At the Arles hospital, the medical interim, a vital emergency – Sciences et Avenir

“The damage is done”: in the emergency department of Arles, in the south of France, the strict limit to the remuneration of temporary doctors, although postponed until 2022, raises fears of an aggravation of the shortage of personnel suffered by the public hospital .

“It was necessary to review the system of interim doctors” but “they voted for this law without anticipating the consequences that it would have on the ground,” a nursing assistant member of the group Inter Urgencias of the Joseph hospital explains to AFP. Imbert, who wished to remain anonymous.

“If there are not enough doctors, it is dramatic for serious cases, there is really a loss of possibilities” to recover or survive, he continues, recalling that the Arles emergency service, which receives around 36,000 patients a year, works with 40 % of temporary workers to fill vacant medical positions.

“What is happening now is almost more serious than during the Covid,” he adds.

Last Wednesday, a dozen emergency planning spaces had not found a recipient for the month of November and the deprogramming of operations was being considered, which generated fears of a dramatic situation for the supply of medical care in the largest municipality of France, seven times bigger than Paris.

In question: the will of the Government to strictly apply the ceiling on the remuneration of temporary doctors at a maximum of 1,170.04 euros gross for a 24-hour day, or about 900 euros net. An emergency doctor hired by the hospital at the beginning of his career receives 4,500 euros a month, with two guards.

Currently in great demand to fill the staff shortage, these temporary workers, sometimes described as “mercenaries”, can earn up to 3,000 euros net in certain hospitals.

The measure was supposed to go into effect on October 27, but was eventually postponed at the last minute until next year.

“The Arles area is huge with many isolated farmhouses,” underlines another member of the Inter Urgences collective, also a nursing assistant. “If there is no Mobile Emergency and Resuscitation Service (SMUR), in a vital emergency it is a disaster, especially since the liberal medicine next door is no longer present at night, you only have the hospital,” he adds.

– Priesthood –

From the site’s car park, only the LUMA Foundation tower, standing out against the gray sky, reminds us that the center of Arles is only three kilometers away. The village of Salin-de-Giraud, in the city but on the edge of the Camargue, is 40 kilometers away.

“I had two strokes and had a big problem with my lungs a year later. If I had been in Salin, it would have been a disaster,” says Jeanne Diacomicoli, 62, a driving school instructor. And a possible absence of SMUR makes the fear worse.

If in the immediate future the threat of closing the emergencies and the Arles SMUR recedes with the postponement of the measures on the medical interim, the problem of the attractiveness of the public hospital remains unresolved.

“It is like a small bandage that is put on a hospitable wooden leg that is in great difficulties”, although “it can give a punctual impulse until the holidays. Merry Christmas! But the next day is going to be a lot.” less rosy ”, estimates Philippe Valero, emergency physician.

“To have four doctors permanently in the emergency room, you need almost twelve or fifteen in a team and that is what we do not have,” laments Laurent Donadille, director of the hospital.

Même si tout le monde s’accorde sur le bien-fondé de l’encadrement de l’interim medical, qui a souvent entraîné une surenchère malsaine between établissements et grevé les budgets, il est devenu un luxe dont l’hôpital public peut difficilement se spend.

“The hiring of incumbents is getting worse and worse, even fixed-term contracts,” confirms Anne-Marie Lesage, secretary of the CGT union.

“The damage is done,” judges Inter Urgencias. “It is not only a problem of Arles, it is national. We are destroying the French health system. Nothing, the government has not learned any lessons,” laments the group.

Et de conclure: “Avant, the gens are battaient to become practicing hospitaliers, maintenant ils ne veulent plus travailler à l’hôpital public it seems that c’est trop dur, c’est très mal payé. Il faut avoir la foi” pour faire this work.

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