Tribune. Twenty years ago, hospital services were working with doctors in all services, and positions of hospital practitioners (pH), via a national competition, were quite sought after.
Today, not a single hospital in France, all over the territory – Great hospitals of the University Hospital Center (CHU), regional or local hospital -, is not in trouble for recruitments.
All are looking for pH and virtually for all disciplines (see report of the National Management Center 2021 on the website of the National Management Center, CNG ). On average, there are more than 30% vacancies of hospital practitioners, and for “small” hospitals that are already with reduced medical numbers seen their size, this figure often exceeds 50%. It is even 75% in Guyana.
Some 30% vacancies, this means services that constantly appeal to substitutes via temporary agencies subject to supply and demand. This system still leads today, despite the so-called reforms that are not applied, at day rates for these fully indecent replacement physicians. What’s more, it’s the smallest hospitals that suffer the most.
Hyperbureaucratic operation
In some hospitals, “guard lines” are removed, especially emergencies, sometimes only one or more days, and then, little by little over several months. This situation can lead, for example, to no longer have a team of the available mobile service and resuscitation (SMUR), or that management imposes a “degraded” system by accepting that one doctor is Present to emergencies for a whole institution.
And if we talked about the organization of health in France? Why in France does not happen to have enough hospital practitioners? How is it that the bodies, like regional health agencies (ARS) and the ministry, who are aware, do nothing. And yet, it is also an essential public service.
A large part of the responses to this situation is in the hospital management, introduced since the hospital, patient, health, territory (HPST) law of July 2009. Roselyne Bachelot was then Minister of Health. This great reform provided for a group of hospitals by strengthening major hospital centers and a quasi-disappearance of small, and above all a very increased power of the hospital director who eventually can take all decisions even against the opinion of the medical community. (“Only one boss at the hospital,” said President Nicolas Sarkozy).
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