Out-of-hours emergencies: Monaco introduces on-call home visits from 1 October
The on-call vehicle was handed over on 30 September © Monaco Tribune
The handover ceremony for the medical on-call vehicle took place on Tuesday 30 September, in front of the Ministry of State, with Minister of State Christophe Mirmand in attendance.
The “Médecins de Garde Monaco” (Monaco on-call doctors) service will be officially operational from October 1, 2025. The medical service will be available to residents and Monegasques from 7 p.m. to 7 a.m., compared with 10 p.m. previously. This is a major advance, driven by the Prince’s Government and welcomed by Christophe Robino, Minister for Health and Social Affairs, who was present at the handover ceremony.
A concrete response to residents’ needs
“This is a very important moment for me, because I am still committed to my medical values,” said Christophe Robino at the press briefing after the ceremony. “Expanding the Principality’s healthcare offering and providing increasingly effective care for its residents is a key objective, in my view.” The Minister thanked the Prince’s Government for supporting the introduction of the scheme, as it addresses a persistent demand from the Monegasque population. The keys to the on-call vehicle were officially handed over by the donor, Jean-Marc Proceddu, to Dr Mélanie Macchi, the first doctor to be on duty from Tuesday 1 October.
A service designed to make life easier
The initiative was prompted by the observations of Dr Mélanie Macchi, an emergency doctor, who could see the difficulties faced by patients to come to A&E at night: “Young mothers with several children who can’t leave one to take the other to hospital, elderly people who are forced to come by ambulance for lack of an alternative, or situations that aren’t strictly hospital emergencies,” she explained.
The service will also relieve pressure on the CHPG’s emergency departments and will assist the Police Department, particularly when assessing custody, avoiding the need to involve police and hospital staff for situations that can now be handled differently. “It will be possible to have access to a doctor within an extremely reasonable time which, when you look at neighbouring countries or regions, I would almost say is a luxury,” said Christophe Robino. The Minister hailed “real progress on a number of fronts,” stressing that the new service will increase the care offering while relieving congestion in emergency departments, which regularly deal with patients who could be treated at home.
A well-oiled machine with 15 to 20 doctors on call
It works simply and effectively: one doctor is on call every night, while a second can be reached if necessary. Between 15 and 20 doctors, practising in Monaco and neighbouring France, are taking part in the scheme, each working around two shifts a month. The vehicle is equipped with a connected electrocardiogram, whose data can be sent directly to the cardiothoracic centre for interpretation if a heart issue is suspected. The doctors are accommodated in the IM2S premises, where they also collect their equipment: tablet, telephone and vehicle.
“With over 80 doctors working in Monaco, compared with around 50 at the end of 2022, we have considerably increased the range of care on offer,” said Christophe Robino. “This out-of hours on-call service completes the offering, giving residents access to a doctor 24 hours a day.”
At the press conference, Alexandre Bordero, Director of Health Action, underlined the considerable administrative work carried out by the DASA to coordinate the scheme as it involves Monegasque and French doctors, and attendant negotiations with the social security funds in both countries. The service relies on close cooperation between several players: the Monaco Fire Brigade receives and tracks calls, the CHPG provides medical resources, the Cardiothoracic Centre analyses electrocardiograms in real time and the IM2S handles logistics.
Practical Info
- Emergency numbers: 116 117
- This European number automatically redirects the call to the Monaco Fire Service, who record the call and pass it on to the doctor on duty.
- Operating times: 7pm – 7am, 7 days a week
- Area covered: Monaco
- Cost: The professionals’ on-call payments are financed by the social security funds, consultations are billed in line with conventional rates with a commitment from doctors not to exceed double that rate for carte bulle patients.