The public hospital crisis “is the manifestation of the end of a system”, estimated Thursday, May 19 Frédéric Bizard, professor of economics at ESCP Business School, founding president of the Health Institute. Rémi Salomon, president of the conference of presidents of CHU establishment medical committees, alerted Thursday morning to “an imminent risk of disruptions in access to care” due to lack of medical personnel. It’s necessary “sending a message of hope” to the hospital explaining that “the sacrifices necessary to overcome crises are temporary sacrifices”he explains.
franceinfo: discomfort in public hospitals is not new?
Frederic Bizard: Emergencies were already in a massive strike in 2019 and strikes are often thought to be corporate protests of a sector. But it is in fact a warning signal that has been sounded for a long time, so well before the Covid-19. All this is the manifestation of the end of a system. We are at the end of the cycle of a system which was developed in 1945 and 1958 and which has proven its worth in the 20th century world of acute pathologies to have access to care among the best in the world, but which has not been thought of at all in an environment with an aging of the historical population between 2010 and 2030, between pathologies which are no longer acute, but which are chronic, which completely changes the nature of the risk with an elongation of risk and therefore a hospital which normally becomes a place of passage and no longer the crossroads of the system. And then a technological revolution which must really allow with technology to considerably improve care. We have a huge waste of an exceptional resource in France, the human resource, the technological resource, the financial resource is unique in the world in France, but we have a huge waste because we remain on a system that has derailed and we try to patch it up rather than take a more systemic approach.
Have these alerts been taken seriously enough?
Absolutely not. Once again, we took that for a one-time problem, as we do today. When I hear “there is a problem this summer”, but there is not a problem this summer. There has been a problem for years and obviously the staff have to take their vacation. Rémi Salomon says there is a “recognition” problem. It’s not just a recognition problem. We believed with the Ségur de la santé that by increasing each staff by 186 euros, we were going to send them a message. But the message that must be sent is “we are asking you for a sacrifice which is a temporary, one-off sacrifice because we are going to transform the system to really put it back on the right track and to recreate working conditions and system performance that is what you expect.”
What can be the roadmap of the new Minister of Health?
There are two things to do. The first is governance. During the health crisis, when we were overwhelmed, we finally said, we leave the whole organization of services in the hands of the doctors and, coincidentally, we managed to solve most of the problems. This should not be an exception, it should be the rule. Obviously, the senior public service cannot do that. The second thing is to send a message of hope that the necessary sacrifices, especially to get through the summer or to get through crises, are temporary sacrifices. And we are not in a kind of common law because we are launching a transformation of the health system. This is the roadmap for the new Minister of Health.