The major parameters of organisation and planning of healthcare facilities have been modified substantially
by redefining the role of regional strategic health plans (SROS - Schéma régional d'organisation sanitaire).
The new plans put greater emphasis on the health care needs of the population at the local level and promote
an integrated health care approach coordinating prevention, acute and rehabilitation care.
In order to limit out-of-pocket payments on reimbursable healthcare services, it is proposed that a yearly threshold
for out-of-pocket expenditures should be installed. This “sanitary shield” aims mainly to protect patients without
supplementary health insurance. The project will be discussed with main stakeholders in the first semester of 2008.
A new general agreement was signed in June 2007 between the national sickness fund and the private nurse unions.
The agreement reinforces the nurse's role in clinical and technical care for dependent elderly and calls for a more
stringent territorial regulation of their activity to deal with regional shortages in nursing supply.
In order to improve long-term health and social care for the growing number of elderly people with disabilities, a number
of measures have been implemented. The current major concern is to ensure equity of access by maintaining public
coverage of such services. The creation of a fifth branch of social security to cover long-term care was proposed
by Nicolas Sarkozy before the election and a policy paper is being prepared for the end of the year.
Rochereau T. (Irdes), Azogui S. (Paris VII)
In 1997, major French health insurance funds introduced a prevention scheme for improving access to dental care
for teenagers. It involved offering a free annual visit with 100% coverage for any subsequent treatment to those aged
between 15 and 18 years. The evaluation of this scheme demonstrates that more than half of the teenagers who took
part in this program needed treatment. But the participation rate was quite low, especially amongst the most deprived.
The French Government has enacted a law making smoking illegal in public areas and in workplaces since
January 2007. The ban will be extended to restaurants and cafés in 2008. This law, aiming to reduce the number
of smokers and passive smoking appears to gain a surprising support in public opinion. While it is too early to make
an assessment of its effectiveness, we already note a significant increase in sales of nicotine-replacement drugs
and in physician consultations to quit smoking.
In 2003, the government launched an ambitious reform plan, known as “Hôpital 2007” for improving overall efficiency
and management within the hospital sector. The measures introduced not only modified the mode of financing public
and private hospitals but also the rules of hospital sector planning and the governance of public hospitals.