Doctors in the deserts, scalpels in the window: the decree that reminds us who benefits from medical time

According to Le Figaro, the government is preparing to limit doctors' cosmetic practice through a decree from the prime minister, expected this Friday. The daily adds that dermatologists, ophthalmologists and GPs are already too scarce, and that the text is upsetting practitioners. We know no more than that: the dispatch gives neither the precise content of the limits, nor their timetable, nor any figures. The rest is our reading.

You'd like to laugh, but the scene speaks for itself. To get an appointment with a dermatologist, you need patience, luck and sometimes a move. Meanwhile, some of those same skills are busy smoothing, plumping or rejuvenating those who can pay. Nobody chooses this out of malice: it is the plain arithmetic of a working day. An hour of a doctor's time can only be sold once, and it goes wherever it earns the most.

This is where the question of work becomes one of class. Medical time is a collective resource, trained at public expense, then thrown into competition with a private market that, for its part, has no deserts. The decree looks like an attempt to reallocate hours, and that is why it irritates: it touches the freedom to dispose of one's own time, a cardinal virtue when it belongs to the practitioner, much less so when it belongs to the patient waiting eight months.

Marxist tradition helps to see the set-up. The marketisation of public services turns a common good into private capital: here, years of training funded by the community become a cosmetic rent. And health falls under what is called social reproduction, the labour that produces people rather than commodities. When hands go missing, the work does not vanish: it falls back on families, overwhelmed emergency rooms, carers, very often women.

Let us be honest, though: curbing an activity has never created a single post. If we stop at a decree, we treat the symptom, not the cause. Medical deserts are the product of an organisation that tolerates scarcity as long as it costs the budgets too little, and where town GP fees lack the appeal of a cosmetic surgery quote. Prohibiting without paying, training or distributing doctors asks practitioners for virtue where the system rewards the opposite.

The Republic loves to proclaim that protection of health is guaranteed to all. It would be good to check that against the appointment calendar. What remains to be seen is what the text actually contains, and whether the government will dare to touch the logic that makes care hours an article like any other. Angry practitioners are not the only ones who need to be heard: patients on waiting lists should be too, even if they don't go on strike.