The La Grave medical care center closes its doors on May 31, for lack of subsidies. In the heart of Toulouse, in the Saint-Cyprien district, it was the oldest structure in Haute-Garonne for the reception of patients in the evenings, weekends and public holidays.
This time it’s over. The Toulouse medical center of La Grave, the oldest in Haute-Garonne, will lower its curtain on May 31. Opened in 2003, it carried out more than 10,000 consultations in 2022 with an increase in activity compared to the period preceding the Covid-19 epidemic. But for lack of subsidies, the association decided to cease its activity.
For twenty years, the medical center of La Grave received funding to support its action. In 2022, the Regional Health Agency (ARS Occitanie) paid him 85,000 euros, which represented more than two-thirds of his operating budget. But during the development of the new organization of the permanence of ambulatory care in Haute-Garonne, that is to say the medical guards outside the opening hours of the cabinets, the rules were redefined. “In order to restore equity in the financing of medical houses”, explained the ARS last January.
Compulsory regulation to access a medical care center
The on-call sectors have been redefined in Haute-Garonne, going from 38 to 16 by the end of 2023, with a medical on-call center positioned in each territory. The establishment of these places of care, evenings, weekends and public holidays, is accompanied by an obligation of regulation. The patient does not go directly to the site, he must first dial 15 or 39 66 or be redirected by the emergency department. “We must educate the population for the proper use of the permanence of care. I do not want a patient to arrive alone without having received an orientation. I am optimistic about the organization that is being put in place, it is a paradigm shift, a new way of looking at care”, underlines Professor Stéphane Oustric, president of the council of the Haute-Garonne medical order.
“Surprises among patients”
The La Grave structure was no longer considered a medical care center since it did not work with this regulation filter. Reclassified as an unscheduled care centre, it has not received any more subsidies from the ARS since 1er April 2023. “Some doctors from the association agreed to continue to do call duty at the weekend, but we had to ask for authorization… That’s enough, they don’t want us, we’re stopping. We keep our money to pay the indemnities of our five employees (the doctors paid part of the remuneration of their on-call duty into the coffers of the association)”, declares, with bitterness, Dr Jean-François Reinard, president of the association Maison Médicale de Garde Toulouse 31. “There will be some surprises among patients and we will see how Sunday evenings will go in Toulouse without our structure”, still slips the doctor whose association had received the support of the Haute-Garonne section of the Socialist Party.
Funding now goes to the new medical centre, in Purpan, on the first floor of the children’s hospital and therefore close to the emergency room and its flow of patients (77,000 annual visits to Purpan’s adult emergency room and 55,000 annual visits to pediatric emergencies). On-call consultations began there on March 6. “Out of 440 doctors registered in Toulouse, 210 fill the diary. For the moment, only three days are not filled and if there is a shortage, I request a requisition”, explains Professor Stéphane Oustric.
For the city of Toulouse, 7 lines of guards on evenings and weekends
In the new organization of the permanence of outpatient care, the city of Toulouse now has 7 lines of guards: two doctors are positioned in the Purpan medical care center (premises of the children’s hospital), two on the SOS Médecins site of Jean-Jaurès, two on the SOS Médecins site on the road to Spain and one in La Faourette. This last position is due to leave in a year at the Reynerie where a multidisciplinary health center is under construction.
In the Toulouse conurbation, the next opening of a line of care will take place on the site of the L’Union clinic.