During his speech on Monday April 17, Emmanuel Macron promised to “unclog all emergency services” by the end of 2024, setting an a priori unattainable objective while the shortage of caregivers is already preventing the health system from meeting the growing demand.
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Stretchers in the hallways and crowded waiting rooms. Day and night, winter and summer. The crisis is deep, the symptom has become unbearable. “By the end of next year, we should have decongested all our emergency services”ordered the President of the Republic.
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Easier said than done. Because the hospital does not suffer from mild congestion: 20.4 million emergency visits in 2021, compared to just over 10 million in 1996. Inexorable increase only stopped by the Covid. Unless there is a miracle cure, the pre-crisis record (22 million) will soon be beaten. The Head of State did not specify how to reverse the trend, but “we need concrete results in the short term”.
“The goal is unattainable”
The first interested parties find it hard to believe. “The goal is unattainable”judge Marc Noizet, president of the Samu-Urgences de France union.
In the absence of power “inject caregivers” to rapidly increase the number of hospital beds, it will be necessary “profound changes” organization that will be “complicated to manage”he explains. “With the current method, it’s a wishful thinking”reacts Agnès Ricard-Hibon, spokesperson for the French Society of Emergency Medicine (SFMU).
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On the other hand, “by listening to the emergency physicians it is still possible”she adds, provided “to apply the solutions” already offered in 2019 in the “emergency overhaul pact”.
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This plan announced at the time after months of strike, had not yet been enough to appease the anger of caregivers ulcerated by their working conditions. No more than the general increase in the “Ségur de la santé” of 10 billion euros per year, granted in the midst of a pandemic.
Treating emergencies will require taking out the checkbook. “It’s fun”more “We will need concrete measures and immediately”warns Jean-François Cibien, president of the Action Practitioners Hospital union.
“Go even further”
“A lot has already been done in recent months”underlines the entourage of François Braun, recalling that the measures put in place upon his arrival in the summer of 2022 (access to emergencies filtered by the Samu, increase in night hours) “have allowed our hospitals to hold on” until now.
Nevertheless, “We need to go even further”recognizes the Ministry of Health, which has just opened a series of consultations with hospital doctors, supposed to be completed before the summer on crucial subjects such as salaries, careers and “continuity of care” evenings and weekends.
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The government is also relying on “care access services”, associating Samu and liberal doctors, tested for two years in about twenty departments, and which must be generalized by the end of the year. But at the same time, the executive chose to cap the prices of medical interim, leading to total or partial closures of small emergency services such as in Feurs (Loire), Vittel (Vosges), Pontivy (Morbihan) or Manosque (Alpes-de-Haute-Provence).
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And the situation of hospitals is in “significant degradation” with an overall deficit “around one billion euros in 2022”according to the latest opinion of the alert committee on health expenditure.
It will therefore be necessary “strong actions to restore all its attractiveness to the public hospital”considers the president of the French Hospital Federation (FHF), Arnaud Robinet, welcoming “displayed voluntarism” by the Head of State while pleading for “better solidarity” with private clinics and liberal doctors.
However, the latter have other concerns, starting with the “arbitration rules” who must set their new rates, after the failure of negotiations with health insurance. Their unions are invited on Monday to a ” information meeting “ on this subject, indicated the French Union for Free Medicine (UFML), claiming “a shock of attractiveness and financial”.
