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HEALTH

ANALYSIS: Why have so many in Marseille rebelled against French government health measures?

France's second largest city has seen a lot of anger at the government since the decision to temporarily close down all restaurants and bars in the city, in a bid to halt the rapid spread of Covid-19 in the area.

ANALYSIS: Why have so many in Marseille rebelled against French government health measures?
Bar and restaurant workers throw plates on the street to protest against the Covid-19 closures. Photo: AFP

The decision, announced by health minister Olivier Véran during a press conference, did not go down well with local authorities, who said they were not consulted in advance and quickly denounced what they claimed was a central government out of touch with anywhere that was not Paris.

The metropole of Aix-Marseille is currently the only area of France on 'maximum alert' level which involves closing all bars and restaurants, although Paris could be following suit on Monday.

On the first day of the closure, several bars and restaurants seemed to be deliberately flouting the rules.

“End the health dictatorship,” read the banner of a restaurant that refused to close down, along with a few other establishments in the city, at the risk of steep fines if caught by police.

“I'm not scared, not of anything, I don't give a flying fig,” the owner of one of the restaurants that kept open told French media.

 
But was this a Covid-specific situation or are the people of Marseille more prone to rebel against the Paris-based government?

A restaurant that did not want to close down in Marseille. Photo: AFP

 
'A city without name'

 
Marseille is France's second biggest city. It is a long-time rival of Paris, for its size, its football team and rap music. 
 
“Marseille is a city that has a special relationship with the French state,” said Gilles Pinson, a professor in political science at the Sciences Po University in Bordeaux.
 
To understand that special relationship, we have to go a little bit back in time.
 

Marseille was integrated into the French kingdom in 1481, relatively late and following several failed attempts by the central power that were pushed back by rebels in the city.
 
In the centuries that followed, this became some sort of pattern: Marseille rebelled, Paris quashed the rebellions.
 
One of the most humiliating episodes occurred just after the French revolution in 1789, when the Paris authorities punished Marseille for its refusal to back up the Jacobin government by renaming it “A city without name.”
 
The port
 
Despite the occasional tensions with Paris, Marseille for a long time enjoyed a relatively autonomous power over its economy, which – thanks to its port – was thriving. 
 
Then, in the 1960s, the French state decided to nationalise the port and Marseille lost control over its top income source.
 
“By meaning well, the state contributed to break down Marseille's economic system,”  Pinson said.
 
This was, Pinson said, “a painful story of impoverishment” and its scars are still visible today. 
 

 

A new kind of French rebellion? Photo: AFP
 
When local officials following the bar and restaurant closures used loaded rhetoric such as “collective punishment” and “sanctions,” they remind Marseille and the world that Paris had a history of acting in a way it said it was in Marseille's best interest, but turned out to be harmful.
 
“Local authorities in Marseille learned long ago how to use old tensions between Marseille and the capital to score points,” said Nicolas Maisetti, a political researcher at the Gustave Eiffel University Paris-Est.
 
When Michelle Rubirola, Marseille’s Green Party Mayor, tweeted: “I do not accept the people of Marseille to be victims of political decisions that no one can understand,” she was spinning an old line, appealing to a decades-old, hurt collective ego.
 
'Marseille against the world' 
 

This also helped explain the city's cult-like enthusiasm for Didier Raoult, the controversial microbiologist made world-famous for his unequivocal support for hydroxychloroquine as a remedy for Covid-19.
 

 
 
Raoult's ragged looks, loud voice and unashamed bashing of the “elites”, made him the “ultimate” Marseille character, Maisetti said. 
 
“It was Marseille against the world. People supported him no matter what he said, it was crazy,” Maisetti said.

 

A few years back, Maisetti created a website called Marseillologie.net, a website that aims to do away with what he said was an obsession by the rest of France to make Marseille into an exception. 
 

“The stereotype of Marseille – that it is a dirty, crime-ridden, corrupt city, neglected the elites and infested by mafia – has had harmful impacts during the pandemic,” Maisetti said.
 
Although not true, stereotypes like these pushed a narrative that Marseille could not itself make its own decisions about Covid-19 – it could not even govern itself properly, Maisetti explained.
 

“But really, you could talk about Marseille like you talk about Gironde, or Brittany, or Corsica,” he said, other areas of France that traditionally have sought to emphasise their local uniqueness and difference from the capital.

 
“Mistrust towards Paris is not the exception, it's the rule, but people pay more attention to it when it happens in Marseille because it fits into their world-view,” Maisetti said.

 

'France is extremely centralised'
 
Cesare Mattina, an Italian sociologist at the Aix-Marseille University, agreed. 
 
