“We need to restore some attractiveness to what we have to do in emergencies, what the job of emergency physicians should be“, alerted Wednesday on franceinfo Louis Soulat, vice-president and spokesperson for the Samu Emergencies of France and head of service of the Samu-Smur Emergencies of Rennes, while hospitals must face, after the Covid-19 crisis, the emergency crisis faced with a lack of staff this summer.
>> The Bordeaux University Hospital in “degraded mode”, patients will be “welcomed by volunteers”
To cope, the CHUs will have to bring caregivers back on their leave. Rémi Salomon, the president of the conference of the Medical Commissions of Establishment (CME) of CHU, calls on the new government for the means to pass this difficult course. If the money”is an important element“, Louis Soulat underlines that it is “the disaffection of services by caregivers and doctors“that needs to be resolved.
franceinfo: Are you going to be able to face the summer in Rennes in good conditions?
Louis Soulat : The situation is catastrophic, not only at the level of an establishment, of an agglomeration community, but also at the level of a regional hospital group (GHT). We already have emergency structure closures in our GHT at the moment, which has a strong impact on the other services due to the activity.
Will the money demanded by Professor Rémi Salomon be enough?
No. It is an important element, of course, to give a little attractiveness. Because the real problem is the disaffection of services by caregivers and doctors. It is a problem that has grown. We can’t fully explain why there are emergency department closures that we know of as early as May. The problem is old. We have worked with constant means in terms of human resources for years. We are impacted by the difficulties of the upstream, ie the saturation of the offer in ambulatory medicine. But we are also very affected by the downstream difficulties. We used to say that patients are waiting on stretchers. But it is also because we lack hospital beds and endorsement. We realize that they will be very important this summer with beds, services closed much earlier in follow-up care establishments. And so this has a doubly impact on the activity of emergencies. Staffs are exhausted with insufficient resources. If I take the example of Rennes, our main problem is a 30% increase in activity compared to the same period two years ago.
What should be done to try to limit breakage as much as possible this summer?
We are in a situation of very strong tension, which is known, which has been announced to our supervisory authorities for weeks and months. Today, we need to restore some attractiveness to what we have to do in emergencies, what the profession of emergency physicians should be. The emergency doctor is not there to compensate for the shortcomings of outpatient medicine, nor for downstream difficulties. We have a core business. We want to make young people more attractive because that’s our main concern. And for that, we must close the loopholes and start by regulating admissions to emergency services. That’s why the national message is going to be, ‘call 15 before going to the emergency structures’. And this is crucial for us. Because it allows us, on the one hand, to identify the vital emergencies for which we will trigger a mobile means of intervention, the SMURs. These are medical teams that we try to preserve as much as possible to treat vital emergencies. In a second step, we must regulate access to emergencies so that we only have patients in our emergencies who come from the technical platforms, especially during on-call hours. And that’s something that’s going to be very unpopular. We’re going to have emergency services closed. We will have to communicate on this subject. It is only in the interest of the patients that the emergency services are closed with an important filter. This regulation must be done by the Samu and try to direct patients towards outpatient care when possible and reserve access to emergencies for patients who really need it. This is our core business.