What will change from 1st January?

A number of fiscal measures take effect from tomorrow. Most important for taxpayers is the introduction of payment at source of income tax, not unlike the UK PAYE system. For most of the readers living on pensions arising from overseas there will be no change. What may affect some readers is the reduction of social charges for pensioners having less than 2000 euros per month; if there is an amount taken into account for the monthly payments it will be reimbursed by July.
The minimum wage will rise to 10.03 euros per hour gross, giving 1204 euros net per month for a person working 35 hours per week. Workers earning up to 1.3 times the SMIC (minimum wage) will be paid a top up of 90 euros per month if they claim it from the CAF. Given that will concern an extra 1.2 million people prepare for delays at the CAF (our comment not the government's).
Overtime payments will be exempt from tax and social charges in a nod to the gilets jaunes, as with the suspension of the increase in fuel duties and gas prices reduced by 2%.
On the other hand the price of cigarettes will increase as will the price of stamps, a red stamp being 1.05 euros and a green stamp 88 centimes.
There is a heating allowance which will go up by 50 euros to an average of 200 euros. Details of the extra 2 million households affected will be published later.
The environmental measures include a 100 euro per window allowance for double glazing (ndlr watch out for more cold calls); up to 4000 euros for changing a car for a less polluting vehicle for less well off workers using a car for work; the ban on using pesticides by private individuals come into force.
Hearing aid prices will be limited to 1300 euros maximum, with minimum reimbursement up to 300 euros and the maximum charge will be reduced to 950 euros by 2021.

The French exchequer will also introduce special tax measures for the so-called GAFA companies (named for Google, Amazon, Facebook and Apple) which make profits from the internet in France whilst being based overseas. Since the EU has opposed a blanket measure it suggests that France has control of its money - something the Brexiteers say is not the case with the UK. Another lie? Sorry for the political point in making this report!

UK Government's proposals for Healthcare

Could this be the cure for our healthcare? On 26 October, Stephen Barclay, Minister of State for Health, issued the written statement below which sets out a new Healthcare Bill for future reciprocal healthcare arrangements. After two years we finally have something which might just give some peace of mind to worried pensioners and other British citizens living in the EU. Today, the Government is introducing the Healthcare (International Arrangements) Bill. This will provide the Government with the powers that are needed to fund and effectively implement arrangements for UK nationals to obtain healthcare abroad after the UK exits the European Union (EU). Current EU reciprocal healthcare arrangements enable UK nationals to access healthcare when they live, study, work, or travel abroad and visa-versa for EU citizens when in the UK. They give people more life options, support tourism and businesses, and healthcare cooperation. The UK also has a number of reciprocal healthcare agreements with non-EU and EEA countries, such as Australia and New Zealand. These arrangements ensure that UK nationals living and working in the EU, European Economic Area (EEA) and Switzerland can access healthcare in exchange for paying taxes and social security contributions. The UK also funds healthcare abroad for a number of current or former UK residents. This includes healthcare for UK state pensioners who spend their retirement in the EU and needs arising healthcare when UK residents visit the EU for holiday or study through the European Healthcare Insurance Card (EHIC) Scheme. The Bill is part of the Government’s preparations for EU Exit and will ensure that whatever the outcome of EU Exit, the Government can take the necessary steps to continue reciprocal healthcare arrangements or otherwise support UK residents to obtain healthcare when they move to or visit the EU. Presently, the Secretary of State for Health and Social Care has limited domestic powers to fund and arrange healthcare outside of the UK. When the UK leaves the EU the current EU regulations will no longer be part of UK law and new legislation will be needed. This Bill confers powers on the Secretary of State to make, and arrange for payments to be made, in respect of the cost of healthcare provided outside the UK. This would allow for the funding of reciprocal healthcare arrangements for UK nationals living in the EU, EEA and Switzerland. The Bill also confers powers on the Secretary of State to make regulations for and in connection with the provision of healthcare abroad and to give effect to healthcare agreements with other countries or territories (both EU and non-EU) or supranational bodies such as the EU. Finally, the Bill provides for the lawful processing of data where necessary for purposes of implementing, operating or facilitating the operation of reciprocal healthcare arrangements or payments. Current healthcare agreements benefit people in all parts of the UK, assisting people to obtain healthcare when they are abroad. The UK Government is therefore engaging with the devolved administrations to deliver an approach that works for the whole UK in a way that fully respects the devolution settlements. The Bill underscores the Government’s commitment to reaching a reciprocal healthcare agreement with the EU, or where necessary making agreements with Member States, and to exploring potential agreements with third countries in the future. The Government welcomes the forthcoming scrutiny of the Bill, to ensure that it achieves its aims for the continuation of healthcare support for UK nationals in the EU, EEA and Switzerland after the UK exits the EU, but also enabling the UK to look to the future. This statement has also been made in the House of Lords

Toulouse Lautrec for sale?

