The Minister of Health, Olivier Véran, is going to Le Mans (Sarthe) this Tuesday, November 16, 2021 to present the regional section of the “Investment Segur” for hospitals and medico-social establishments in Pays de la Loire. He will do the same for Brittany next week, during a scheduled trip to Brest (Finistère).
Have we really entered a fifth wave?
The circulation of the virus has accelerated for a few weeks now, in the order of 30% to 40% increase per week. We are not yet in a so-called exponential phase, but we are very clearly in the start of a wave. This wave is European. France is no exception, even if we suffer it in a delayed way and even very delayed compared to many of our neighbors because of our good vaccination coverage and the health pass.
Is there a risk of hospital saturation?
During the fourth wave this summer, we rose to several tens of thousands of cases per day, without saturating hospitals and with a mortality that was much lower than in previous waves thanks to vaccination, the health pass and barrier gestures. But this wave is winter, the traffic conditions are more favorable for the Covid but also for other viruses. That is why, In addition to the Covid vaccination and the booster, I call on those eligible to do the one against the flu, and all French people to scrupulously respect barrier gestures.
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The recall campaign “has accelerated markedly for 10 days”
Do you plan to condition the health pass to the booster dose for those over 50?
We haven’t made that decision today. The 50-64 year olds will receive their booster doses from December, but they must be given the necessary time to be vaccinated anyway. In addition, we will take into account the conditions of circulation of the virus at that time.
Why is the vaccine booster campaign laborious?
I wouldn’t say that. Even before the speech of the President of the Republic, more than half of people over 65 called to receive their recall had received it within the following month. And this has accelerated markedly for 10 days, especially after the President’s speech, which allowed an increase in the number of appointments. Vaccination coupled with Covid and flu booster also promotes this dynamic. Regarding influenza vaccination, nearly 5 million people are already protected. This is more than in 2019, and we will have flu shots for anyone who wants them.
Should children be vaccinated against Covid-19?
France’s position is to wait for the opinion of the European Medicines Authority, which should rule in December. If the European Medicines Authority tells us that the vaccine is safe and effective in 5-11 year olds, then the High Authority for Health and the Vaccine Strategy Steering Committee will have to make a decision. It will undoubtedly be by the beginning of the year 2022.
“Our ability to track down variants is very strong”
Are the new drugs that could soon be validated a game-changer?
For once, France has clearly taken the lead: under this mandate, we have reformed the system for early access to innovative treatments. This means that even before their validation by the European authorities, they may be available for French patients under certain conditions. This was already the case for monoclonal antibody treatments. Several thousand French people at risk have benefited from it. New oral treatments, in tablet form, which are therefore easier to administer, are being developed. We ordered 50,000 treatments of monulpiravir, a drug that would reduce severe cases of Covid by 50% when prescribed in patients at risk. It will be available before the end of the year and I hope it can be prescribed by general practitioners.
Should we always fear new variants?
France is one of the countries which performs the most virus sequencing. You may have heard of a Congolese variant. Eight cases were identified in the Republic of the Congo and a family cluster was discovered at the end of September in people who returned: several cases in Brittany and some additional cases in Paca related to these Breton contaminations. I’m not saying this for concern, nothing indicates that this variant is particularly dangerous, but to emphasize that our ability to track variants is very strong.
You are presenting the “Investment Segur” for Pays de la Loire, in Le Mans, this Tuesday, November 16. What is it about ?
The Ségur of the investment, it is 3,000 hospitals and nursing homes in France which will benefit from 19 billion euros of support, in the form of a recovery of their debt or the financing of large investment projects. We asked the hospitals to tell us their needs, establishment by establishment, via the regional health agencies. These projects will be financed thanks to the European and French recovery plan.
Ségur of the investment: 1.2 billion in Pays de la Loire
For the region, what does this represent?
