Haro on the “mercenaries”. From Monday, temporary doctors, sometimes essential to keep an emergency service or a maternity hospital open, can no longer be paid more than what the law provides.
An obvious fact that should prevail since the creation of this ceiling in 2016. Except that its application has so far come up against the walls.
When the former minister Agnès Buzyn sets the maximum rate in 2018 at 1,400 euros for 24 hours, those concerned respond with a “black list” of hospitals to “avoid”.
When the device is reinforced with a second law in 2021, while the price of custody has dropped to 1,170 euros, Olivier Véran suspends in extremis its entry into force, in the midst of the winter wave of Covid.
A year and a half later, François Braun in turn promises to put an end to “the cannibal interim” and his “drifts” – up to 4,000 or even 5,000 euros gross for 24 hours – “who will sign the death of our public hospital service in the short term”.
This does not prevent it from dropping, a week before the deadline, an increase of 20%, to 1,390 euros (gross) for 24:00. “A perfectly acceptable sum”he believes.
But behind the scenes, the minister has been preparing for a difficult spring for months. “The temporary workers will go on strike or refuse to work, we know it perfectly, it will last a month”he already predicted in October.
To “cross the line”, the regional health agencies have been instructed to play the “territorial solidarity” between hospitals in “all areas at risk”. How much and where? “The situation is changing every day”we dodge avenue de Ségur.
“Restore attractiveness”
In the Grand Est, for example, “the situation is still very fluid”, recognizes Thierry Gebel. The regional delegate of the French Hospital Federation (FHF) is less worried than in early March, when he feared the total or partial closure of 79 services.
Eventually, “few will be out of stock”because many establishments “have deprogrammed part of the activity” in order to preserve “the rarest resources”starting with anesthesiologists, emergency physicians and gynecologists.
Not sure that this degraded mode is enough everywhere to avoid the open crisis. The union of hospital replacement doctors (SNMRH) has thus identified 167 services “threatened with imminent closure” in a hundred hospitals, mostly located in small or medium-sized towns. Non-exhaustive list where no specialty is spared: surgery, paediatrics, psychiatry…
“We are determined to refuse any cap”warns its president, the emergency doctor Eric Reboli, however lonely in the medical community.
The unions of hospital practitioners are indeed eyeing the potential savings on the interim – which costs hospitals 1.5 billion each year – and are asking the government to open wage negotiations.
“We must restore the attractiveness of hospital medicine”, also pleads Thierry Godeau, president of the national conference of medical commissions of hospital establishments. On behalf of his colleagues from 750 public hospitals, he wishes “talk about guards, on-call duty”or “double overtime pay”.
Claim supported by the Order of Physicians, which judges at the same time as “certain excessive practices (…) have no ethical reason to exist anymore” and calls the temps and “hospital administration” To “respect tact and moderation in remuneration”.
The Syncass-CFDT hospital directors, the leading union among these senior civil servants, hope “to be able to count on the support of the State”so that none of their colleagues find themselves “alone to assume the closure of a service for lack of practitioners accepting the rates set by the texts”.