Question 27674 — health establishments

Summary

Mr. Jean-Paul Lecoq alerts the Minister of Solidarity and Health to the situation of the staff of the Le Havre hospital group, even more so in the current pandemic context. The growing unease within the public hospital is reaching its peak in the face of the mobilization of staff and in the face of this covid-19 pandemic. However, doctors have less and less power in the management of care, because the objectives imposed are the reduction in costs. We are witnessing a reversal of logic since it is costs that take precedence over care and not the other way around. This system put in place inevitably results in endangering both patients and professionals. Initially, the official objective of the reorganization was to better adapt to the needs of patients, particularly dependent patients. But beneath this laudable objective lies a real hunt for productivity, in order to always do more with less. Concretely, this new organization results in a reduction in the number of beds, in discharges at any time from emergencies regardless of the age of the patients, or even in the multiplication of outpatient services. The issue of outpatient care is a thorny one, because if it is made primarily for the well-being of patients, its promotion with the sole aim of reducing the time of Patient care, and therefore costs, becomes counterproductive medical nonsense. The consequences of this haste in patient care are, for example, patients returning because of too short a course of care; some families see their elders asked to leave the emergency room in the middle of the night; or again, newborns and mothers, despite a mother-child center, are invited to shorten their stays. All these practices deteriorate the image of the public service and the staff, exhausted but obliged by their profitability objectives, no longer have the choice of making unbearable choices for their own ethics and for the patients. In this race for economy and profit, private hospitals and companies are joining in, favoring profitable care. And this aberrant organization is verified when the GHH has outpatient examinations for hospitalized people in order to earn money. Doppler examinations are carried out privately and billed to the GHH, because places are saturated. Although GHH's activity has increased, it is still done at constant resources, as shown by the laundry service where the increase from 600 to 1200 sheets per hour is not possible with more staff. Moreover, in this service as in the kitchen, the GHH is no longer the “only” customer and is no longer a priority. This results in the absence of linen for some GHH patients. It is the same with housekeeping, which is outsourced whereas it would be less expensive with ASH. Finally, the MP alerts him to the Happytal system, representing the public hospital open to liberalism since three concierges are responsible for recovering the best rates per room from mutual insurance companies. individual. Thus three prices would exist depending on the patient's mutual insurance, with a system of gift vouchers for the best mutual insurance companies (here the night could be billed at 49, 55 or 75 euros depending on the mutual insurance company and offer different services to patients). Beyond the risk of an increase in mutual insurance prices, Happytal would represent triple-speed medicine. He wants to know his position on the subject.

Machine translation from French. The official text remains authoritative.

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