It is a hindsight that says a lot about the reality of the bleeding of doctors in the hospital. Faced with the risk of paralysis of many hospital services, the Minister of Health and Solidarity Olivier Véran announced last Thursday to postpone the cap on the remuneration of temporary doctors, which was to come into force today, until next year. . As part of the Ségur de la santé, the government had undertaken to strictly enforce the theoretical ceiling of 1,170 euros for 24 hours of temporary work. A laudable objective whereas the report of the deputy LaREM Stéphanie Rist pointed to a cost of 1.4 billion euros of non-permanent staff at the hospital in 2018, but totally unrealistic for hospital practitioners who had been warning for months on the consequences of this measure which comes when the public hospital is already suffering from the desertion of health professionals. “In recent days, services in the hospitals of Pontivy or Bayeux have already had to close temporarily for lack of doctors”, pointe Carole Poupon, president of the Confederation of hospital practitioners (CPH) and vice-president of Action Praticiens Hôpital.
“This postponement, as we had anticipated, was made compulsory in view of the reality on the ground: shortage of hospital doctors linked to the lack of attractiveness of hospital careers, in particular in specialties with a strong constraint of permanent care” , The organizations Action Praticiens Hôpital and Jeunes Médecins reacted, urging the government to take advantage of this period to open up the work of attracting hospital professions more widely. “The first of the measures to limit the interim and its prohibitive cost (…) is to keep the incumbent practitioners in post”, they point out, moreover.
Working conditions prompt practitioners to flee the hospital
« Let us recall all the same that the government has paid doctors at rates worthy of mercenarism to vaccinate the population since the beginning of 2021. That hospital practitioners have been excluded from these rates. That emergency services and anesthesia-resuscitation had acute difficulties in recruiting temporary workers this summer. Radio silence from the ministry. That the permanence of the care of the liberals reached these rates, and that the Igas mission on the permanence of care did not hear the trade unions of hospital practitioners. Incomprehensible “, also raises the National Union of Hospital Anesthesiologists and Resuscitators Expanded (SNPHARE).
Failure to address the issue of salaries of hospital doctors and that of their working time, the government’s desire to tackle the medical interim risks remaining a dead letter, warn the various trade unions. The overhaul of the salary scale for doctors at the start of their careers, in September 2020, created inequalities between professionals. “Some practitioners who had four years of seniority have been caught up, or even overtaken by colleagues appointed more recently”, denounces Carole Poupon, who says that this difference in treatment pushes some caregivers to resign.
But it is also the working conditions that encourage practitioners to flee the public hospital, alert their representatives, who point out in particular the extended hours. “We go far beyond the legal European framework for 48 working hours per week ”, deplores Carole Poupon, who notes that “If, until now, the hospital system has held on thanks to the goodwill of the doctors, the youngest now want to have a family life”. The unions are asking, for example, that night guards can be included in the count of the ten half-days of weekly work carried out by doctors. It is on all of these subjects that the doctors’ organizations hope to be heard by the ministry, which has still not invited them to join in the reflection on the inflation of medical interim.
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