Many of us have used the Clinique Toulouse Lautrec at Albi. This clinic specialises in various ailments which can affect the elderly, as well as more common surgical interventions. But because it is owned by the same group as the Clinique Claude Bernard, also in Albi, the competition authority demanded that one of the clinics be sold.
Long negotiations have taken place with the public Centre Hospitalier Albi which wanted to take over the private clinic. But once again the lack of competition worried the authorities and no deal has been done.
It was thought that a buy-out by the staff was possible, but it seems that they were unable (or unwilling) to raise the money needed. Unions representing nursing and ancillary staff want assurances on jobs - preferably via the CH Albi purchase. However it seems that a new private buyer has come forward and all await the next moves.

Anyone looking for a professional carer?

Is anybody looking for a part-time carer for young or older people? I am a qualified nurse with lots
of experience in caring for the elderly and the infirm. English and French spoken, driver, living near
Saint Antonin and looking for local work, short or long term. If interested please contact me by
email.
margaretnewland82@gmail.com

Another GP at Varen health centre

Dr Fabre at the Maison de Sante Pluridiscipline de Varen (MSP)

It is always good news when a new GP arrives in our rural villages. The health centre (MSP) in Varen offers a wide range of medical services on a daily basis or on occasional rendez-vous for more specialised treatments.
Dr Pierre Emmanuel Fabre has joined Dr Bouvier and her colleagues as a Medecin Generaliste at the MSP since the start of the month. Native of Gaillac, Dr Fabre has wide experience in the region as well as in various parts of the world.
For such a small village the success of the MSP has attracted patients from all around the area, meeting the demands of old and young alike.
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Open day for CSF

Dear friends of Cancer Support France, 

I am delighted to announce that we are holding an open, information day regarding Cancer Support France here in the Tarn. This is an opportunity for those who have expressed an interest in our organisation to find out exactly how we work and what we do.  

It will be held at my house in Bournazel, 81170 (4km from Cordes sur Ciel) on Tuesday 13th March at 10.00am.  

Our CSF Sud president, Penny Parkinson, will be attending, as will a number of our active listeners and volunteers. We will be discussing the following items:

The history of CSF and CSF Sud and what we do
What is Active Listening (AL)
Confidentiality & Boundaries
How you can help

After this presentation, there will be a light buffet lunch and then there will be a chance to chat with our members and ask any other questions you may have about our organisation. We should be finished by about 2.30pm.

If you would like to attend, please contact me directly to reserve a place. Also, please pass this email onto anyone that you think may be interested.



Please do not hesitate in contacting me if you have any queries.

Kind regards

Caroline Maslin

06 16 32 25 44

Toulouse health centre to help WHO

Gerontopole Toulouse CHU

The World Health Organisation has chosen the Gerontopole, part of the Toulouse CHU (University hospital) as a centre for research and training in the treatment of elderly populations. The hospital department is recognised for the quality of its work in this field at a time when many countries have an increase in the average age of their population.
The Gerontopole will lead research over the next four years to identify the intrinsic and functional needs and capacities of older people. The WHO considers that most world populations will now expect to have a life span in excess of 60 years and that it is urgent that governments and agencies consider the impact this will have.
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New medical consultation rates

The cost of a visit to your GP has gone up to 25 euros some months ago and now some charges for consultations will rise from 1st November. These are for "complex", "very complex" or "longue" cases. They concern certain difficult illnesses which require the GP to spend more time with the patient, including newly born babies, preparations for complex surgery, Parkinsons or cancer. Also consultations on teenage contraception or assisted pregnancy may cost more.
The tariffs may be up to 70 euros, though normally 46 euros will be the charge for the "complex" consultations. Reimbursement will be 100% for the poorest patients and long term illnesses and 70% for most others, with the complementaires making up the balance.
GPs will discuss these things with their patients and their families so they are prepared and such charges will be limited to three consultations per annum. It is estimated that the changes will add 870 million euros to the Social Security bill.
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Health care expectations

A wide-ranging study by American researchers into health care provision throughout the world concludes, unsurprisingly that the best access to quality care in a wide number of diseases is in western Europe. Only Australia features in the top ten outside Europe.
France comes in at 15 and the UK at 30 (USA at 35). The study is based on the number of "preventable" deaths suffered in each care system as a result of difficulty of access to treatment in the various diseases. The study was funded by a "Global Health Burden" group, presumably aimed at finding ways of improving care provision. So if you want to survive best - go to Andorra. Worst place is Central African Republic.

For those interested in reading the full review it is in The Lancet at this link http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30818-8/fulltext

On the first of May..

Apart from the monthly book swap at the Gazpacho, the day is an official holiday so many shops and offices will be closed. There will be the ritual handing over of muguets (lily of the valley) in over-priced little parcels .... and it will cost more to consult your doctor.
Normally a consultation with a GP costs 23 euros, but will rise to 25 euros from that day. Other increases are planned (under six year olds 30 euros) and specialist charges could go up later in the year. The aim is to try to halt the decline in GP numbers and doctors' unions see it as a first step, though suggest it will make little difference on its own. Apparently the average fee in Europe is 40 euros. Presumably the CPAMs and mutuelles will reimburse the additional charge as at present.
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All about vaccinations

If you want to know about vaccinations, if you are up to date, what are the risks etc. Health professionals are on hand to answer all your questions in the Varen medical centre tomorrow, Monday 24 April, from 10am.

