to be Able to visit the pharmacy in the evening or on the weekend to get into emergency medicine because we do not have a prescription. The idea, which is not new, had been put back on the table by the member of parliament Thomas Mesnier (LREM), rapporteur of the project of act Health, which is currently discussed in the national Assembly. She has just been adopted by the mps. The amendment adopted provides that specifically allow pharmacists to issue, under certain conditions, of the drugs under medical prescription is compulsory for mild illness such as cystitis or nasopharyngitis. “There is no question here of give a right of prescription to the pharmacists (…) The objective is to enable them, within the framework of a coordinated exercise with other health professionals, to be able to deliver drugs according to a protocol established by the High authority of health, after training and with a requirement of a link and information to the treating physician”, has immediately warned Thomas Mesnier. The list of pathologies involved has not yet been specified.
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Carine Wolf-Tahl, a pharmacist in Rouen and president of the College of pharmacy, is at the initiative of the amendment. His goal: to “troubleshoot” the patients in the event of a small emergency, when the attending physician is not available. Thomas Mesnier had already suggested such a measure last year and a similar amendment had been tabled by the mp LREM Delphine Bagarry in October 2018 within the framework of the Project of Finance law of social security. The text, which had been rejected, provided for an experiment in two regions for three years.
This time, the measure has been validated with the support of the government. “This amendment has been discussed at great length in committee, and I am not in favour of it to be deleted,” said the minister of Health, Agnes Buzyn, during the debates. The communist mp Jean-Paul Lecoq has in vain tried to highlight “the danger of a ” two-speed medicine”. According to him, “with this shift of tasks between doctors and pharmacists, we are concerned that the medicine of the common law is reserved for the better off, those who live in the right places, while the citizens relegated will be entitled to a medical derogation”, he denounced. “I will endeavour to find a consensus between pharmacists and doctors, because we have not been able to, due to lack of time, to have a dialogue on the subject,” promised the minister that the project requires “more work for everyone to be comfortable with this drug delivery”.
Degradation of the quality of the care
Side pharmacists, the idea is welcomed. Hervé Jouves, president of the groupement Pharmacies Lafayette, writes that “as a first point of contact for health, the pharmacist occupies a strategic position to implement actions of prevention and of relevance in the care of”. He wished, however, to nuance: “It is there to intervene on emergency situations and not as a substitute for doctors!” But in the face of the problems of access to practitioners and to the desertification of some areas, “it is necessary to somewhat shake up a health system that is now showing some limits,” he says.
A view that does not share the Fédération des médecins de France (FMF), fiercely opposed to the project. For its president, Jean-Paul Hamon, “it is once more a réformette, a craft, in addition to, not going in the right direction”. According to him, to give more powers to pharmacists would lead to a degradation of the quality of care provided. “The pharmacists are not authorized to prescribe care, but to advise. They have a very important function, but I do not want to what they are changing business.” The practitioner points out that “pharmacists do not have the same medical follow-up of the patient as may have a general practitioner. If someone comes to cystitis, for example, may be that it is not very serious, but it may also be that it is the symptom of something else more important. The pharmacist has no means to distinguish this kind of phenomenon”.
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Possibility of vaccinating scope
the anger of The physicians is not likely to subside with the adoption of other amendments that broaden the prerogatives of pharmacists but also of midwives. The meps have thus extended the possibility for the latter to prescribe directly some of the vaccines. The midwives will also be able to prescribe and practice of vaccinations to children in certain conditions. Objective: to facilitate the course of patient care and contribute to the strengthening of the immunization coverage.
“Since 2016, the competencies of midwives has been expanded, in particular in respect to vaccination. They can practice for the vaccination of pregnant women, newborn and their families,” said Agnes Buzyn. “In the logic of simplification of the course of vaccination, I grabbed the High authority of health of a notice on the enlargement of the capacity of vaccine to healthcare professionals, including midwives. Its opinion must be made aware in 2019, but this amendment opens the way, even if it will come back to HAS to pronounce judgment and a decree to fix the vaccines allowed,” she said.
