- After the coronavirus health crisis, the government launched consultations at the end of May to reform the health system and upgrade caregivers, mobilized to ask for more resources for several years.
- This “Health Segur” has resulted in pay increases announced last week, and investments and measures presented on Tuesday.
- Among these announcements, the possibility of punctually creating 4,000 hospital beds in the event of a crisis, and an investment of six billion over five years for the sector.
- Defended by the majority as transformative measures, these proposals are received in a mixed way by professionals of the sector.
After the announcements on compensation, make way for new proposals for medicine. The Minister of Health Olivier Véran presented this Tuesday 33 measures, financial and organizational, to "accelerate the transformation of the system" of care, within the framework of the "Ségur" of health, named after the avenue of his ministry. These negotiations began on May 25, against the backdrop of the coronavirus crisis, but the anger of healthcare workers had been expressed long before. "We acted quickly and hard because it was necessary", pleaded the minister. 20 Minutes scrutinizes his plan.
What has the government announced?
A week after unveiling salary increases for hospital staff, for a total of 8.2 billion euros, the minister is this time tackling issues of governance, operation and investment. An envelope of 50 million euros per year will be created to finance the opening or reopening of 4,000 beds "on demand" in hospitals, in the event of "seasonal or epidemic overactivity". A change in logic after years of declining number of beds in France, which is now barely above 5,000. During the peak of the Covid-19 epidemic, around 9,000 additional beds were created.
Six billion euros will be invested over five years in the health system, to renew equipment, renovate buildings, and develop digital technology. A third of this envelope will be devoted to nursing homes.
Olivier Véran also wants to "accelerate the reduction of the share of T2A", the much criticized pricing per activity. This system, introduced in 2005, fixes the resources of hospitals according to the medical acts performed, pushing the race for volumes according to its detractors.
The medical interim is also in the crosshairs of the government, which wants to fight against "mercenarism" in the public hospital. There will be "no more payment beyond the regulatory ceiling" framing the remuneration of physicians carrying out short-term missions in the hospital, assured Olivier Véran.
Why are these measures a priority according to the majority?
These announcements should make it possible to "put people, resources and meaning back into our health system", Olivier Véran concluded. After years of mobilization among healthcare workers, regularly in the street, and the Covid-19 crisis, the executive could hardly leave hospital claims unanswered.
"It is a priority, we owe it to our caregivers and our fellow citizens who massively supported health personnel during the crisis," said Julien Borowczyk to 20 Minutes , deputy La République en Marche de la Loire. "We could not stop in the middle of the ford, salary increases are not enough, we must reform the functioning of the hospital," continues this professional doctor. This Ségur is "a real fundamental reform", he assures us, "as we had not had for 20, even 30 years".
The announcements made on Tuesday will, according to him, allow "to start again on a healthy basis". "We need a peaceful country, coming out of this crisis".
How were they received by professionals in the sector?
On the health staff side, the French Hospital Federation (FHF), which represents public hospitals, has rather favorably received Olivier Véran's proposals. Several measures were part of his demands, such as the abolition of Copermo, a national committee that decides on investments in the hospital, replaced by a national council including elected officials.
"We seem to be moving away from a purely accounting logic, both in the management of beds and in the management of establishments, the management of the men and women who make up the hospital, to move towards a much more pragmatic approach", rejoices Frédéric Valletoux, president of the FHF. The proposals are "likely to move the lines of a health system which today is crossed by many dysfunctions", but it nevertheless points to "two or three reasons for dissatisfaction", in particular on relieving congestion in emergencies.
"The measures announced this morning by @olivierveran are likely to finally move the lines of our #health system: trust in actors in the field, financial regulation through the relevance of medical acts, debureaucratization, reinforced cooperation ..." @franceinfo
- Frédéric Valletoux (@fredvalletoux) July 21, 2020More mixed, the co-founder of the Inter-Hospitals collective, André Grimaldi, estimated on France Info that “there is a structural problem” concerning the number of hospital beds.
On the union side, Unsa welcomed several announcements, but regrets the lack of measures to promote access to care. As for the CFE-CGC of the hospitals of Paris, requests more staff in order to materialize the creation of 4,000 additional beds.
With which nursing staff?
A team is not a sum of individuals, made up of temporary nurses and doctors who get to know each other in bed!
Strengthen the substitute teams but we need permanent beds that are not ephemeral! #Nosviesdabord https://t.co/OTrxEDzjTd
Government announcements must now be translated into regulatory or legislative texts. The reforms are not finished: a “Public health Segur” must begin in September, and the issue of overseas territories will be discussed later.
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