Joël Hocquelet, the mayor of Marmande in the Lot-et-Garonne department of southwestern France, has issued a symbolic municipal decree prohibiting residents from falling ill within his town.
The mayor, a medical doctor by profession, took the voluntarily absurd step to raise alarm over the critical condition of the Marmande-Tonneins Intercommunal Hospital Centre, which faces severe operational disruptions and healthcare staffing shortages.
Hocquelet explained that while local authorities cannot prevent citizens from becoming sick, officials cannot accept that residents are forced to travel tens of kilometres to access medical treatment. He described the municipal decree as a joke, but emphasized that the situation facing the hospital was not.
The Marmande-Tonneins Intercommunal Hospital Centre sits at the heart of a medical desert serving 110,000 residents and has suffered severe instability for several years. In January 2026, France's Regional Health Agency placed the facility under provisional administration after allocating several million euros in financial assistance to support its operations.
Marmande is a commune in the Lot-et-Garonne department within the Nouvelle-Aquitaine region of southwestern France. In rural departments where healthcare access has become a critical concern, local hospital facilities and emergency departments serve as the primary safety net for the population.
Municipal motion and emergency room closures
Local anxiety has intensified following a French government circular issued on July 29, 2026, regarding Territorial Hospital Groups. Hocquelet noted that the directive outlines new resource pooling and organizational restructuring, with an evaluation set for autumn 2026 followed by an action plan in early 2027.
On September 28, 2026, the Marmande municipal council unanimously voted to adopt a motion defending the local hospital and regional access to care. While acknowledging that sharing resources can consolidate medical teams, elected leaders warned against the progressive concentration of clinical activities onto fewer hospital sites.
The council motion specifically demands the preservation of the medical analysis laboratory at the Marmande-Tonneins hospital and the maintenance of operational emergency services 24 hours a day, seven days a week. Elected officials cited the temporary shutdown of emergency services during the night of September 9 to September 10, 2026, caused by a lack of an emergency doctor, as a strong warning signal.
Hocquelet stated that any reduction in local healthcare availability was unacceptable, maintaining that health equality must include territorial equality so that a postcode never determines a person's medical outcomes.
Regional mayor pushback and postcard campaign
Concerns over emergency services are shared across the department. At the Lot-et-Garonne Mayors' Congress on September 18, 2026, Guillaume Lepers, president of the Lot-et-Garonne Mayors' Association, voiced strong protest over the emergency room crisis.
Lepers noted that developments considered unacceptable a year ago were now becoming routine social media notices announcing temporary emergency closures, warning that becoming accustomed to shutdowns amounted to condoning them. Lepers has requested a formal meeting with Health Minister Stéphanie Rist.
During the September 18 congress, departmental leaders launched an initiative calling on local officials to mail postcards to Health Minister Rist bearing the message that health must not depend on where a person lives.
Health Minister Rist is set to receive further appeals from the region. Hocquelet, acting as president of the Val de Garonne Agglomération intercommunal body, is expanding the campaign to neighboring municipalities by encouraging local mayors to pass similar motions and by launching a resident petition to be delivered to the health minister.
