Health, the top concern for French voters in the March 15 and 22 municipal elections, reignites debates on sanitary decentralization. In a Le Monde op-ed, sociologists Daniel Benamouzig and physician Franck Chauvin highlight the strengthening of local levels, especially municipal, amid strains on the health system.
In an op-ed in Le Monde, sociologist Daniel Benamouzig and physician Franck Chauvin examine recent developments in French public health policy. They observe that, despite the Prime Minister's promotion of the France Santé label to improve access to care and the bolstering of departmental roles, the departmental level has not proven effective, particularly in areas like aging or maternal and child protection.
Meanwhile, territorial authorities such as metropolises, intercommunalities, and communes are showing growing interest in their populations' health and are already taking action. This trend occurs amid ongoing budget constraints and democratic fragility, with unstable majorities, rapid turnover of Health Ministers, and a lack of coherent structuring legislation.
Since the Covid-19 crisis, local authorities have been called upon to provide concrete responses to care access challenges, signaling a shift in democratic expectations toward mayors rather than distant central administrations. The authors emphasize local authorities' ability to promote health 'in all policies,' in line with the World Health Organization's approach. This focuses on health determinants like housing, transport, urban planning, access to green spaces, and physical activities, which largely fall under local competencies beyond the national responsibility for care.
