Deemed crucial by caregivers, the issue of hospital staff is so far little addressed by the “Ségur de la santé”. A source of concern for the unions, who fear that the subject will be “hidden” by the government.
Will there be a “hiring plan” for hospital staff and if so, to what extent? Two weeks after the launch of the discussions of the “Ségur de la santé”, the vagueness persists on the intentions of the executive in terms of job creation.
“Emmanuel Macron and Edouard Philippe talked about increases in pay and working time. But they did not say anything about the workforce ”, recalls Anne Gervais, co-founder of the Collective Inter-Hospitals (CIH), who considers this silence“ surprising ”.
“The revaluation of wages seems to have been taken, even if we do not yet have a precise figure. But on the hiring, we have nothing: it is as if the subject was evaded ”, abounds Jacques Trévidic, president of the union Action Practitioners Hospital (APH).
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Among the pillars of “Ségur” (salaries / careers, investment, territoriality, governance of establishments), none refers to the issue of staffing. And the subject did not appear anywhere in the documents initially given to the unions.
A paradoxical situation, while caregivers keep calling for a “massive recruitment plan”, focusing in particular on nurses and caregivers, in order to relieve “overwhelmed” medical teams.
“Our first demand, even before that of salaries, is hiring. Not making it a full-fledged theme of Ségur is incomprehensible ”, annoys Christophe Prudhomme, emergency doctor in Seine-Saint-Denis and CGT activist.
“The risk is that the subject becomes a blind spot” in the discussions, adds Jacques Trévidic. “However, the lack of personnel has been a problem for years, everyone knows it”, insists the hospital pharmacist.
In particular in question: the reform of the 35 hours, entered into force in 2002, but which was never accompanied by the 40,000 recruitments initially envisaged to accompany the reorganization of work within the establishments of health.
“We did not recruit nurses to make up for the time freed up by the reform. Suddenly, the nursing staff must do the same tasks as before, but in a shorter time, which is exhausting ”, explains Anne Gervais.
A headache for the organization of care, especially in nursing homes and in emergency services, where patients are sometimes placed on stretchers… for lack of personnel to take care of them.
Will the “massive plan” promised by the Elysee Palace provide solutions to this problem, even if the subject is not among the topics for discussion? Some hope so, recalling that the understaffing also results from the hospital’s lack of attractiveness.
“The problem, very often, is the lack of candidates”, underlines Zaynab Riet, general delegate of the Federation of hospitals of France (FHF), who recalls that many positions are currently budgeted but not filled.
Before the Covid-19 crisis, 500 nursing positions were thus vacant in AP-HP establishments. And last year, nearly 30% of medical positions at the hospital did not find a taker, according to the FHF.
This situation forces hospitals to increase the use of temporary workers, even if it means straining their budget and giving up additional hires, the employment of temporary workers having a very high cost.
“The issue of staffing is a long-term problem, which cannot be resolved by snapping your fingers”, underlines Didier Birig, of FO Santé. “This does not require strong commitments in terms of training and attractiveness”.
In total, “10% of jobs in health establishments are vacant,” insists for his part the president of the Federation of Private Hospitals (FHP), Lamine Gharbi. “Stimulating an attractiveness shock” would “create 100,000 jobs”, he calculates.
An “attractiveness shock” for once at the heart of the discussions, via the question of salaries and careers. “The issue of staffing in my opinion cannot be avoided. Otherwise, the ‘Ségur’ will be a failure ”, warns Didier Birig.