Strasbourg (AFP)

"It is the economy that will run the hospital": after having the feeling of finding "meaning" in their work during the coronavirus crisis, caregivers in the Grand Est now fear the return in force of "managers" , whom they accuse of "destroying" the public hospital.

It was March 25 at the Mulhouse hospital: Emmanuel Macron, visiting this Alsatian establishment at the forefront of the epidemic, promised for the post-crisis period a "massive investment and upgrading plan" for careers for the hospital.

An advertisement then greeted with skepticism by caregivers who came out of long months of strike to protest against years of budget cuts in hospitals. The mobilization had prompted the government to announce several measures, all deemed insufficient by the white coats.

A month and a half later, when the details of this plan have not been revealed and the epidemic begins its slow decline, the caregivers of Grand Est, one of the regions most affected by Covid-19, say without illusions.

The resources claimed for years for hospitals "will not be released" after the crisis, "we will return to an exacerbated budgetary austerity because the economy will take a few years to recover", predicts Eric Thibaud, head of the service emergency at the Colmar hospital.

"What we would expect is for the government to give active support after the crisis. For the moment, it is clapping at its window," he quipped.

- "Find meaning" -

Before the epidemic, many agents wanted to leave the hospital in Mulhouse, recalls a union source, who laments: "It's been a long time since we destroyed the public hospital, it takes a health crisis to realize its importance" .

Salaries must be upgraded "over the long term" and, above all, put an end to the "abolition of beds and positions", recurrent in public hospitals, which are always asking for more savings, says Alexis Lienhardt, emergency nurse and in intensive care at the Strasbourg University Hospital.

The virulence of the epidemic, which has strained hospital structures, "has demonstrated the limits of the (...) health system as it has been wanted for the past fifteen years", with savings "which are in the billions, "also notes Yannick Gottwalles, head of the Emergency Department at Colmar.

But the crisis has also made it possible to "rediscover meaning in care" and to temporarily regain control of the operation of the hospital, in particular by urgently piloting the restructuring of services, in order to accommodate the many Covid patients.

"The doctors had really been excluded from the decisions, there they regained the upper hand a little," analyzes Sophie Perrin-Phan-Dinh, nurse and CGT representative at the Nancy University Hospital.

- "Sticking plasters" -

But once the crisis is over, "I fear that we will put sticking plasters on very serious issues", worries Dr. Gottwalles.

When the "hero" caregivers are forgotten, "I fear that the managers will take up the torch and continue their measures of budgetary restrictions", abounds Alexis Lienhardt.

A symbol of these much-maligned "managers", the Regional Health Agencies (ARS) - public bodies responsible for applying health policies in the regions - concentrate criticism.

In the Great East, the ARS made headlines in April when its director general, Christophe Lannelongue, declared, in the midst of a health crisis, that he saw no reason to question the restructuring underway at the Nancy hospital where 598 jobs and 174 beds are to be cut.

Mr. Lannelongue was dismissed following these comments. He was replaced by Marie-Ange Desailly-Chanson.

"He just repeated what the government has said for years, that the hospital must be profitable," points Sophie Perrin-Phan-Dinh.

"We cannot speak of savings in a job like this!" Indignantly, on condition of anonymity, an intern at the Mulhouse hospital, for whom it must be accepted that the hospital is "not profitable" .

"The vision of the ARS is that they are there to verify how we do our work" when its role should be "to accompany" the hospitals and "to make it work", explains a source hospital, which deplores this "purely financial" vision.

Requested by AFP, the ARS Grand Est did not immediately react to these criticisms.

© 2020 AFP