2023-04-17 04:00:12
The law is now officially applied, so what? Two weeks after the entry into force of the salary cap for medical interims, known as the Rist law – at 1,390 euros for a twenty-four hour guard – it is still difficult to measure the effects.
At the origin of the standoff led by the government, there was the desire to control the prices of these doctors who come to compensate for the lack of hospitals. And the « drifts » some, to use the expression of the Minister of Health, François Braun, who, to listen to him, were selling at a high price, taking advantage of the shortage and the law of the market. Some of those concerned, who refuse to be treated as “mercenaries”brandished the threat of slowing down, to remind us that the system cannot run without them.
By deciding to apply, on April 3, a law inherited from his predecessors (the principle of capping dates back to 2016, that of its control to 2021), the Minister made two commitments: to avoid “dry closures” of services and leave no patient « sans solution » of care.
Since then, the ministry has made a “daily point” with the regional health agencies (ARS) to identify the sites and/or hospital departments where, due to a lack of sufficient doctors, the pressure is mounting. At this stage, about ten have been identified. According to the National Union of Hospital Replacement Physicians (SNMRH), this figure must be at least multiplied by five.
A “regulatory” remedy
The list changes daily, without any clearly established mapping. To the chagrin of health actors who demand clarity: “We need a real, independent impact study of the effects of this law”, says Anne Geffroy-Wernet, president of the National Union of Expanded Anaesthesiologists-Resuscitators Hospital Practitioners.
From Sarlat (Dordogne) to Bastia, from Sedan (Ardennes) to Feurs (Loire) via Aubenas (Ardèche), Epinal or Bourges, the regional press echoes the tensions and dysfunctions it can spot. Often in local hospitals or maternity wards, even if larger hospitals are not spared. Often, too, in departments which, because they are on the job 24 hours a day (emergencies, anesthesia, obstetrics, follow-up care, etc.), need reinforcements to run full. Saturday April 15, in Vittel (Vosges), hundreds of people, including several elected officials, demonstrated against the closure of emergencies at night and on weekends, since the beginning of the month.
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