In October 2021, 2% of additional beds were closed in public and private hospitals compared to 2019, according to a survey by the Ministry of Health. For its part, the Hospital Federation of France evokes a number of 6% and the Scientific Council, for its part, has 20% but only in the public. A war of numbers that “drown the real reality”, according to François Salachas. The neurologist at La Pitié-Salpêtrière and member of the Inter-Hospitals Collective indeed denounced on franceinfo Thursday, December 16 a crisis “major of recruitment” in the hospital, and asked that the “services” can take care of it, instead of directions.
franceinfo: Do the figures on the number of closed hospital beds correspond to the reality on the ground?
Francois Salachas : No, but I think it’s really a communications company. In fact, these numbers drown out the real reality. What is the point, in the context of a health crisis like that of the Covid, and while a lot of deprogramming is underway, to integrate the private sector into the account of closed beds? It does not make sense with regard to the health care offer, because that is what it is all about. Is the supply of care currently extremely degraded at the public hospital? Yes. Are there any losses of opportunity? Yes. Are doctors, especially at AP-HP, aware of this? Yes. And I want as proof the letter to the President of the Republic, which appeared a fortnight ago and which was signed by 67% of the academics of the AP-HP and a large majority of hospital practitioners. Clearly, everyone has realized that urgent measures are needed, which are effective in the coming month, to fight against the recruitment crisis which is major. The departure figures are impressive. As for the question of knowing whether the hospital directors have an interest in lowering or increasing the figures, I think it is clear to everyone: they have an interest in lowering them.
How should the hospital recruitment system be rethought?
What we have in mind is to obtain emergency measures which would ensure that, in the end, the recruitment is carried out by the services. When I say services, I mean department head, nursing manager, senior nursing manager. And that it is they who define the job descriptions, the workload, that is to say the ratios in relation to the staff, in relation to the open beds and who also define the schedules. Because what is clear is that a whole generation of caregivers has been disgusted by continuing to work in the public hospital. It is an observation of a bankruptcy of resource management at the public hospital. In other words, it is no longer up to nursing directors, hospital directors, to decide who to hire and where to put staff. It has to be done at the service level. For a very simple reason, it is that the nursing staff no longer have any confidence in the institutions. And there, there is urgency.
The measures taken by the Ségur de la santé, in particular salary increases, have they not made it possible to curb this phenomenon?
Everyone makes this observation. I think even Olivier Véran could do it. We are now in the fourth Ségur. And it’s weird, because every time, every plan doesn’t work. Let’s ask ourselves the right questions. What will be the operational measures to find staff at the public hospital? And this opinion is widely shared by the entire hospital medical and paramedical community.