2024-01-20 09:00:00
Rodolphe Bourret, general director of the Nice University Hospital (CHU), was the guest of L’Interview à la une, the major Nice-Matin interview in partnership with Radio Émotion. Excerpts.
Catherine Vautrin was appointed Minister of Labor, Health and Solidarity. What do you expect from her?
“I expect support for the public hospital, to improve attractiveness and develop health professions. I also expect financial measures and support at the interface between health, medico-social and social. The world of health wants a systemic and long-term vision, with long-term measures.”
Can you explain the role of the Nice University Hospital?
“It is the leading healthcare player in the Alpes-Maritimes. The “U” of CHU means that we are associated and backed by a medical faculty. Beyond care, its missions also include training and research. “We thus have university professors but also lecturers who provide teaching and direct research. The Nice University Hospital is located between 15th and 20th place in budgetary terms. Among the 32 University Hospitals in France; the three largest are the APHP (Paris hospitals), the APHM (Marseille) and the HCL (Lyon civil hospitals).”
A new decentralized governance charter was signed during the wishes of the CHU. What is his role?
“Thanks to this charter, we will be the first university center in France to adopt medicalized governance. Thus, we are reversing the hierarchical pyramids: at Nice University Hospital, from now on, doctors are the order givers and the administrative services are there to help with the processing of files. Thanks to this polar delegation, decisions will be taken as close as possible to patients’ beds.”
Doctors in charge, these are doctors who have less time for patients. Can we do without this precious medical time today?
“This medical-administrative time will affect a small part of decentralized governance. The division heads will manage their teams, with the support of department heads, nurses, etc.…”
How to combat the shortage of doctors?
“On this issue, training is a major issue. Indeed, we have the smallest faculty of medicine, in terms of training of doctors: only 178 interns per year while we would need to train 278 to meet the needs of the population of the territory. To counter the shortage and reach the least well-resourced areas, it is important that we fight to obtain more interns.”
Waiting times in emergency rooms remain high. Which solution ?
“At the national level, the average waiting time in the emergency room is 4 hours. At the Nice University Hospital, it is 3h30; we are therefore below the national average. But of course, this remains long. The influx to hospital emergencies reflects a lack of care at the city level. Certainly, offices with extended hours have relieved emergencies. However, this is not enough. The basic problem is that the territorial network of health care is is erased. For example, the family doctor, always available, who knows his patient’s history, has almost disappeared.”
Hospitals are running out of beds. Is opening one at Nice University Hospital part of the plans?
“We do indeed have closed beds, but it is due to a lack of caregivers. Reversing the process will take time; but the lights are green with the establishment of this new decentralized governance which allows doctors and caregivers to manage their own resources and no longer calculate the numbers on Excel tables, but according to needs. I would like to point out that we have found at the CHU level the number of caregivers that we had before the covid period, this is one of the first successes .”
The Var plain project amounts to around 500 million euros. But is it really necessary?
“This center has been in the works for years; we have been waiting for political impetus. Currently, we are examining the files with the two partner establishments: Lenval and the Antoine Lacassagne Center. The CME presidents of these structures are aligned with this project which has true medical coherence: a grouping of care for adults and children, adding oncology. The idea is to work together while preserving each person’s identity.”
Is Nice University Hospital still one of the most indebted in France (2)?
“In 2017, the report from the general inspection of social affairs (Igas) was alarming and the situation deteriorated in the following years. Today, we are trying to stop this terrible cycle of deficit. But the Nice University Hospital is a large liner, it needs time to change course and return to cruising speed.”
1. The project aims to bring together – by 2031 – Lenval, the Antoine-Lacassagne center, L’Archet and the Cimiez hospital in a single location, located on the Var plain.
2. With a cumulative deficit of 473 million euros and 35 million in 2023.
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