“We have an imminent risk of disruptions in access to care”, confirms Thursday, May 19 on franceinfo Rémi Salomon, president of the conference of presidents of the medical committees for the creation of the CHU, while the public hospital is on the verge of explosion due to a lack of nursing staff like in Bordeaux, where patients are organized by volunteers† “There is a lack of beds. There is a lack of nurses to operate the operating rooms. There is a lack of emergency physicians to direct the emergency services”warns Rémi Salomon for whom the job is no longer attractive.
franceinfo: How’s the French hospital going?
Remi Solomon: It’s not new. We’ve been saying for a long time that we were having trouble in the hospital. There is a lot of talk these days about emergency services. In many places, the pregnancies have great difficulties. There is an imminent risk of disruptions in access to care. When I say that there is an imminent risk, it is already happening and will probably worsen significantly in the summer, that is, during the holidays.
Is the situation worse than two years ago when Covid-19 arrived?
Yes. This is what is paradoxical because we have seen how much the hospital and the whole health system had played their part during this Covid-19 crisis, which was still something. It was incredible to see how all these health workers in the city, in the hospital, mobilized and gave all their energy to cope with the significant influx of patients. We knew how to do it, we organised. It’s an exciting job that I love. All the caregivers I meet love this job and we are quite committed. We are willing to give a lot, but dedication has limits.
At the time of the Covid-19 crisis, all French people saw how important the hospital was. We said “whatever it takes”, it must work. We put a lot of money into it to make up for all the delay. We have made up for some of the delay. The delay, it’s been twenty years since we take it. When the hospital budget is set, mainly on financial criteria, because there is government spending, there is a small deficit every time. And so, over time, there is indeed a shortage of nurses because the working conditions and salaries are not adequate.
How many jobs are currently missing in hospitals?
Probably tens of thousands. In every hospital there are beds that are closed due to staff shortages. And so there are 10%, 15%, 20%, sometimes more beds closed due to lack of staff. It may be slightly more important in Île-de-France, as there is an issue with the cost of living for paramedics. It is more expensive in Île-de-France and therefore the salaries are not in line with the cost of living. But everywhere there are no beds. There is a lack of nurses to run the operating rooms. There is a lack of emergency doctors to direct the emergency services.
Are they carers who have left the profession or are they recruitment problems?
It’s both. What I am very much afraid of right now and what I am observing is a kind of detachment. I told you about dedication. There is exhaustion and lack of recognition. So after a while people say, ‘I’d rather keep myself, my family life, my personal life. I can’t keep exhausting myself like this. It is an exciting but demanding job. There are strong restrictions: night work, weekend work. And if, for example, you are called back on leave because you have to fill in the waiting list, that is very restrictive. One night, for a nurse, it’s an extra euro per hour, it’s 10 euro more per night. It is ridiculous ! Mandatory remuneration is not sufficiently compensated. This is the first step that the next Minister of Health must take.
Should all salaries go up?
I don’t think it’s necessary to raise all wages right away. There have already been revaluations, even if they are not sufficient. What urgently needs to be done is coercion. Pay the restriction. Nights, weekends, holidays. It is really necessary. And to do that in a meaningful way. But it’s not just that, there will be many other things to do.
Can carers take leave?
In some places it will be necessary to shorten the holidays. Holidays will probably have to be shortened to fill in the availability schedules. Emergencies testify to the dysfunction of the entire health system. We talked about the hospital, but it’s not just the hospital. It is also upstream, ie the so-called unplanned care, which is mainly covered by city medicine, but also by the hospital when city medicine can no longer cover it. There are many places where urban medicine is struggling. There are not enough doctors. There are medical deserts and people go to the hospital at that time. To ensure continuity of care, all care providers in the city and in the hospital must participate.
Can you imagine caregivers refusing to shorten their vacation?
The situation obliges us. It is hard to imagine that in a country like France there are places where there is no longer access to health care. I think there will be a necessary arrangement. I, I have enough faith in the responsibility of people, of everyone, in the hospital, in the city to join in and avoid being left without carers in August.