Question 4453 — health establishments

Summary

Mr. Pascal Markowsky alerts the Minister of Labor, Health, Solidarity and Families to the repeated and serious closures of emergency services in Charente-Maritime, a direct consequence of the difficulties in recruiting medical and paramedical staff. On February 6, 2025, the Saint-Georges-de-Didonne polyclinic announced the suspension of its emergency reception service (SAU) for an indefinite period, citing a shortage of qualified personnel. This closure places the territory facing a critical situation in terms of access to urgent care. The Pays Royannais emergency health cooperation group (GCS), which brings together the SAUs of the Royan Atlantique hospital center (CHRA), the Pasteur clinic and the Saint-Georges-de-Didonne polyclinic, until now benefited from an emergency population allocation (DPU) of 6.45 million euros, of which 1.19 million euros allocated to the Saint-Georges polyclinic. The temporary closure of this establishment will not reduce the demand for urgent care in the region. On the contrary, it requires the two remaining structures to absorb a significant increase in attendance, in a context of increased pressure on staff numbers and reception and hospitalization capacities. It is imperative that this allocation of 1.19 million euros be maintained and reassigned to other structures of the health cooperation group in order to enable them to cope with this overload. As the only emergency structure in the Pays Royannais accessible 24 hours a day, the emergency reception service at the Royan Atlantique hospital center assumes a major responsibility in the management of unscheduled care in the region. Already in high demand, it is facing saturation chronic exacerbated by persistent structural difficulties: insufficient hospital beds, vacancies in medical posts and fragility of specialized care sectors, making the organization of patient transfers particularly complex. The cessation of activity of the SAU of the Saint-Georges-de-Didonne polyclinic will only aggravate this situation, further increasing the pressure on an emergency system already under pressure. tension. This crisis is not limited to Royan. In August 2024, the pediatric emergencies at the Saintes hospital center had to close temporarily due to a lack of available pediatricians. During the same period, the Jonzac hospital center was also forced to limit access to its emergency department to only vital cases, due to a lack of sufficient medical staff. Furthermore, the SMUR of Royan hospital, due to a lack of doctors, does not can no longer provide outings 24 hours a day, further accentuating the difficulties of access to emergency care in the department. At the national level, the situation is just as worrying. According to a survey by the Samu-Urgences de France (SUdF) union published on September 17, 2024, 61% of the emergency services surveyed had to close at least one medical line during the summer of 2024, compared to 57% the previous year. In addition, almost 80% of SMUR were unable to operate continuously during this period. In Charente-Maritime, despite the efforts made to attract new doctors, the results remain insufficient. Since 2020, 57 general practitioners have benefited from installation assistance as part of the departmental health plan, but these initiatives are not enough to compensate for retirements and meet the growing needs of a growing population. Every summer, the department's population doubles, exceeding 1.6 million inhabitants, further straining an already struggling health system. The MP asks the Minister what emergency measures the Government intends to take to immediately guarantee the maintenance of access to urgent care in Charente-Maritime. He also wishes to know if the Government is committed to maintaining and reallocating the allocation of 1.19 million euros to other emergency structures in the Pays Royannais in order to avoid a collapse of the system. Finally, he asks what structural actions will be put in place in order to make the emergency sector less vulnerable to the vagaries of medical recruitment and guarantee access to emergency care for all residents and visitors to the department.

Machine translation from French. The official text remains authoritative.

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