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France to fine patients who miss medical appointments

France is to introduce a five euro penalty for people who fail to turn up for millions of doctors' appointments missed each year, the prime minister said Saturday.

Published: 7 April 2024 11:47 CEST

A doctor calls a patient in the waiting room at the surgery consultation at Argenteuil hospital, north of Paris on July 19, 2013. The French government plans to fine patients who don’t attend appointments. (Photo by Fred DUFOUR / AFP)

The fine was one of several measures announced by Prime Minister Gabriel Attal to boost a health service struggling to keep up with increasing demands from an ageing and growing population.

“We cannot allow this,” Attal said of the 27 million consultations that the main doctors’ union says are wasted each year by patients not turning up.

Attal said the measure could free up between 15 million and 20 million appointments for other patients.

He said a law allowing a “mechanism for responsibility” would be put to parliament and that the government wanted the penalty to start from January 1.

The money would be paid by any person failing to turn up for an appointment or who gives less than 24 hours notice.

Individual doctors will decide if the reason for missing an appointment was good enough to avoid the financial penalty.

The prime minister will also seek to increase the number of students finishing high-pressure medical training in a bid to answer a critical shortage of doctors.

He said the number of students entering the second year of medical degrees would rise from 10,000 a year in 2023 to 12,000 in 2025 and 16,000 in 2027.

Medicine is considered one of the toughest university degrees in France with up to a third of students dropping out at the end of the first year.

Officials acknowledged that the change may only affect the French health service from 2035 because of the time it takes to train doctors.

Attal told a press briefing that there would also be an experiment from next year to allow patients to make appointments with some specialists without being referred by a general doctor — which is the current rule.

The proposal was criticised by the main union for general practitioners, MG France, which insisted “it will not solve anything” as there is the same shortage of specialists as for generalists.

Attal’s advisors said action was critical as getting reliable access to a doctor was one of the main gripes of French voters.

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Azerbaijan vehemently rejects the accusation it bears responsibility for the riots that have led to the deaths of five people and rattled the Paris government.

But it is just the latest in a litany of tensions between Paris and Baku and not the first time France has accused Azerbaijan of being behind an alleged disinformation campaign.

The riots in New Caledonia, a French territory lying between Australia and Fiji, were sparked by moves to agree a new voting law that supporters of independence from France say discriminates against the indigenous Kanak population.

Paris points to the sudden emergence of Azerbaijani flags alongside Kanak symbols in the protests, while a group linked to the Baku authorities is openly backing separatists while condemning Paris.

“This isn’t a fantasy. It’s a reality,” interior minister Gérald Darmanin told television channel France 2 when asked if Azerbaijan, China and Russia were interfering in New Caledonia.

“I regret that some of the Caledonian pro-independence leaders have made a deal with Azerbaijan. It’s indisputable,” he alleged.

But he added: “Even if there are attempts at interference… France is sovereign on its own territory, and so much the better”.

“We completely reject the baseless accusations,” Azerbaijan’s foreign ministry spokesman Ayhan Hajizadeh said.

“We refute any connection between the leaders of the struggle for freedom in Caledonia and Azerbaijan.”

In images widely shared on social media, a reportage broadcast Wednesday on the French channel TF1 showed some pro-independence supporters wearing T-shirts adorned with the Azerbaijani flag.

Tensions between Paris and Baku have grown in the wake of the 2020 war and 2023 lightning offensive that Azerbaijan waged to regain control of its breakaway Nagorno-Karabakh region from ethnic Armenian separatists.

France is a traditional ally of Christian Armenia, Azerbaijan’s neighbour and historic rival, and is also home to a large Armenian diaspora.

Darmanin said Azerbaijan – led since 2003 by President Ilham Aliyev, who succeeded his father Heydar – was a “dictatorship”.

On Wednesday, the Paris government also banned social network TikTok from operating in New Caledonia.

Tiktok, whose parent company is Chinese, has been widely used by protesters. Critics fear it is being employed to spread disinformation coming from foreign countries.

Azerbaijan invited separatists from the French territories of Martinique, French Guiana, New Caledonia and French Polynesia to Baku for a conference in July 2023.

The meeting saw the creation of the “Baku Initiative Group”, whose stated aim is to support “French liberation and anti-colonialist movements”.

The group published a statement this week condemning the French parliament’s proposed change to New Caledonia’s constitution, which would allow outsiders who moved to the territory at least 10 years ago the right to vote in its elections.

Pro-independence forces say that would dilute the vote of Kanaks, who make up about 40 percent of the population.

“We stand in solidarity with our Kanak friends and support their fair struggle,” the Baku Initiative Group said.

Raphael Glucksmann, the lawmaker heading the list for the French Socialists in June’s European Parliament elections, told Public Senat television that Azerbaijan had made “attempts to interfere… for months”.

He said the underlying problem behind the unrest was a domestic dispute over election reform, not agitation fomented by “foreign actors”.

But he accused Azerbaijan of “seizing on internal problems.”

A French government source, who asked not to be named, said pro-Azerbaijani social media accounts had on Wednesday posted an edited montage purporting to show two white police officers with rifles aimed at dead Kanaks.

“It’s a pretty massive campaign, with around 4,000 posts generated by (these) accounts,” the source told AFP.

“They are reusing techniques already used during a previous smear campaign called Olympia.”

In November, France had already accused actors linked to Azerbaijan of carrying out a disinformation campaign aimed at damaging its reputation over its ability to host the Olympic Games in Paris. Baku also rejected these accusations.