French Health System Overview
Health System Rankings
Health System Outcomes
Health System Coverage
Costs for Consumers
Health System Expenditures
French COVID-19 Policy
Density of medical doctors (per 10,000 population) (2012-2020): 32.7
Density of nursing and midwifery personnel (per 10,000 population) (2012-2020): 117.8
Density of dentists (per 10,000 population) (2012-2020): 6.5
Density of pharmacists (per 10,000 population) (2012-2020): 10.6
Source: World health statistics 2022: monitoring health for the SDGs, sustainable development
goals. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO.
Remuneration of Doctors, Ratio to Average Wage (2017)
General Practitioners: 3.0 (Self-Employed)
Specialists: 2.2 (Salaried); 5.1 (Self-Employed)
Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.
Remuneration of Hospital Nurses, Ratio to Average Wage (2019): 0.9
Remuneration of Hospital Nurses, USD PPP (2019): $41,400
Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.
Ratio of Nurses to Doctors, 2019: 3.3
Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.
“While the number of doctors has increased in most EU countries over the past decade, it has remained stable in France. As a result, it is well below the EU average, at 3.2 doctors per 1,000 population in 2019, compared with 3.9 across the EU. There are wide disparities in the density of doctors and other health professionals across regions, with some areas facing shortages.
“Concerns are also rising that shortages of doctors, especially of GPs, may be exacerbated in the future, as a large proportion will retire in the next decade (see Section 5.2).
“The number of nurses in France has increased from 7.9 per 1,000 population in 2008 to 11.1 in 2019 – above the EU average of 8.4. Following the COVID-19 pandemic, the government has taken some measures to increase the recruitment and retention of nurses in hospitals and other facilities (see Section 5.3).”
Source: OECD/European Observatory on Health Systems and Policies (2021), France: Country Health Profile 2021, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.
“As noted in Section 4, the overall number of doctors per 1,000 population in France is much lower than the EU average, and the total number fell by 5.6 % between 2012 and 2021. Combined with rising population, the density of GPs was reduced from 1.5 per 1,000 population in 2012 to 1.4 in 2021. While this reduction occurred in most regions, it was greater in some, and disparities increased (Figure 14).
“Concerns about “medical deserts” have grown and may be exacerbated in the future as a large proportion of GPs will retire in the next decade. The proportion of people living in a region with a density of GPs 20 % lower than the national average increased from 1 % in 2012 to 4 % in 2021 (DREES, 2021).
“The authorities launched a number of initiatives to address these concerns, including offering financial support for doctors to set up practices, and various tax breaks. Since 2007, the main policy to tackle this issue has been to create multidisciplinary medical centres, enabling GPs and other health professionals to work in the same location. In 2020, a total of 1,612 such centres were registered, 30 % more than in 2017. Unfortunately, the most recent centres are in areas where access is not the most limited (Mutualité Française, 2020).”
Source: OECD/European Observatory on Health Systems and Policies (2021), France: Country Health Profile 2021, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.
“About 5.3% of the French population works in the health care sector. Nurses and nursing aides form the largest group of professionals, accounting for approximately half of the health care workforce. Registered health professionals also include physicians, dentists, midwives, pharmacists, professionals involved in rehabilitation (physiotherapists, speech therapists, vision therapists, psychomotor therapists, occupational therapists and chiropodists) and technical paramedical professions (hearing aid specialists, orthoptists and radiographers). Other professions usually identified as contributing to health care include clerical and technical staff working in hospitals, laboratory technicians, paediatric auxiliaries, dieticians, psychologists and ambulance drivers.
“Workforce forecasting and planning of educational capacity is mostly made at the national level using a numerus clausus for medical professionals seeking to prevent shortages or oversupply. However, it does not control for the geographical distribution of medical professionals, as self-employed professionals are free to choose where they practise. In order to solve the resulting great disparities in the distribution of medical professionals, there has been increasing transfer of tasks from medical to other professionals such as nurses and the development of incentives for attracting health professionals to underserved areas.”
Source: Chevreul K, Berg Brigham K, Durand-Zaleski I, Hernández-Quevedo C. France: Health system review. Health Systems in Transition, 2015; 17(3): 1–218.
“In France fee-for-service physician payment occurs within budget constraints set by parliament and the Ministry of the Economy and Finance. UNCAM [Union Nationale des Caisses d’Assurance Maladie] negotiates fees with representatives of the physicians unions. All physicians in the community and in private for-profit hospitals are reimbursed according to this fee schedule. Most public hospital physicians are paid on a part-time or full-time salaried basis. Although the state is not officially involved, it closely monitors the negotiations between UNCAM and the physicians unions.”
Source: Michael K. Gusmano, Miriam Laugesen, Victor G. Rodwin, and Lawrence D. Brown. Getting The Price Right: How Some Countries Control Spending In A Fee-For-Service System. Health Affairs 2020 39:11, 1867-1874.
“As a result of fee negotiations within expenditure targets, physicians in all three countries earn lower incomes than their US counterparts. For example, in 2016 generalist physicians in the US earned an average of $218,173. In comparison, generalists in France and Germany earned $111,769 and $154,126, respectively. Similarly, specialist physicians in the US earned an average of $316,000 in 2016, compared with $153,180 in France and $181,253 in Germany.3 Japanese physicians earned, on average, $124,558 in 2016; however, this is an average of generalist and specialist incomes.
“Policy makers in the US have been concerned that fee-for-service payment results in an excessive volume of services. The French response to excess volume was to impose expenditure targets in 1996 and 2010, but France exceeded its budget targets frequently.12,25 Within the past decade physician fee increases and total annual spending have been held in line. This success reflects tighter political control by parliament, the Ministry of the Economy and Finance, and the Ministry of Social Affairs and Health, which has made budget constraints explicit for UNCAM [Union Nationale des Caisses d’Assurance Maladie] in negotiations with physicians unions.”
Source: Michael K. Gusmano, Miriam Laugesen, Victor G. Rodwin, and Lawrence D. Brown. Getting The Price Right: How Some Countries Control Spending In A Fee-For-Service System. Health Affairs 2020 39:11, 1867-1874.
World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.
Page last updated Dec. 3, 2022 by Doug McVay, Editor.
