- This Tuesday, 1,101 chiefs signed a collective resignation letter to challenge the government on the deep crisis which affects the public hospital.
- In Parisian and Ile-de-France hospitals, the lack of staff and the closing of beds are common.
- A situation which sometimes "does not ensure the quality and safety of care", denounce the practitioners.
Out of breath hospitals, caregivers at the end of their tether and patients who were sometimes at the end of their nerves. Here is the diagnosis posed by the Interhospitals Collective (CIH), while "1,101 heads of hospital departments of all specialties, doctors, surgeons, psychiatrists, university and non-university hospitals have decided to officially present a threat of resignation of all their administrative functions ", to" save the public hospital "in a state of" decay ". A cry of alarm to denounce the lack of human and financial resources which plunged the public hospital into a deep crisis. Their goal: to be heard by the Minister of Health Agnès Buzyn, while many public hospitals have been on strike for more than ten months today.
"The quality and safety of care are not guaranteed"
If the discontent is national, the Public Assistance - Hospitals of Paris (AP-HP) is also on the bone, including in its major hospitals in the capital. “The implementation of activity pricing has done a lot of harm. Concretely, at the Salpêtrière, there are a hundred beds closed for lack of staff, and always patients waiting for stretchers in the emergency room, describes Professor Agnès Hartemann, head of the diabetes department of Pitié-Salpêtrière in Paris who has just resigned. To compensate for the understaffing, there are several hundred requests for temporary workers each month. Currently, there are units where there is no staff, resuscitation services with closed beds, because we cannot run resuscitation services with temporary staff who do not have the skills required, she continues. In my department, when I learn that there is only one temporary nurse for thirteen very heavy patients, with all the serious complications that diabetes can cause, I no longer bring in new patients, because in this case, the quality and safety of care is not guaranteed ”.
The cause of this berezina? "The profitability objective, which has contributed to the collapse of staff working conditions: they have been asked to do more with less, less and less people, flexible hours. All of this pushed the nurses to leave: it was no longer tenable for them, ”she says. And the observation is the same everywhere, including in pediatric services, yet supposed to be better off. "All the specialties of the public hospital are affected by this deep crisis, by this financial development, especially for the past three years, plants Professor Stéphane Dauger, head of the pediatric resuscitation service at Robert Debré hospital in Paris , also resigned. Pediatric resuscitation, which is extremely protected by decree to provide it with the necessary staff, was disrupted this year in Île de France during the bronchiolitis epidemic: for the very first time in our history, 25 infants had to be transferred to more than 200 km from Paris, when we now know thanks to figures from the French Institute for Public Health Surveillance that the epidemic was less severe than that of the previous three years. For thirty years, we only had to transfer two to three infants each year. Everything is said: even a very protected service arrived in a situation where it could no longer meet the needs of the population of Ile-de-France. All this for what ? Because beds are closed, because nurses no longer want to work in such degraded conditions, because they are removed from their service to reassign them elsewhere without asking their opinion, because they are not replaced during their maternity leave, because caregivers are not respected. To the financial devaluation of these personnel is added a discredit that I had never seen before in the past three years: we take people for pawns ”.
"We refuse to be accomplices of this institutionalized underfunding"
For these two department heads of the AP-HP, resigning is a heartbreak, but also a necessity. “It's terrible, being a department head is a journey, a vocation in public service. These are projects that we carry out, a confidence that we have from staff, our peers and colleagues, insists Professor Hartemann. With this gesture, I lose part of my mission: the link with the administration is an end which we hope will have a follow-up, otherwise, we are desperate, "comments the diabetologist, who hopes that Agnes Buzyn, "who has worked in the hospital and knows perfectly well the serious and profound problems that we denounce, will hear us. Because for the moment, faced with the silence that she opposes us when we tell her about the suffering of the hospital, we do not understand it ”.
In practice, “my task as head of department represents one to two hours of additional work per day, for zero cents and zero recognition, explains Pr Dauger. It is a heavy burden, and this resignation is to show the administration that we can do no more. We refuse to be accomplices of this underfunding institutionalized by the new financing plan of Social Security and Ondam [the tool intended to control the expenses of the health insurance] decided by this government. So, these two hours of free time, I will devote to care, research and teaching, but we will no longer participate in any meeting whose sole theme is financial or economic.
600 million euros more and a Grenelle of the public hospital
"In Paris, the situation is cataclysmic, the cost of living is extremely high," says Professor Dauger. We come to a complete demobilization of personnel, who are physically and mentally exhausted. We have passed the breaking point ”. To stem the crisis, the CIH requests at least an additional 600 million euros per year, as well as "a revaluation of the lowest salaries in the hospital public service," says Professor Dauger. The salary of nurses in French public hospitals is the 28th of the 32 OECD countries. Thousands of positions are vacant because the public hospital has lost its attractiveness. ”
The CIH also requests the revaluation of Ondam. The heads of departments who have resigned also call for "restructuring the governance of the hospital". "We no longer want to have an all-powerful director, insists Professor Dauger, but put users, paramedics and doctors at the heart of decision-making: everyone must govern the hospital". For the resigning head of service, "without all of this, the French public hospital, which fell from first place in the world in 2000 to seventh place in 2015 - with its cost-effectiveness - will continue to deteriorate".
Health
Health: Thousands of department heads threaten to resign from hospitals to denounce lack of resources
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Hospitals: Parents in turn alert to the pediatric resuscitation crisis
- Agnes Buzyn
- Emergencies
- Resignation
- Paris
- Hospital
- Health