2024-04-10 10:00:24
Catherine Vautrin, Minister of Labor, Health and Solidarity, should have some reason to show off by presenting, Wednesday April 10, to the Council of Ministers – at the same time as the bill on the end of life – a “ten-year strategy for strengthening palliative care”. The stated objective of this ” strategy “ is to provide palliative care to any patient who needs it. To guarantee this “universal access” by 2034, an additional 1.1 billion euros are planned over the period. That is an increase in credits of 66% compared to a current annual expenditure of 1.6 billion euros, financed by Social Security. A windfall that allows the government to commit to creating hospital beds and new specialized structures (20 new palliative care units by 2025, 100 mobile palliative care teams created over ten years, etc.).
A wonderful picture which nevertheless ignores a reality: the significant number of unfilled positions in already existing structures. The latest study dates back to 2020. Carried out for the National Center for Palliative and End-of-Life Care, it establishes a gap of 30% between the actual workforce and the number of positions to be filled, recommended by a 2008 circular from the Ministry of Health which sets staff ratios in palliative care structures. In this sector, the officially planned and funded number of doctors, nurses, health managers, psychologists, compared to the number of beds, is higher than in other branches of medicine.
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In 2024, what is the shortage of caregivers? “The data we have has not yet been fully analyzed. The figures remain to be refined, replies Ms. Vautrin’s office. But the elements we have clearly show that there is demographic tension in the different structures. » The ministry cites the fact that the circular was replaced by an instruction published in June 2023. Which requires new calculations.
A training “channel”
A few surveys in several regions and departments are enough to establish the importance of vacant nursing positions. In Provence-Alpes-Côte d’Azur (PACA), the vast majority of palliative care units operate with fewer than two doctors for ten to twelve beds. The ratio recommended by the ministry is at least two to three doctors. In this region, half of the mobile palliative care teams do not have a doctor, although they should have at least one practitioner. In Ile-de-France, one in two mobile teams also operate without a doctor. However, PACA and Ile-de-France are not the worst-off regions in terms of palliative care provision.
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