Question 9117 — health professions

Summary

Ms. Céline Thiébault-Martinez draws the attention of the Minister to the Minister of Labor, Health, Solidarity and Families, responsible for health and access to care, to the extremely worrying situation of several hospital practitioners and associated practitioners qualified outside the European Union (PADHUE) working at the Grand Hôpital de l'Est Francilien (GHEF). Between 2020 and 2024, these doctors – around fifty – were recruited by the GHEF, which paid them bonuses in order to encourage them to join the establishment and ensure the functioning of its services. These bonuses represented between 30% and 50% of their salary and were included in their employment contracts. They aimed in particular to ensure decent remuneration for these doctors, often foreigners, and to compensate for the fact that many of them work between 60 and 70 hours per week, i.e. more than the maximum authorized working time. The management, renewed in 2023, considers that the bonuses paid – which sometimes represented up to 70% of the remuneration of these practitioners – were unduly collected, although they were provided for in contracts validated by the hospitals themselves. After informing them of her desire to suspend these payments, she is now demanding their reimbursement. The situation is ludicrous: these doctors, who work between 60 and 70 hours per week, today receive between 1,500 and 2,000 euros net per month, for a workload equivalent to that of their tenured counterparts, paid three to four times more. They are now ordered to return the bonuses received between 2023 and 2025, for amounts of up to 100,000 euros per person. This decision places these professionals in a situation of extreme precariousness and arouses deep incomprehension, even though their commitment has been essential, particularly during the health crisis. The social cost is enormous, as these caregivers can no longer trust their public employer, who is trying to make them bear the burden of their own fault, their departure from the GHEF would force the closure of several services and some are already on sick leave. Moreover, the very legal appropriateness of this approach on the part of the GHEF management is itself questionable. The decision of the Council of State dating from October 12, 2009 testifies to this: "the decision of July 1, 1904, Navaggioni, sees in the erroneous payments made by the administration and the delays in ordering the repayment of faults likely to engage the responsibility of the public authorities" (no. 310300). The Council of State in is regularly applied and “in the event that nothing can be blamed on the victim, the latter receives compensation equal to the overpayment”. This situation clearly illustrates the way in which PADHUE doctors, whether already recognized or in the process of being validated, are treated in the operation of the public hospital. Too often considered as cheap labor, they face conditions of degraded work, a lack of recognition, or even real contempt on the part of certain managements. And yet, their role is crucial, particularly in the fight against medical desertification. Today, nearly 80% of French territory is affected by a shortage of health professionals. These doctors are essential to guarantee access to care for all French people. She asks what Measures the Government intends to put in place to legally secure the employment conditions of these caregivers and to avoid these reimbursement requests with dramatic consequences, in order to guarantee them fair recognition of their work.

Machine translation from French. The official text remains authoritative.

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