Faced with a shortage of doctors, with 15 vacancies out of 38, the Tarn-et-Garonne emergency federation had to reorganize. From July 1, access to emergency services in Moissac and Montauban will no longer be automatic, whether day or night. Patients will have to go through their attending physician, or call 15 or 3966. Those who present themselves spontaneously to the emergency room will be put in touch, via an intercom, with an emergency doctor.
It’s confirmed. The emergency departments of Montauban and Moissac hospitals will undergo a profound change in their organization, from July 1, against the backdrop of a structural crisis in medical demography. The reception of the public will no longer be automatic.
Before being admitted to the emergency room, day or night, any person must be regulated beforehand. If she has a doctor (Editor’s note: 26000 Tarn-et-Garonnais do not have one), it is through him that she will have to have the doors of the emergency department opened. Otherwise, she can call the 15where the 3966 during a period of on-call care, and the doctor she will have on the phone will assess whether her situation is a medical emergency.
This organization, which is a long-term one, will require a lot of education from the population. Sébastien Massip knows this well. The director of the Montauban hospital center organized a press conference, this Monday evening, with the president of the supervisory board, Brigitte Barèges; GCE President Dr Jérôme Roustan; the medical coordinator of the departmental federation of emergencies, Dr. Dominique Coppin; the director of Samu 82, Dr Hélène Pizzut; Grégory Alaux, president of the Order of Physicians and Jean-Jacques Galouye, medical regulator of outpatient care.
Marc Bersou, president of the CME of the Moissac hospital, restrained by his professional obligations, he who is the only emergency doctor of the CHIC, and Jacques Cabrières, director of the intercommunal hospital of Castelsarrasin-Moissac, were excused… but earlier in the day they had had a visit from the regional director of the ARS.
Brigitte Barèges tackles the ARS
“It was urgent to take care of emergencies,” admitted Brigitte Barèges, tackling the Regional Health Agency in passing. “I regret that the ARS is not here today. We have fallen behind. Everything has been paralyzed for electoral reasons, I find that scandalous”, but the mayor of Montauban preferred to insist on “the good coordination of all good intentions”.
“There is a shared objective from the start: to preserve the operation of the emergency department of the Montauban hospital. It is not closing, it is reorganizing to avoid closure”, explained in the preamble Mr. Massip, recalling the shortage of personnel hitting the emergency department of Tarn-et-Garonne, with 15 vacant emergency room positions out of 38. the equivalent of the University Hospital of Rangueil) and “medical resources which have decreased. We tried to recruit but the interim did not respond. So, we had to imagine a reduction in the supply of care”.
Since December 2021, a Smur line has been closed in Montauban, another in Moissac and the federation has had to close night emergencies in the uvale city. These measures remain in effect. “There were no serious adverse events with this organization in Moissac,” says Dr. Coppin.
The emergency room door is closed: it doesn’t matter, but it’s still slightly open. The emergency service, it will work when we need it, this is the message that must be conveyed to the population.
The director of Samu 82 makes no secret of it: “What we have in sight is to create an SAS, a healthcare access service on the model of what exists in Denmark. Emergencies , you don’t get in like that, you get in with a ticket, but that means doing a lot of work in terms of regulation.”
Sébastien Massip: “There is no other possible alternative if we want to preserve the public hospital service”.
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This is why the 82 emergency federation asked the ARS to provide it with “the same means as during the first Covid crisis in 2020. We will benefit from an H24 regulation assistant, which is equivalent to 6 agents to be recruited at Samu .” City medicine will have an important role to play in regulating patients. For Dr. Alaux, who welcomes this project from the field, “the important thing is to know that the Tarn-et-Garonne is trying not to suffer this crisis of medical demography”.
Hélène Pizzut knows very well that people, unaware of the new conditions (even if the hospital promises to communicate a lot), will continue to present themselves spontaneously after July 1 at the entrance to the emergency room. “A special intercom will allow them to discuss with a medical regulator of the Samu. It will be the same operation in Moissac. This model is called to become generalized in France”, she assures, anxious to de-dramatize things. “The emergency room door is closed: that’s okay, but it’s still a little open. The emergency department will work when we need it.”
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