Shortage of caregivers: the French hospital model on the verge of collapse

They wonder how they will spend the winter. While an epidemic rebound is taking shape in France, many nurses and caregivers no longer have the strength to continue: resignations and absenteeism derail a hospital system at the end of its rope after two years of health crisis.

The red alert was launched by the scientific council on October 5, 2021. According to the organization chaired by Jean-François Delfraissy, 20% of beds in public hospitals in France are closed due to a lack of caregivers to take care of them. .

In nearly forty years of profession, Thierry Amouroux, spokesperson for the National Union of Nursing Professionals (SNPI) had never seen that. “We have always closed beds from July to allow agents to go on leave. But this is the first time that we have not been able to reopen them at the start of the school year.”

“Everyone is tired in my service, testifies to France 24, Virginie, a nurse from Pitié-Salpêtrière in Paris. Some temporary workers no longer come. tense flow. However, by pulling on the rope, the staff finally let go “.

Between the congestion of patients linked to unscheduled operations, the return of winter pathologies and the resumption of the epidemic, health professionals still do not see the end of the tunnel.

The result: an increase in absenteeism, of the order of 10% on average, but also a wave of departures. According to the French Hospital Federation (FHF), between 2% to 5% of nursing posts are currently vacant in hospitals and public medico-social establishments.

“Things are only getting worse”

The only good news is that the vaccination obligation has had very little effect on this shortage of caregivers. In mid-October, the Assistance publique – Hôpitaux de Paris (AP-HP) counted only 500 suspended agents out of the 100,000 in the organization.

>> To read on France24.com: Covid-19: these caregivers who refuse to be vaccinated

On the government side, the Minister of Health, Olivier Véran, concedes difficulties, but disputes the figure of 20% of closed beds. A survey is underway with all health establishments to accurately assess the situation.

“There are vacant positions in all establishments in France,” assures Thierry Amouroux for his part. “We are desperate and things are only getting worse.”

A point of view shared by Alexandre Brudon, vice-president of the Syndicat des Internes des Hôpitaux de Paris (SIHP). “There is a scissors effect between patients whose pathologies have worsened”, for lack of having been taken care of in time because of the Covid-19 pandemic and “the trajectory of reduction in beds which continued in 2020 “.

According to a report from the Directorate of Research, Evaluation Studies and Statistics (Drees), published in September, France had 386,835 hospital beds at the end of 2020, or 5,758 less in one year. Since 2013, 27,000 hospital beds have been eliminated, a drop of 6.5% in seven years.

In the wake of the Ségur de la santé, the government had promised to suspend restructuring projects for purely accounting reasons. But on the ground, this new doctrine is struggling to materialize.

>> Read also on France24.com: Covid-19: home helpers no longer want to be forgotten by the Ségur de la santé

“The Health Segur was a tribute paid to the hospital with bonuses for staff who had not had salary increases for a long time,” said Alexandre Brudon. But on the real issues, there were above all announcement effects, “points out the vice-president of the SIHP, who cites as an example the lack of resources committed to prevention.

Saturation in pediatrics

And this shortage of caregivers and beds does not spare pediatric services either, particularly in Île-de-France. Due to the winter epidemic of bronchiolitis which began earlier than usual this year, “children in emergency situations can no longer be taken care of” the Inter-Hospitals Collective (CIH) warned on Thursday. speaking of “sorting” to be done between young patients.

“In this month of October, we were unable to welcome five children in a vital emergency situation and had to cancel 25 hospitalizations scheduled for several months”, detailed Oanez Ackermann of the pediatric hepatology department of the Bicêtre University Hospital Center. (AP-HP) at a press conference.

To be taken care of in intensive care, children are sent to hospitals located around 100 kilometers from their parents’ homes.

“Even if pediatrics was less impacted by the Covid crisis, the staff went to lend a hand in other services”, details for France 24 Brigitte Virey, pediatrician in Dijon and president of the national union of French pediatricians, who reports also a growing number of burnouts and absenteeism among nurses and childcare workers.

Traveling Thursday to Blois hospital, Olivier Véran admitted that 1,300 nursing students had resigned between 2018 and 2021.

“It is not a crisis of vocation, but a shock between the dream profession and the profession exercised in the conditions of understaffing”, analyzes Thierry Amouroux. “And we don’t want to work in conditions that jeopardize the quality of patient care.”