Guide to French Health System

11. Accident and Emergency Services

There are several ways in which medical services in an accident or emergency are provided.

11.1. SAMU

The main ambulance services in France are provided by the SAMU – Services d’Aide Médicale Urgente, which is part of the public hospital system.

The SAMU can be contacted by simply dialing the number 15. You can also ring the 'pompiers' on 18, or the European wide number for emergency services 112.

There are around 100 SAMU call centres in France each run by the local major hospital. Many of those manning the centres will themselves be doctors, or, at the least, trained medical staff.

Depending on the circumstances, they can organise transport to hospital, a home visit by a doctor or simply medical advice over the telephone.

SAMU operate the network of around 500 mobile emergency response teams called SMUR - Service Mobile d'Urgence et Réanimation. A SMUR vehicle will normally have a doctor on board.

Transport to hospital may otherwise be arranged either via a private ambulance service, through the fire and rescue service (sapeurs-pompiers).

Depending on the circumstances, the pompiers may be the first on the scene, who may decide to call in SMUR for emergency treatment.

Transport costs arising out of an emergency are fully covered by the social security system. If a private ambulance taxi is used, you may be asked to pay (at some point) and then later receive reimbursement. You can read more in our chapter Travel and Transport for Health Treatment.

If a doctor is needed, you may well be sent an on-duty local GP or a doctor from SOS Médicins a national emergency doctor service, although this service is less widely available in rural areas and the South West.

There is widespread concern in France about the excessive use of the SAMU in circumstances that prove not to be warranted.

In theory, if you call out the SAMU and it proves not to be a real emergency, the doctor or hospital receiving you may be unwilling to sign off your treatment certificate, as a result of which you will be expected to pay the costs.

In practice, this rarely happens but given the pressure on emergency services it is, nevertheless, important to consider carefully before making an emergency call.

11.2. Hospital A&E

You can present yourself (or more likely the person who is ill or injured!) directly to the local hospital by making your own way using your own transport.

Not all hospitals offer an accident and emergency service (urgences), so some familiarity with the services offered by your local hospital might avoid an abortive visit.

11.3. Maisons Médicales de Garde (MMG)

This is an out of hours medical service offered by health professionals in some parts of the country, although it is less common in rural areas.

The service guarantees the permanent availability of emergency health care 24/7, either through a general practitioner or other health professional. Some MMGs are only open until midnight.

Where there is no formal MMG in place, you may find that doctors within a locality operate a shift system for out-of-hours emergency cover. More often than not, however, you will need to ring the SAMU by dialing 15, who may then decide to contact a local MMG.

The cost of emergency treatment is reimbursable in the normal way, although the treatment costs are higher.

You will need to make local enquiries to establish if there is an MMG (or similar) in your area and the contact number. You may also ring SAMU who will have their number.

11.4. Family Doctor

You can always call your family doctor in an emergency, or, if you are unable to get access (either because you are not in the area or the surgery is closed), you are entitled to visit or call another doctor and receive treatment, which is fully reimbursable in the usual way.

Remember that in a ‘group practice’ anyone in the surgery is able to see you, even though your own doctor may be away.

The basic doctor’s or hospital fee for emergencies will range from about €42 up to €75 depending on the type of service and the time of day.

These fees exclude the cost of prescriptions or other medical treatment that may be needed.

The basic fee and any treatment or prescriptions received are reimbursable in the usual way.

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