Question 18106 — health establishments

Summary

Ms. Bénédicte Taurine questions the Minister of Solidarity and Health about the alarming situation at the intercommunal hospital center of the Ariège valleys (CHIVA) and for this, details the history of the last three years that the nursing staff provided to her. CHIVA's mission was to support, within the framework of regional hospital groups (GHT), four small local hospitals: Jules Rousse in Tarascon, Saint-Louis in Ax-les-Thermes, the Ariège-Couserans hospital center in Saint-Girons and the Pays d’Olmes hospital center (CHPO) in Lavelanet. However, in September 2017, a first series of bed closures took place: 15 beds in hepato-gastrology, consequence of the merger of visceral surgery services and gastroenterology beds and 20 beds in general medicine for the benefit of short geriatric stays. On January 1, 2018, the CHIVA and the CHPO merge without management organizing the election of the establishment medical commission (CME). This constitutes a transgression of article R. 6141-13 of the public health code of which the minister is nevertheless the “guarantor”. In addition, from January 2018, the psycho-social risks (RPS) expertise mandated by the CHSCT revealed 32 personal situations evoking suicidal ideas linked to work. Furthermore, the CHIVA is the largest employer in Ariège with 1,600 agents including 400 precarious contract workers (25%), and thousands of induced jobs; it is also an economic hub of the department. Generally speaking, CHIVA management remains deaf to the requests of doctors, particularly those carrying out activity development projects in different specialties, causing several departures. These forced departures would have contributed to the closure of the neurology, diabetology, ophthalmology and infectious diseases, thus increasing a medical desertification that is already unbearable for the population. The absence of social dialogue and decisions taken unilaterally by the director are the daily life of CHIVA, such as for example the blocking of the general computer distribution network between doctors, generating a significant conflict between the director and the local medical community. In 2019, nursing staff recorded 54 bed reductions in several departments (pulmonology, neurology, cardiology, etc.). Furthermore, the nursing staff would like to point out that there were 30 beds from the long-term care unit (USLD) at CH Tarascon transferred to the Bellissen EHPAD. To date, the ARS has not transmitted authorization for this transfer of activity to the Bellissen site. Consequently, this decision unilateral decision of a new "capacity" in the absence of a constructive information meeting with management and by not respecting the rules of social dialogue, has inflamed all staff, users and elected officials regarding a further elimination of hospital beds to satisfy the return to balance plan (PRE) imposed by the ARS. All the actors and actresses of the Ariège territory call for a reconsideration of the needs of the population and the cessation of managerial and budgetary management which dismantles the public hospital service, endangering the population and in particular the most vulnerable people. In this regard, strong measures are expected. She asks her if she intends to erase the CHIVA debt, finance a fourth building for geriatric purposes, impose the immediate placing under status of contract workers and develop the specialties medical conditions that the population needs to be born, live, work and care for themselves.

Machine translation from French. The official text remains authoritative.

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