The government wants to put an end to the excesses of the “mercenaries” by capping the amount of guards at 1390 euros gross for 24 hours. But hospitals fear that the temps will neglect the public, which could lead to service closures.
The 24 hours at 5000 euros, it’s over in the public hospital. Seven years after being voted, the text of the law capping the amount of guards at 1390 euros gross for 24 hours comes into force on Monday. The government wants to put an end to the abuses of “mercenaries”, these temporary doctors who ask public establishments to align themselves with the higher remuneration of the private sector to accept a contract. But in hospitals, there are fears that lower pay will scare doctors away.
Put an end to “cannibal interim”
In October 2022, the Minister of Health François Braun promised to put an end to “cannibalistic temporary work” and its “drifts” – up to 4,000 or even 5,000 euros gross for 24 hours depending on the time of year – “which will in the short term sign the death of our public hospital service”. These comments were seen as a declaration of war by some temporary workers, some of whom are now threatening to refuse to work.
“The working conditions have become very difficult. Doctors at the hospital are the ones who are poorly paid, it’s not the temporary worker who is overpaid”, testifies a temporary anesthesiologist.
Many temporary doctors, however, take advantage of the lack of arms in the establishments to assert their claims: sometimes very high remuneration that hospitals have no choice but to accept to operate their services. “
“These are people who have been offered contracts for so many euros in another establishment and who come to see us saying ‘look, we have such and such a proposal so either you line up on the rise or we will elsewhere ‘”, confides to BFMTV David Trouchaud, general manager of the Collines de Normandie hospital group, in Orne.
The possibility of negotiating their remuneration has convinced many doctors to lay off: they now represent 12% of all practitioners.
Risk of service closures
Could temporary workers with degraded salaries therefore flee the hospital? The union of hospital replacement doctors (SNMRH) has identified 167 services “threatened with imminent closure” in around a hundred hospitals, most of them located in small or medium-sized towns. Non-exhaustive list where no specialty is spared: surgery, paediatrics, psychiatry…
“We are determined to refuse any ceiling”, warns its president, the emergency physician Éric Reboli, however lonely in the medical community. The unions of hospital practitioners are indeed eyeing the potential savings on the interim – which costs hospitals 1.5 billion each year – and are asking the government to open wage negotiations.
“We must restore the attractiveness of hospital medicine”, also pleads Thierry Godeau, president of the national conference of medical commissions of hospital establishments. On behalf of his colleagues from 750 public hospitals, he wants to “talk about guards, on-call duty”, or even “double overtime pay”.
Demand supported by the College of Physicians, which judges at the same time that “certain excessive practices (…) have no longer ethical reason to be” and calls on temporary workers and “the hospital administration” to “respect the tact and moderation in remuneration”.
The Syncass-CFDT hospital directors, the leading union among these senior civil servants, hope “to be able to count on the support of the State”, so that none of their colleagues find themselves “alone to assume the closure of a service for lack of practitioners accepting the tariffs fixed by the texts”.