“I think we should turn the question around: Is Marseille a particularly rebellious city or is the French state just really centralised?”
 
Mattina, who grew up in Napoli, another proud European city that has a longstanding rival relationship with the capital, said Marseille historically had been more subject to domination than his Italian hometown.
 
“France extremely centralised, everything is focused on Paris,” he told The Local.

 
“There is an almost colonial link that exists between Paris and certain cities, Marseille too. In Italy, Rome is the capital, but Rome does not mean everything in Italy,” Mattina said, adding that Germany and Spain also allowed more autonomy to regions than France.
 
“In France, the Parisian domination is so accepted that it's perceived as something against which we are powerless.”
 
“My Italian point of view is that, with respect to Covid-19, is that if decisions are taken too far away from the cities and towns themselves, they won't work,” he said.
 
 

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HEALTH

The different ways you can make a doctor’s appointment in France

Booking a medical appointment in France can be time-consuming – especially if you are new to the country and are looking for an English-speaking doctor.

The different ways you can make a doctor's appointment in France

You do not need a carte vitale to book a doctor’s appointment in France – anyone who needs medical help while in the country is entitled to it, but you may not be entitled to any reimbursement if you are not part of the social security system.

Booking a GP’s appointment can be as simple as phoning up your friendly neighbourhood GP, or using an online service such as Doctolib. 

It helps a lot, if you have a médecin traitant – an attending GP, who adds you (and your family, if they can) to their list of patients. 

READ ALSO Explained: How to register with a doctor in France

It is not always easy to find one. Some parts of the country are short of GPs, which means doctors’ lists can fill up very quickly. But it is important that anyone who lives in France is registered with a named GP, especially if they have a carte vitale.

As well as being the main point of contact between patients and the medical profession in all its guises, it is financially responsible to be registered with a GP in France.

Reimbursement on consultations is typically 70 percent through the French healthcare system, but just 30 percent for anyone without a declared doctor. Meanwhile, top-up mutuelle health insurance companies usually require you to declare a médecin traitant and if you don’t, you may not be able to receive reimbursements on certain treatments.

Bear in mind, it is your responsibility to register with a local médecin traitant. But, even after you have done so, you can still make an appointment with any doctor, anywhere in France, and arrange specialist treatment, if you need it. 

READ ALSO 5 things to know about visiting a doctor in France

How do you go about making a GP appointment in France?

There are several options.

Some health centres – more often in larger towns and cities – operate a walk-in policy. But expect waits to be lengthy. Do not, however, assume that your GP operates a system like this.

You can phone for an appointment. This is another very common method. Your GP will have their own system for making appointments – which may even include something that looks, to the uninitiated, very much like a casual walk-in policy. 

Some may have an assistant to deal with booking appointments and other administration. Others may deal with appointments themselves, and may – for example – operate some sort of triage system based on voice messages from patients. 

What about online booking systems?

And many practitioners are now attached to websites, such as Doctolib. As of 2023, about half of all GP appointments in France were made using Doctolib.

READ ALSO How to use: French medical website Doctolib

Be aware that other online booking systems are available. Doctolib is one of the best known, but your GP may be attached to another system, like the health ministry approved site ‘LeMedecin.Fr’.

This website also has a feature where you can take an immediate online consultation with whatever doctor is available at that moment. By clicking ‘Consultez en vidéo maintenant’ you will be connected to the next doctor who is free. This option may involve an additional charge between €5-10 on top of the price of the consultation, and you will be expected to pay when booking.

If you have any trouble with either of these websites, you can go through the list of registered generalists per département on the ‘Ameli’ website. If you use this option, you will need to call the doctor to see if they are open or available for appointments.

In terms of wait times, online systems have helped to significantly reduce the delay between booking and getting an appointment.

According to a 2023 study by Doctolib, about half of all GP appointments were available within three days from the time of booking on their platform.

Similarly, you can use online platforms to check the medical professional’s qualifications and languages spoken, as well as filter based on the doctor’s English abilities. However, this should be taken with a grain of salt because not every medical professional with English listed on their Doctolib page speaks fluent English. 

An increasing number of doctorsoffer video consultations, known as télémédecine in France. This allows professionals – particularly those in more rural areas – to diagnose less serious conditions remotely. This type of consultation is usually only available from those medical practices that are attached to online booking systems. 

Some pharmacies have also begun offering walk-in télémedicine consults, using ‘Medadom’ machines. More information here.

What about specialists?

In France, you book your own consultations with specialists, even if you are referred by a doctor (your GP may offer a recommendation, but won’t always). The good news is that many specialists do use online booking services. Those that do not usually have assistants to take care of the appointments.

READ ALSO: Urgent care: How to get non-emergency medical treatment in France

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