The Pays de la Loire is one of the most supported regions, with a budget of 1.2 billion euros. This sum will make it possible to finance 80 major health projects for hospitals, 50 health establishments will see part of their debt taken back, and at least 60 nursing home projects will be supported … To this must be added salary increases for 120,000 healthcare professionals in the region and 82 million euros of so-called “everyday” investments, given to teams to buy equipment. This is unheard of for our health system: the situation has clearly changed.
Do you have specific priorities?
Resuscitation, emergencies and follow-up and rehabilitation care. We are investing € 39 million to rebuild the emergency rooms and intensive care units at Laval hospital. We have four rehabilitation and follow-up care projects in the Nantes area, including the construction of a new building at the CH de Maubreuil. We are supporting the creation of a Sarthois Cancer Institute to the tune of 20 million euros and the Monnet Nord project of the CH du Mans with more than 85 million euros in aid. The University Hospital of Angers will benefit from 129 million investments, that of Châteaubriant of 44 million, that of Challans of 50, the whole mental health center of Cholet will be renovated thanks to 31 million, the modernization of the technical platforms of the hospitals of day and the ambulatory of La Roche-sur-Yon will receive 53 million … Until now, 90% of the credits of the hospital investment plans went to large establishments. There, three quarters of the credits go to small structures, whose attractiveness and sustainability will be strengthened for decades to come. It is a very strong signal that we are sending.
“I am not the minister of corporatism”
Will this be enough to reduce the problem of medical deserts?
This will help, especially since at the same time we are training 10,500 doctors this year, 2,500 more than when I arrived. For nurses and orderlies, that’s 6,000 more per year. Corn to respond to the emergency of medical deserts, we must use all possible levers. Telemedicine first: we have multiplied teleconsultations by 100. Then, by decompartmentalizing the city and the hospital in order to limit the use of emergencies to only real emergencies. Finally, we have health professionals who, although not doctors, can carry out missions with skills that they have acquired through practice, for example. We are making progress on all of these topics.
The possibility given to orthoptists to prescribe glasses is criticized by some …
Orthoptists are perfectly competent to prescribe glasses to young people, who are not at risk of having ophthalmological diseases and who today sometimes wait months or have to travel hundreds of kilometers to have them. eyeglasses. This is why I am defending this provision today in Parliament.. France has a considerable delay in terms of inter-professional cooperation. I am not the minister of corporatism, I am the minister of caregivers and patients. They need our access to health care to be facilitated. It is the same logic which makes that today pharmacists and nurses vaccinate. It is also by making these decisions that we push back the medical deserts and that we allow people to be treated.
“The figure put forward by the Scientific Council was false”
What percentage of beds are actually closed for lack of staff?
We agree that the figure put forward by the Scientific Council (a risk of 20% of closed beds) was false, it was a wet finger. The French Hospital Federation and the directors’ conferences tell me that this does not correspond to reality (the FHF has put forward a figure of 6%). In a survey carried out in 15 CHUs outside Paris, there are more caregivers in practice than a year ago. We have the same number of open obstetric beds. We have stable surgical activity. On the other hand, we have difficulties in follow-up care and rehabilitation. Why ? Because a number of beds have been closed to turn them into Covid beds during the health crisis, and these beds are calling for more staff. And since there was the deprogramming of care, there were fewer needs. But these units are brought to reopen. In psychiatry, on the other hand, it has been ten years since the number of open psychiatric beds has been reduced, given the difficulties in recruiting positions which are open and financed, but which do not find takers.
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For you, is there no global hospital crisis?
There is a difficult situation, which can be explained by cyclical reasons – the accumulated fatigue in the face of a crisis – and structural reasons. Take the example of emergencies: one in four emergency doctor positions is not occupied today. This is the consequence of a reform made about ten years ago according to which only emergency physicians can work in emergencies. However, this law did not anticipate that emergency physicians, after a certain number of years, no longer want to work in the emergency room because it is a difficult exercise in medicine, with many nights, exposure to a form of violence and sometimes insecurity. In addition to increasing recruitments, we need to identify other lasting solutions. You will find even different difficulties in operating theaters. But my role, each time, is to transform everything that needs to be transformed so that the difficulties experienced today are no longer found tomorrow.
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