TRUE OR FALSE. Are 65 healthcare professionals victims of violence every day, as Agnès Firmin-Le Bodo assures?

In Franceinfo’s 8:30 a.m., Minister for Health Professions Agnès Firmin-Le Bodo estimated that 65 professionals were victims of violence every day in health establishments in France. A figure to support.

“Unfortunately, we wish we didn’t have to deal with this subject but it is a fact”, regretted Agnès Firmin-Le Bodo in the 8:30 a.m. of Franceinfo, Wednesday December 13. The Minister for Health Professions will launch an awareness campaign on violence targeting health professionals on December 19. On franceinfo, she gave in a few words an estimate of the number of caregivers attacked every day in France: “Too many professionals, 65 per day, suffer violence”, did she say. True or false ?

64 victims, all professions combined, in health establishments in 2022

That’s pretty true. Contacted by franceinfo, the services of Agnès Firmin-Le Bodo explain having found this figure by dividing the number of professionals victims of violence within health establishments by the number of days in a year, based on the latest figures from the National Observatory of Violence in Health Environments (ONVS) included in the plan for the safety of health professionals presented by the minister last September. According to him, in 2022, around 23,500 professionals declared having been victims of violence in health establishments, or 64 victims per day, approximately what the Minister for Health Professions says.

However, this figure does not only include caregivers, it also includes administrative staff. It is not yet possible to know detailed figures by type of profession for the year 2022, because the ONVS has not yet published its detailed annual report.

On the other hand, the latest report published by the ONVS allows us to know these details for the year 2021. That year, there were approximately 24,500 personnel victims of personal attacks in health establishments, including 22,800 caregivers. , or 62 caregiver victims per day. In comparison, there were four administrative staff victims per day in the same year. We must add to these 24,500, other victims: patients (2,400), security agents (1,200) and visitors (220). In total, all categories combined, attacks on people caused nearly 30,000 victims in 2021 in healthcare settings.

Nurses, the profession most targeted by violence

We note that there are fewer reports than victims of personal attacks, because there are sometimes several victims for the same act. Thus, 17,700 reports of attacks on people were made in 2021, or 48 reports per day. Likewise, some reports concern several types of attacks.

In 2021, almost half of the reports concerned fairly serious acts with physical violence (8,300 cases) or violence with weapons (500 cases). Insults came in second place with 5,700 reported cases, then threats in third place with 3,200 reported cases. The attackers often accompany their violence with reproaches about medical care, a possible refusal of care or even a waiting time considered excessive.

The sectors most affected by attacks on people are psychiatry, emergencies, nursing homes and medical practices. Almost half of the victims were nurses in 2021. Doctors represented 8% of the victims. The rest, also almost half, brings together several medical or paramedical professions. Three-quarters of caregiver victims are women, while two-thirds of perpetrators of personal attacks are men. The vast majority of these are patients but also visitors, or even, much more rarely, other caregivers or administrative staff.

Data not exhaustive

Has violence in medical settings increased as a result? Difficult to say in reality because the National Observatory of Violence in Health Care, created in 2005, recently changed its counting method. Until 2019, it only took into account violence in health establishments such as hospitals and on public roads. Since 2020, it also includes violence committed in city offices. It is therefore not possible to compare the reports from 2005 to 2019 to subsequent years.

We can still see that reports increased between 2015 and 2019, for example, going from 19,300 to 34,900 victims of personal attacks, all categories combined, whether caregivers, administrative agents, security guards or patients. We can also see that in 2020, while the criteria for reporting violence had been broadened, the number of victims had decreased compared to the previous year, falling to 28,000 victims.

But these annual variations should be interpreted with caution because the ONVS reports are not at all exhaustive. They are entirely voluntary: establishments can, if they wish, report cases of personal attacks to it. Each year, a different number of establishments agree to participate in the reports. In 2019, 450 establishments participated, or less than 8% of all healthcare settings. A sample which is not representative but which is larger than in previous years and in subsequent years. Only 380 establishments participated in 2020.

This therefore amounts to saying that there were 77 victims per establishment which reported violence to the ONVS in 2019, while in 2020, in the midst of the Covid-19 pandemic and when the context became tense around the medical question and in particular vaccination, this proportion has however decreased: there were 73 victims per establishment which reported violence to the ONVS. Except that we cannot draw any conclusions, since the establishments are not representative of the whole. The ONVS figures actually only give an overview of what is happening in health care settings.