LA TRIBUNE – One of the challenges of your roadmap will be to implement the White Paper of the Montpellier University Hospital, which provides for nearly one billion euros in investments by 2035. An envelope of 250 million euros in investment loans were granted under the Ségur de la santé, which will allow you to deploy the CHU* real estate master plan. What is the process for disbursing this funding?
Anne FERRER, new director general of the Montpellier University Hospital since March 27, 2023 – The Ségur is a process with a uniform dynamic on all territories Experts will audit the relevance of our project, in particular the real estate master plan, which provides for stages and a game of musical chairs because we are on an occupied site. Funding tranches will be released as they become available. Our establishment plan for 2036 will be produced next September, combining the medical project, the real estate master plan, patient care, the carbon footprint or even the digitization of care… The site has already started before me. For example, the CRIBS, Center for Research and Innovation in Health Biology, which will bring together 22 teams in the future single biology building of the CHU and which will be delivered at the end of 2024.
How does this vast project resonate in the current context of the public hospital, which everywhere is experiencing disenchantment among its staff?
There is a real challenge in supporting change so that there is as little irritant as possible on a daily basis, especially in this context of staff disenchantment, the idea being to involve the teams so that they adhere to the project…Supporting the real estate master plan is important for the younger generations because it will affect the quality of life at work, in eco-responsible buildings. This metamorphosis is an attractive element for preparing the hospital of tomorrow. That’s why this alignment is happy, it will be our compass.
Since the fall of 2021, we have therefore been able to observe a flight of medical and paramedical personnel in all hospital departments. Has the Montpellier University Hospital suffered this haemorrhage of skills?
No, we’re not talking about bleeding. We are not understaffed everywhere in the same way. In particular, we lack operating room nurses, like many other hospitals, which may require closing operating areas. We are thinking about how to allow them to work on their core business on the block by replacing them on certain tasks. The problem is that these are small promotions that come out every year… Overall, we lack nurses in general care. But the Montpellier University Hospital is rather less exposed than other establishments. We are vigilant that this does not result in absence of care. Sometimes, we perform certain treatments on an outpatient basis when the indication allows it, and this is also acclaimed by patients. But we have little deprogramming.
How can the CHU act to restore the prestige of the public health service, and retain and attract care staff?
There is a phenomenon that will probably have to be assessed: what is the endorsement of the Covid? This period of health crisis has been the testimony of an unfailing commitment of staff and a meaningful agility. We were all moving in the same direction, carrying the same urgency to save lives, but it was a moment that was accompanied by a phenomenon of great general weariness in all public and private healthcare establishments. Staff are questioning their desire to continue and they need to be made to want to stay or come back. Some elements depend on us, but not only: we wonder about the hardship of the job, about night work and weekends, but we don’t talk about what is magnificent, about those who do remarkable work and who we will allow to express themselves in the establishment project, on governance, on the meaning they want to find at work, on this flexibility and agility that we must maintain to allow them to refocus on care. If we disconnect staff from their values, we open up the field of questioning. And positive projects, such as the school project, can make them want to… In my management, I draw a lot of inspiration from what we experienced during this Covid period: this porosity between the actors for a common objective is paramount. All the lines were moving, but we were all tied up in complicated decisions to implement but with shared objectives. Today, staff must be allowed to get out of a little too much administrative rigidity and a little too much process to focus on patients.
A debate is currently agitating the hospital sector: the application of a ceiling on the remuneration of temporary doctors, which risks depriving certain establishments of their presence and therefore affecting care. Is the Montpellier University Hospital concerned ?
Not directly: out of solidarity, we are vigilant to the difficulties that there could be on the territory, even if for the moment, there are none. We have lasting partnerships with other establishments, the Sète hospital center in particular, with joint teams or with professionals who are “bi-owned”.
You who have worked in other university hospitals, what is the added value of a project like that of MedVallée for a hospital-university structure?
A CHU, to meet its research and innovation missions, works regularly on collaborations with academic partners – university, research laboratories – and industrialists positioned on health R&D. In Montpellier, it is a strong and ancient culture. MedVallée is a catalyst for this dynamic, by offering meeting places and co-construction between actors, by identifying real estate sites to build spaces for joint laboratories and incubators, or by helping to carry out the projects of partner structures .
As part of the France 2030 plan, the government has decided to create up to six new University Hospital Institutes (IHU), future centers of excellence in research, care, prevention, training and technology transfer. in the domain of health. Montpellier University Hospital has applied : do you know where the process is?
We probably won’t know anything before mid-April or the end of April, or even beyond… Currently in the south of France, there are IHUs in Bordeaux and Marseille but there are none in Occitanie. All candidate projects are projects of excellence. This will be played out in particular on the quality of fundamental research or the sustainability of the project over time.
* The real estate assets of the Montpellier University Hospital, spread over five sites to the north of the city (La Colombière, Saint-Eloi, Gui de Chauliac, Lapeyronie and Arnaud de Villeneuve) are ageing.
Montpellier University Hospital in figures
- 7th CHU in France in size
- 5th CHU of France in research on multidisciplinarity
- 12,000 staff, including nearly 3,000 doctors
- 1.945 units
- 37,476 operations in 2022 in the operating room (excluding lithotripsy and intervention in the digestive sector)
- Outstanding debt (as of December 31, 2022): €273.5 million.
An attraction and loyalty plan
In order to boost its attractiveness, the Montpellier University Hospital has implemented an action plan whose measures ” have begun to bear fruit, with in 2022 more than 1,200 people of all professions (including 360 nurses, Ed.) who have joined the ranks of the first employer in the Hérault, a record for the establishment “, indicates the direction of human resources.
« The CHU needs to continue to massively recruit nurses in general care and specialized nurses – anesthetist nurses, operating theater nurses -, adds the HRD. In 2023, 400 new recruits are expected to meet this objective. »
A memorandum of understanding signed on June 14, 2022 between the General Management and all the trade union organizations representing the staff provides for a revaluation of the salary scales, an extension of the use of the CDI, a reduction in the time limits for access to the status of civil servant, the granting of scholarships to certain categories of health students, the development of learning. But also the improvement of working conditions: strengthening support for career development, facilitating internal mobility.
The management of the CHU says it is working on other actions, and last January launched an experiment: the principle of a “cooption bonus” in order to mobilize all its staff to support the recruitment of state-certified nurses (IDE ), operating theater nurses (IBODE) and nurse anesthetists (IADE). That is a bonus of 600 euros gross to any agent of the establishment who, by June 30, 2023, manages to convince a qualified person to join the establishment.
