In September 2024, a patient under 26 can go to a laboratory for STI screening without a prescription, without paying a cent. This concrete change alters the way access to prevention is provided in France. The year 2024 has concentrated several reforms and adjustments that directly affect patients’ daily lives, from the cost of medical consultations to the new rights of nurses.
STI screening without a prescription for those under 26: what changes in practice
Since September 1, 2024, those under 26 can access HIV, chlamydia, gonorrhea, syphilis, and hepatitis B screening without a prescription. Coverage is 100% by Health Insurance, with no upfront costs. Patients can go directly to the laboratory, without going through a doctor.
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For those over 26, the situation is different. HIV screening remains fully covered at 100%, but the screening for the other four STIs is only reimbursed at 60%, with the remainder covered by supplementary health insurance. Checking supplementary coverage before getting tested avoids unpleasant surprises regarding out-of-pocket expenses.
This measure addresses a field observation: many young adults delayed screening because they first needed to get a medical appointment. Removing this step reduces the time between decision-making and sample collection. This type of measure is regularly reported in the news on Your Health Assistant, which gathers health developments in the French-speaking world throughout the year.
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General practitioner consultation at 30 euros: impact on out-of-pocket expenses
Since December 22, 2024, the reference consultation fee with a general practitioner has increased to 30 euros. For children under 6 years old, the fee rises to 35 euros. This increase has a direct effect on the amount of the co-payment for patients without supplementary insurance or with a low-reimbursement mutual insurance.
At the same time, teleconsultation remains set at 25 euros. The five-euro gap between in-person consultations and teleconsultations pushes some patients towards remote consultations, especially for prescription renewals or simple issues. Feedback on this point varies: some doctors report an increase in teleconsultation requests, while others do not observe any significant shift.
For patients with long-term illnesses (ALD), 100% coverage absorbs the increase. The change mainly impacts those consulting in sector 1 without mutual insurance, a population often precarious and already distanced from care.
Nursing skills reform in 2024: direct access and expanded prescription
The new decrees published in 2024 expand the scope of nursing interventions. Direct access, meaning the ability to consult a nurse without prior medical prescription, changes the care pathway for several common situations.
Specifically, this includes:
- Renewal of certain chronic treatments without going back to the doctor, reducing wait times in areas under-resourced in general practitioners
- Autonomous prescription of medical devices and certain preventive actions, allowing nurses to manage wounds, post-operative follow-ups, or preventive assessments
- Expansion of technical procedures that can be performed without supervision, enhancing the capacity of nursing practices to absorb part of the primary care demand
Direct access to nurses reduces care wait times in medical deserts. This reform does not replace medical consultations, but it creates a faster initial response level for actions that do not require complex diagnosis.
What this changes for patients in rural areas
In regions where the average wait time for an appointment with a general practitioner exceeds several weeks, this reform provides an immediate alternative. A nurse can renew antihypertensive treatment or manage a chronic wound without the patient waiting for a medical slot.
Prevention and mental health: public health priorities in 2024
Mental health remains a priority work area for public health authorities in France. Initiatives like MonParcoursPsy, launched before 2024, continue to evolve, but the field observation persists: the wait times for reimbursed psychologists remain long in most departments.
On the prevention side, Public Health France continues its campaigns on major modifiable risk factors:
- Reducing alcohol consumption, with Dry January as a popular entry point each year
- Quitting smoking, through the tools of Tobacco Info Service (app, hotline, chat coaching)
- Nutrition and physical activity, supported by the Manger Bouger program and its updated recommendations
In terms of sports and well-being, prescriptions for adapted physical activity (APA) are developing, especially for patients with chronic diseases like diabetes or obesity. The attending physician can refer to a trained sports educator, with partial coverage depending on the insurance funds.
Heatwaves and adaptation of the healthcare system
Repeated heatwave episodes require healthcare facilities to adapt their organization. Water distribution, adjustment of consultation hours, increased monitoring of isolated elderly individuals: these measures have now become part of the summer routine rather than exceptions.
Anticipating heatwaves is an integral part of health prevention just like vaccination or screening. Departmental heatwave plans are activated earlier each year, a sign of the healthcare system’s gradual adaptation.
The year 2024 will primarily mark a shift towards simplifying access to care: screening without a prescription, expanded nursing skills, teleconsultation maintained at a lower rate. These adjustments do not solve the shortage of healthcare providers, but they reduce administrative friction between the patient and care.