The public hospital is bad, emergency services are very bad. Symptom and consequence of a deep hospital crisis, accelerated by the Pandemic of COVID-19, the emergencies are on the verge of rupture. For lack of hospital staff, one in five service is in danger of closure this summer.
There will therefore be deaths … All scientific studies demonstrate it, Engorgement to emergencies is a factor associated with undue excess mortality. The emergencies are however the showcase and the gateway to the hospital. The massive departure of caregivers and doctors has destabilized our establishments, with fingerings of beds and services, which makes the bottleneck that constitute our emergencies.
This deep, visceral disenchantment of the hospital staff results from a dehumanized management of human resources, transforming the administration of our hospitals into entrepreneurial management, whose only compass remains profitability. Absurd criterion, since our revenue aggravates the health insurance deficit, and therefore the accounts of the nation, based on the famous activity pricing (T2A), with deadly effects. We clearly arrive at the end of a cycle, calling for a substantive structural reform, many times announced by our different ministers, but never made or even initiated.
How to spend the summer without too much “breakage”? With the holidays of our hospital staff, the situation will worsen. In order to limit the damage, it is therefore necessary, in an emergency, to recover in the configuration of crisis, exactly as for the crisis due to the COVID-19. Regional health agencies and hospital departments must reactivate our famous crisis cells, by establishing “bed management” organizations (bed management), by the daily census, at the departmental level, of all available beds and ‘real -time information of establishments in crisis. Yes, this “dispatching” could be effective, but will not be mistaken, face this new crisis will impose other sacrifices for suffering and exhausted staff. The use of new deprogramming to release beds thus becomes a possible option.
How did we get there? In my service, I always ask nurses, nursing assistants, health executives the reasons for their departure. Two types of arguments: first, the lack of “factual” attractiveness of the institution; Then, the feeling of a lack of human recognition. Lack of attractiveness: Housing difficulties due to extra-ground rents disconnected from the income of our caregivers, hence longer and more expensive journeys. You have to take this problem in the horror by reserving, by contracting with town halls, affordable housing for our caregivers.
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