2023-08-17 05:08:04
From the Channel to the Mediterranean, the observation is the same everywhere: the hospital crisis has not disappeared this summer, it has worsened. And temporary solutions, like regulating access to the emergency room, only expose other problems of a strained health system.
She was on the front page of all the newspapers last year: the hospital crisis. Lack of staff, bed closures, regulation of emergencies, operation in degraded mode… These problems have not disappeared in twelve months, they have worsened. “This summer is characterized more by a lack of hospital practitioners. It is difficult to fill the duty rosters”notes Frédérick Marie, the director of two Norman hospitals in Saint-Lô and Coutance.
>> TESTIMONY. “We can’t do miracles”: a hospital director confides his difficulties at the dawn of a new difficult summer
According to Frédérick Marie, the RIST law has a lot to do with these difficulties. Since April, this law has governed the salary of temporary doctors, now capped at 1,390 euros gross per 24-hour call. If the health establishments agree that it was necessary, everyone can see how much difficulty it has generated, in the emergency room, in the anesthesia departments, in surgery… with sometimes up to 30% loss. fewer temporary workers to fill the duty rosters and take over from incumbents on leave. “We still have temporary workers who responded, but to a lesser extent than in other yearsrecognizes the Norman director. Concretely, in Saint-Lô, that represents around twenty fewer medical beds, and another twenty fewer beds, for surgery this time, less compared to the same period in other years.
Call 15 before going to the emergency room, a solution… provided there are enough people to answer
Faced with problems at the hospital, in addition to bed closures, the Normandy Regional Health Agency has begun to regulate the influx of patients. Since the beginning of July, there has been no free access to the emergency room: the only way to access it is to dial 15, a measure implemented throughout the Manche department. Inevitably, at Samu 50, the calls explode. “Over the year 2022, on August 6, we were at 1,100 calls over one day and there, currently, we are at 1,500 calls”notes Antoine Hubert, executive at Samu de la Manche.
“Of these calls, 500 or 600 go out to the different partners, the different establishments, to find out if they can take charge of this or that victimhe continues. The idea is that they take care of patients who may not necessarily need to come to the emergency room, but rather to go see a treating doctor.”
“The phone rings all day, sometimes the assistants don’t even take a break, because they do their best to keep response times from getting longer.”
Antoine Hubert, executive at Samu 50at franceinfo
In France, there are 2,500 medical regulation assistants throughout the territory who answer when you call 15. But with an increase in the number of calls compared to the summer of 2022, tensions are appearing, especially in tourist areas: Brittany, Atlantic coast, Mediterranean… According to the French Association of Medical Regulation Assistants, it would be necessary “800 additional positions to work in more humane conditions”. A strike is ARM is also underway in 69 Samu out of 100. The negotiations started before the summer, while François Braun was still Minister of Health, for the revaluation of the salaries of the ARM failed. Afarm is now waiting for a gesture from his successor, Aurélien Rousseau.
Send patients back to city medicine, which is also saturated
Filtering patients to send them to liberal doctors to allow emergencies to treat only emergencies is a complicated solution, when we know that many of them are not replaced in the summer.
>> REPORT. “For emergencies, dial 15”: Barneville-Carteret, 15,000 inhabitants in the summer, will spend the month of August without a doctor
Just back from vacation, Doctor Fréderic Paing will take care of the Saint-Lô hospital tomorrow, Tuesday August 15, in addition to the patients he sees parading all day in his office. “Patients who should be hospitalized are no longer hospitalized or come out more quickly, which multiplies the consultations for us”he observes.
“We are overstretched, the hospital too. Sometimes, unfortunately, we have the impression that everyone is sending patients back to each other and we are sinking. It’s getting worse and worse.”
Dr. Frédéric Paing, general practitioner in the Manche departmentat franceinfo
“A lot of GPs are running out. Some are going to quit. It’s getting too difficult for those who staynotes Dr. Paing. We lack human resources, we lack material resources, beds. We really need to increase the number of caregivers.”
Health Minister Aurélien Rousseau says he is not satisfied with this situation. But training health professionals takes time, and making the profession more attractive requires money. Announcements on the revaluation of night and weekend guards are expected soon. In the meantime, if the public hospital continues to hold out, all caregivers are wondering until when. A new epidemic, an upsurge in cases of Covid-19, the flu or even bronchiolitis, and the whole health system is in danger of wavering, once more.
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