of French administration, mayors can offer all sorts of deals on income tax and professional charges whereby the incoming doctor is exempt for three years and can thus accumulate a considerable sum.

But even this kind of deal fails to tempt most young French doctors, who, as my correspondent said, want the facilities of a larger town: good theatre, concerts, things I admit we don’t have close by (although there are compensations: last night I was treated to a private screening of “Atonement” – that is I had the cinema to myself. I asked the young woman who is manageress, front-of-house and projectionist (and not a glorified DVD player either, she handles a proper 35mm projector with reel changes) if that happens often. She smiled sadly and replied much too often). But if rural France doesn’t tempt the French it tempts other Europeans. My GP quoted two pretty major local towns (population 501 and 636) each with a Rumanian doctor. “They’re very nice, and not bad doctors,” he conceded, “but their French isn’t up to it. I’ve been present when a Rumanian doctor asked a patient which ear was troubling him – his notes said “fibrillation auriculaire”. I had to point out it was the patient’s heart, not his ears that was the problem.”

My doc reckons they’ll stay for the three years of their tax exemption and then, like Spanish doctors before them, go back home wealthy, or to another small town offering a further three years tax-free. It’s no solution, he says, but at least these GP’s coming from abroad are willing to work hard – French doctors have for years been practising what Nicolas Sarkozy now preaches: Earn more by working more. Paid per patient, they more they treat the richer they are. But apparently the money doesn’t count that much for the young French – it’s time off that’s important. “They want their evenings and weekends. The death of the French health service is the feminisation of the profession,” my doc continues, sounding more and more like an old reactionary, although he can’t be more than 35. He says 60% of medical students and young doctors are women: first of all they want long periods off work to have a family and then regular hours to watch them growing up. The very arguments put forward in the bastions of British maleness in the 1970’s and ’80’s. I don’t know whether they have been resolved. At one time many British women doctors were happy to share a practise with another woman so they each could work part time, but sooner or later someone has to cover weekends and nights.

The other solution is to get used, as the British have done, to foreign doctors. The contact may not be as good, but one advantage is that coming from poorer countries they perhaps won’t tolerate the absurd and expensive molly-coddling French patients have got used to. “Fibrillation auriculaire? Heart flutter? Nothing to worry about dear chap. You’re still alive and that’s what matters: if you’re breathing you can write a cheque. But about your hearing: we must fix that so you make it out for the right amount.”

This entry was posted on Monday, February 4th, 2008 at 8:11 am and is filed under Political. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.