Question 10168 — health

Summary

Ms. Marie Mesmeur alerts the Minister to the Minister of Labor, Health, Solidarity and Families, responsible for health and access to care, about the worrying situation of medical regulation assistants (ARM) and the deterioration of their working conditions. According to feedback from the CGT CHU santé, these agents work in precarious conditions within a service that is already in high demand. Overload of activity, direct consequence of the gradual disengagement of traditional emergency services, considerably increases the pressure exerted on the teams. The regulation service of the University Hospital Center (CHU) of Rennes currently relies on a small team of 43 ARMs, several of whom are contractual, external or interns. On weekdays, the center receives between 1,400 and 1,500 calls per day, with a peak of up to 1 700 calls from Monday. On weekends, this load increases further, reaching between 1,700 and 2,000 calls per day. To cope with these volumes, only 12 to 13 agents are mobilized during the week and 17 at the weekend, to cover the entire 24 hours. This represents on average between 116 and 125 calls per agent per day. In theory, each call is estimated at 5 minutes, but this average does not reflect the complexity or intensity of the daily. Some calls, longer and psychologically demanding, leave little room for recovery. ARMs are then confronted with a rate which exceeds the limits of a sustainable workload in the long term. The CGT CHU santé estimates that at least one full-time position would be missing at Rennes University Hospital, as well as a significant strengthening of the replacement pool. Furthermore, it should be noted the lack of recognition from which ARM coordinators suffer. Their missions, such as managing teams, piloting the activity and leading an approach to improving the quality of service, fall under executive status. However, since the creation of this function in 2023, coordinators have noticed a drop in their remuneration, which amounts for example to 150 to 200 euros net per month within the Brest University Hospital. In Rennes, the gap remuneration between a coordinator and an ARM is barely 20 euros gross monthly. The current salary scales do not provide for any real salary increase for this function, despite the increased responsibilities and the qualifications required. The Rennes and Brest University Hospitals are unfortunately not isolated cases, as evidenced by the tensions reported in the establishments of Laval, Bordeaux and even La Roche-sur-Yon. In this context, she asks what measures the State intends to implement to guarantee effective and equitable access to emergencies for all citizens, while ensuring dignified and sustainable working conditions for medical regulation assistants.

Machine translation from French. The official text remains authoritative.

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