Question 11152 — health professions

Summary

Mr. Michel Larive draws the attention of the Minister of Solidarity and Health to the extremely difficult situation of hospital speech therapists. Speech therapists, 97% of whom are women, intervene to treat oral or written communication disorders. They represent 4% of all health professionals. Today it is estimated that there are 36.9 speech therapists per 100,000 inhabitants on average throughout the country. French. If since 2013, speech therapists have finally obtained recognition for a bac +5 (master), their salaries have not been re-evaluated accordingly. The salary scales of hospital speech therapists are always aligned with those of occupational therapists and nurses in general care, which is equivalent to a bachelor's degree (bac +3). Speech therapists estimate their annual shortfall between 3,228 and 10,068 euros, compared to other hospital professions of equivalent level. This under-remuneration leads to a lack of attractiveness of the profession, which results in a flight of hospital speech therapists towards liberal activity, and undeniably harms access to care in a context where the aging of the population nevertheless increases the needs of the most fragile people. In the territory, there are 1,760 employed speech therapists in the sector public (FPH), but only 950 full-time equivalents. More than 50% of speech therapists employed at the hospital are part-time. Most often, speech therapists are encouraged to supplement their income by developing a parallel professional activity. However, it turns out that self-employed speech therapists are subject to significant fixed costs. They need to work a large number of hours to be able to pay, which is difficult to achieve when working part-time. The excessive use of part-time work therefore leads to significant job insecurity for employed speech therapists. The quality of care is degraded by the non-use of speech therapists fully integrated into the establishments' care teams. These practitioners are so rarely present in hospitals that doctors are often unaware of their existence when they develop care plans. For example, urgent care, such as waking up from a coma, which requires the intervention of the speech therapist to stimulate the patient's communication, is less and less accessible. Some diagnoses are incomplete and sometimes rehabilitation is delayed, which considerably impairs the rehabilitation and reintegration capacities of patients. The disappearance of hospital speech therapists worsens the situation and also has negative consequences on speech therapy students who struggle to find clinical placements in specialized services. Hospital speech therapists therefore wish to be remunerated in accordance with the skills and responsibilities they exercise, which would make public service attractive again to practitioners. With this in mind, they want the creation of a specific body of speech therapists, detached from the corps of reeducators who are not adapted to the ba c+5 level grids. Indeed, this category was created for bac +3 diplomas, alongside the body of nurses, subject to the administrative hierarchy of healthcare executives at bac +3 +1 level most of the time. Speech therapists also wish to remain fully integrated into the care teams, so that their skills are recognized by the teams. caregivers, and in particular doctors, which would make it possible to put an end to the shortage of care and would contribute to raising doctors' awareness of speech therapy skills. Considering these elements, he would like to know what she thinks of the situation of speech therapists in France, and what concrete measures she is considering to bring them greater recognition and a more stable situation.

Machine translation from French. The official text remains authoritative.

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