The city’s hospital center has been on strike since April 25. It seems that a way out of the crisis can be envisaged.
“We are approaching the end of the crisis. Negotiations have never been broken off with the unions and a memorandum of understanding should be signed soon resulting in a gradual strengthening of the care teams for psychiatry,” believes Bernard Carayon, mayor of the town and chairman of the hospital’s supervisory board.
The inter-union (CGT, FO, CFDT) also acknowledges progress. “After five negotiation meetings, the human resources department (HRD) has finally sent us, at our insistence, a draft strike exit protocol. It contains positive progress. A solution therefore seems possible. On the other hand, certain aspects that never appear in this type of document must be removed, such as the terms of denunciation or suspension of agreements. At this stage, it is as if the director were asking the inter-union to sign an exit protocol… a protocol!”, the inter-union criticizes.
“What the unions fail to say is that there has never been a social plan at the Lavaur hospital and that there has, however, been an increase in staff numbers. In 2018, there were 893 full-time equivalents, and last month 951, i.e. fifty-eight more in six years,” emphasizes Bernard Carayon.
Psychiatry, a sticking point
And if the psychiatry sector seems to be a sticking point, the elected official is keen to point out that “for this sector, we are going from 310 to 319 full-time equivalents. If we compare what has been done for psychiatry in terms of staff between Lavaur and other establishments such as Bon Sauveur, Lavaur is not the poor relation.”
The municipal opposition, for its part, emphasizes that “The hospital is experiencing a tense financial situation and the teams that ensure the quality and continuity of care are exhausted. The only action taken by the mayor – who was approached twice by the inter-union – was to have the banners removed on the pretext that “it looks dirty.”
“No comment,” says Pauline Albouy-Pomponne, leader of Lavaur Citoyenne.
“We have obtained funding of six million euros to transform the most damaged buildings. They will be validated at the end of 2024, the Regional Health Agency (ARS) supports us and I have no doubt that we will obtain them,” explains the mayor. At the beginning of the year, we obtained aid from the ARS to cover the deficit, of around six million euros, and we obtained aid of 2.4 million from the ARS. The deficit will be of the same order this year,” estimates Bernard Carayon.
Where does the deficit come from?
With “fee-for-service” pricing, commonly called T2A, a large part of the resources allocated depends on the number of acts and stays recorded for all medical, surgical, obstetrical or “MCO” activities in medical jargon. In this context, it can be difficult to understand where a deficit comes from, the financing of the establishment was correlated with its activity.
“Since the CoVid crisis, the establishment has had a lot of trouble finding doctors, and therefore producing activity. This is not a problem specific to Lavaur, it is true for most hospitals of our size,” emphasizes Bernard Carayon.
For the inter-union, “the problem of CH Lavaur, like most hospitals in France, is not that of expenses but that of revenues. It lacks financial and human resources. For years, the Lavaur hospital has suffered from chronic underfunding maintained by the different governments and the votes of the different deputies of yesterday and today.”
“There is also a second factor: inflation, which last year caused current expenses to explode,” explains Bernard Carayon, joined by the inter-union group which emphasizes that “the explosion of costs linked to inflation is not compensated by the State. The agents, the population and the patients are not responsible for the current situation. They do not have to suffer the deterioration of our hospital, nor pay for the State’s disengagement.”
It should be noted that the French Hospital Federation, which brings together most of France’s public health establishments, is calling for a 6% increase in the hospital budget to ensure their survival.
