After the empathetic Agnès Buzyn, a charming asset of Macron’s first five-year term often compared to his illustrious mother-in-law Simone Veil, then the voluble Olivier Véran present on all fronts during the Covid, François Braun succeeds in July 2022 to the ephemeral Brigitte Bourguignon (1 month and 14 days) and becomes Emmanuel Macron’s fourth health minister. Imperturbable, never one word higher than the other, with his “big teddy bear” physique, the former head of emergencies at the Metz hospital embodied a form of quiet strength. Probably too quiet. Which earned him his job and being part of the cart of ministers thanked because they “did not print”. He was replaced on Thursday by Aurélien Rousseau, former chief of staff of Elisabeth Borne.
It must be said that health, the first concern of the French, is both a subject too serious to create a buzz, and too complex to give rise to populist shortcuts. François Braun undoubtedly pays for not having yielded to any of these facilities. At 60, devoid of political ambitions but with his composure as an emergency doctor who has seen others – he participated in numerous medical evacuations – he was appointed avenue de Ségur in July 2022 when the health system comes out exhausted from the Covid and that everything is to be rethought. Recognized by his peers, this son of a doctor, grandson and great-grandson of military doctors, married to a paraplegic retired doctor, a former trade unionist – he chaired SAMU-Urgences de France for 8 years -, enjoyed sympathy and real legitimacy upon his arrival.
But “he had no vision, no program. There was not the beginning of the tail of a reform”, regrets a health professional. “He probably didn’t have his hands free. His balance sheet is meager, but his capacity for action was reduced, ”adds another. In fact, the National Council for Refoundation (CNR) in health, wanted by the President of the Republic to rebuild the system, is a failure: it gets stuck in endless conferences, mobilizing hundreds of participants, without clear directions and results for public opinion.
Appointed to solve the crisis of emergencies, which lack arms and face a doubling of the number of passages in 20 years, François Braun set up regulation by the “15” and the service of access to care (SAS), which allows to redirect part of the patients to city doctors. But if this device, planned from 2019 by the Emergency Rebuilding Pact, has made it possible to reduce the influx of patients by 5% to the emergency room, it is far from being a panacea.
The hospital was also unable to calm relations with the town doctors. The liberal doctors are more reassembled than ever after the failure of the conventional negotiation on their revalued prices of only 1.50 euro. Led by Medicare, this negotiation scrupulously followed the Minister’s framework letter. And the resumption of discussions promises to be complicated. As a result, some doctors are calling for deconvention, that is to say a break with social security which would sign the advent of two-tier medicine.
Not to mention that the liberals do not take off against the Rist law voted in the spring which grants part of their prerogatives to paramedics, or the Valletoux bill which reinforces the constraints of territorial organization. “We have probably misjudged the malaise of the profession,” admitted Thomas Fâtome, director general of Medicare. The situation therefore remains very flammable.
If François Braun managed to block the attempts of deputies to put an end to the freedom of installation of doctors, a measure deemed “both ineffective and counterproductive”, he on the other hand imposed on students a disputed 4th year of general medicine internship in medical deserts. The minister was also unable to put an end to the unregulated deployment of teleconsultation platforms, even as Medicare called for the end of the “Wild West” to be whistled.
The Minister’s decision to regulate the work stoppages issued by the platforms was invalidated by the Constitutional Council. And private groups like Ramsay have been offering a monthly package at 11.90 euros for several months, giving access to teleconsultations 7 days a week, 24 hours a day, raising fears of an uberization of health. If the Minister regrets it, he has done nothing to prevent it.
