“We lack a coherent project to finance our health system today”said Tuesday June 7 on franceinfo Benjamin Rossi, infectious disease specialist at the Robert-Ballanger hospital in Aulnay-sous-Bois in Seine-Saint-Denis, while nine unions and hospital collectives are organizing a day of mobilization this Tuesday to demand wage and workforce increases without waiting for the result of the “flash mission” ordered by Emmanuel Macron.
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Benjamin Rossi points to the fee-for-service which resulted in having “an indebted hospital”. It is necessary, according to him, “to change” the system for “find a breath”otherwise it warns: “The day the system will collapse, health will be expensive for everyone.”
franceinfo: how is your hospital?
Benjamin Rossi: he’s not doing very well, a bit like all hospitals. Our emergencies were closed during the last holidays due to a lack of caregivers. We have service closures. In the infectious diseases department, we have a third of the beds that have been closed for more than a year in general silence. There are surgical departments that are closing. Radiology is privatized. Since it brings in money, investment funds get into it and take over all the sectors that make money. So these are short-term solutions since this will put the hospital in even more debt in the long term. Can’t say it’s going well.
What are you missing today in your hospital?
We lack a coherent project to finance our health system. We realize that we pay very dearly for people who do much less important medicine, for patients who are not hospitalized, who will overcharge their acts and all of this is reimbursed by social security. But what is essential is not valued. As a result, the hospital finds itself in debt. It is said that we cannot increase salaries, that we cannot compete with the prices proposed for doctors in the private sector, in fact we need a coherent system where there is equality between specialists. It is not normal that certain specialties such as psychiatry, pediatrics, do not work because they are understaffed since it is consultation and we pay a lot of public money for radiologists. You have to find a breath. For the solution for emergencies, I propose taking all the money given to temporary workers, since these are thousands of euros for a day’s work, versus 250 euros for full-time workers, and redistributing it to the teams who are in place. It is a short-term solution which would already make it possible to stimulate, to rehire at the hospital.
Do we have to review everything in the hospital, reform everything?
Sure. Since there is this activity rating which was implemented in 2008, everyone says that it doesn’t work, it can’t work. This system is an inflationary system. People who do acts will do lots of acts even if they are not necessary, since they are the ones who decide whether to do them or not, and they will make as much money as possible. And where it is essential to do acts, they are in competition with people who do unnecessary acts. So we only impoverish the people who do it reasonably. It is a system which is not good, which is inflationary, which is very expensive and therefore it must be changed. They don’t listen to us because I think people don’t know how to approach the problem.
“Our politicians don’t understand how our healthcare system works. That’s what’s worrying.”
Benjamin Rossi, infectious disease specialist at the Robert-Ballanger hospital in Aulnay-sous-Bois in Seine-Saint-Denisat franceinfo
Do you expect anything from the “flash” mission launched by Emmanuel Macron?
If you have to do flash missions to understand the basics, that is to say how to rebalance, to spend the summer… I don’t expect much from this mission. At one point or another, you have to make decisions and making decisions is making bets. I believe that we must bet on trust in caregivers. Today, we have an administrative system that is so complicated, that costs so much, that it should perhaps be streamlined a little. It is also the bet of the public system, because I believe that it is a common good and that we all have an interest in making it work. The day it will collapse, health will be expensive for everyone, much more expensive. So you really have to find a system. It is really in the interest of all French people.