Continuity of hospital care and foreign doctors: regularisation of a system and its limitations in France

The medical demography is a major public health issue for health policies in France, and elsewhere in the world, to reflect on. The media is often echoing the under-medicalisation of France. This statement merits thought and moderation. Inequalities of territorial distribution, already significant, will only continue to be exacerbated. We know that the distribution across the French territory is ruled by the well-known solar tropism of liberal professions. The North of France is demographically deficient in terms of doctors compared to the South, and the Champagne-Ardenne region does not escape this trend. This distribution, far from being homogenous, concentrates doctors in urban areas to such an extent that Nice's back country is as deserted as the Santerre from Picardie. The maintenance of a continuity of care in ongoing hospital care services becomes a difficult exercise. A focus on the Champagne-Ardenne region, a region of migration in Europe, enables us to understand the role of foreign doctors in the maintenance of the continuity of such services in the hospital setting. The stakes and limitations of such a set up must be considered at the European and global scale. If foreign doctors represent a resource for hospital care in France and other countries of Northern Europe, this migration needs to be better regulated in order to prevent the massive desertification, in particular from Eastern European and sub-Saharan African countries. (Global Health Promotion, 2012; 19(3): 74-77)