Paris (AFP)

Minimize the emergency room for seniors, improve bed management ... The first series of measures unveiled Monday by the Minister of Health Agnès Buzyn aims to relieve emergency services, affected by a strike movement from near six months.

Why are emergencies "overheating"?

Started in mid-March after a series of attacks, the emergency strike spread to half of the public sector services - 239 according to the Inter-Emergency group which is behind it, 195 according to the Ministry of Health. the health

The staff denounce degraded working conditions and insufficient means.

In twenty years, attendance at emergencies has more than doubled, with 21.4 million passages recorded in 2017. At the same time, upstream, the lack of liberal doctors in the city has increased in some territories. Downstream, some 100,000 beds were removed in hospitals, limiting the number of places available to accommodate patients.

As a result, some people sometimes wait for hours or even days on stretchers, which "shock" the French, according to Ms. Buzyn.

What solutions for the elderly?

This will first pass through a generalization "direct admission channels" allowing seniors to be hospitalized in a medical service without going through emergencies, especially following an agreement between the attending physician or the coordinating physician an Ehpad (nursing home) and the hospital doctor.

"A financial incentive, a form of bonus" will be granted next year to "hospitals will (they) put in place," according to Ms. Buzyn.

Another measure is the development of "video-assistance between the Ehpad and the (regulator of) Samu", to avoid hospitalizations in the event of "benign pathologies", for example via telemedicine suitcases equipped to transmit in real time pictures of wound or burn for example.

What role for liberal medicine?

The Samu will be allowed to send an ambulance to a city office or a health home, where it will be possible to practice some biology exams.

To fight against the financial difficulties of access to the care, the third-paying (exemption of advance of expenses) will be put in place for the acts carried out during the guards (the night, the week-ends and holidays) of the doctors of city, on the part of the costs borne by social security.

And for the nurses?

In order to streamline emergency room visits, nurses will have the right to "do things they can not do today," such as "prescribe x-ray (or) suturing," which will allow them to "cooperation bonus" of 80 euros net per month, according to the minister.

In the longer term, the new profession of advanced practice nurse, with expanded skills, will be extended to the specialty "emergencies", with first training from autumn 2020, and first graduates in 2022.

The minister also wants an extension of computerized real-time management of hospital beds, or "bed management", to all hospitals, a profession imported from Anglo-Saxon countries, accessible to nurses and other paramedics "in order to optimize the empty beds that exist today in the "regional hospital groups.

What do the strikers think?

"It's heated up and it does not respond to the urgency of the situation," said emergency physician and vegetarian Christophe Prudhomme, citing bed managers, who wanted to develop the previous government.

The same goes for Hugo Huon, the president of the collective Inter-Emergency, who sees nothing "innovative" and deplores the lack of beds and staff, the heart of the demands of the strikers.

Asked about possible job creation, the minister replied that they would depend on the needs and would be "in the right place", not necessarily emergency but, for example, in the downstream services.

Supported Monday by several organizations of doctors and emergency doctors, the Inter-Emergency organizes a general meeting on September 10 in Saint-Denis, the day after new announcements by Agnès Buzyn and on the eve of a mobilization decided by the CGT.

© 2019 AFP