Medical waiting times getting longer

Are we spoiled here by our medical service? GP appointments usually the same day; X-rays same week; hospital specialists often within a week or two. But it seems this is not the norm throughout France (nor for all disciplines).
A study published this week suggests that GP waiting times are getting longer, both because doctors are getting older and retirement is not being matched by replacement, and because many are concentrating on areas which are more remunerative as there are no limits on fees.
But delays in some specialisms are now so long that patients are not bothering to ask for appointments. Ophthalmologists average 117 days; dermatologists 64 days and even gynaecologists 68 days, all much higher than 5 years ago.
The report suggests that things will get worse over the next 5 years, especially as government wants mutuelles to limit payments to patients to discourage them from simply seeking consultations that they know will be covered. It suggests that only patients with a good insurance cover will be able to get the best from the health service - it seems pretty more like UK private practice or the US system than the effective French care we have become used to.
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Hospital doctors take strike action today

Doctors in hospitals throughout France have been called on to strike today and then refuse to work evenings and nights. The movement was started by anaesthetists but is supported by most branches.
Shortages of staff, excessive hours, low pay are all points of discord and the government has promised a new structure and finance, but doctors claim it is continually delayed.
In practice some operations may be postponed, but continuous care will be assured. It may pay to check with your hospital if you have a scheduled operation this week.
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Cost of consulting GPs set to rise

The Assurance Maladie, which oversees the funding of the French health service, is negotiating a new 5 year contract with the medical professions. As part of this they are proposing that a consultation with your GP should cost 25 euros, rather than 23 euros as at present. The rise will be staged over 2 years, 1 euro at each of April 2017 and April 2018.
So far the GP's union has rejected this as inadequate, as there has been no increase since 2011. One young GP we spoke to said he thought the "payment at the time of consultation or treatment" discouraged patients from attending with minor ailments which they could treat themselves.
The relative ease of getting a GP appointment may support that, but perhaps it is that France has nearly double the numbers of GPs compared to the UK.
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From Lourdes with love

The Lourdes maternity hospital closed last November, but it surplus equipment, including beds and wheelchairs, is not being wasted. A local charity has arranged for everything to be packed and shipped in a container to Senegal. There the material will equip a maternity ward in a small town about 80 kilometres from Dakar. Local health authorities say the gift will transform services to around 50000 people.
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Miniature pacemaker fitted

Surgeons from the CHU and Clinique Pasteur in Toulouse teamed to implant a pacemaker 10 times smaller than the conventional model, claimed to be the world's smallest. Capable of being introduced into the heart via the venal system it has retractable anchors which enable the device to be fixed within the heart without causing damage en route.
The surgeons believe the risk of complications is much reduced and expect with normal use that the pacemaker will function for about 10 years.
In a separate story, 11 rooms had to be evacuated at the Pasteur when a fire was discovered - no one was hurt and there was no damage. We wonder if the newly transplanted patient was enjoying a secret smoke!
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Children's heart surgery pioneers

The CHU (centre hospitalier universitaire) in Toulouse is leading the world in treating infant cardiac malformations without the need for open heart surgery. Using 3D echography and catheterisation surgeons are able view the heart in actual size and introduce the necessary instruments via a vein or artery. Two children treated last month were able to go home after 36 hours as the risk of complications and infection are reduced and anaesthetic for the shorter procedure is also much lighter. The CHU treats about 150-200 children a year and can treat over 40 anomalies in this way.
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Picture MaxPPP

Montauban hospital strike continues

Major Montauban clinic Pont de Chaume has been experiencing industrial action for 10 days now, leading to the closure of 7 wards from the 15 available.
Members of the CGT union are seeking improved pay and conditions and nurses, auxiliaries and porters are taking action. Staff from the Tarn and Garonne prefecture are offering to mediate in the dispute which is a major disruption to Montauban's health provision.

pickets at Montauban. Photo: Stephane Compan

Toulouse clinic leading the way

The Clinique Pasteur is recognised as one of the leading cancer treatment centres in France and has become the first in France to have a new radiology system which is computer guided.
Some tumours are "mobile" and move around, making it difficult to treat them, but new software in a system called VERO tracks these cancers in real time making it possible to treat them more accurately and quickly. The clinique treats 220 patients each day.
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Montauban hospital under threat

Residents of the Montauban/Castelsarrasin/Moissac corridor are to demonstrate in the departmental capital at the Health authorities HQ against plans to reduce considerably the orthopaedic beds in two local public hospitals. Many readers will think that one can simply use the private clinics, but without a comprehensive insurance cover they can be expensive. As many as 50% of such beds could go in the re-organisation. The demo will be held on Monday 28th April.
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