At the hospital, if the pandemic filled the intensive care units, it also emptied the other departments. The drop in hospital activity, estimated at 6.7% in 2020 in volume, took a long time to be caught up.
If private clinics have returned to a pre-Covid level of activity in 2022, the situation has not completely recovered at public hospitals.
In 2023, the federation of public hospitals (FHF) still observes an under-use of care in digestive surgery (-11%), cardiology (-13%), care related to the nervous system (-11%) and transplants (-7 .5%) compared to the expected level.
“We closed operating theaters during Covid because there was no longer any activity (…) And at the time of the resumption, which took place gradually, we did not reopen everything”explains Dr Marc Noizet, president of the emergency doctors union Samu Urgences de France.
Behind this slow recovery lies an unprecedented human resources crisis.
Wave of resignations among nurses
The pandemic has ” revealed “ the lack of resources at the hospital and given to caregivers “the hope of real change”remembers Thierry Amouroux, spokesperson for the SNPI (hospital nurses union, CFE-CGC). “But when, during the deconfinement, the small managers returned to resume their economic plans where they were before, it was terribly violent. There has been a divorce with the white coats” and resignations, he points out.
In 2022, the FHF counted nearly 6% of vacant nursing positions, or 15,000, unheard of. The situation has eased a little since then, with the rate falling to 3% in 2023.
But for Thierry Amouroux, these figures underestimate reality. According to a calculation by the union based on the establishments’ social reports (including unreplaced sick leave, burn-out, etc.), 60,000 nursing positions remain vacant today in public and private hospitals.
After the crisis, “pillars of service have left, those who tutored young people… Because they have lost hope”he sighs.
On the financial level, the hemorrhage of caregivers forced the government to loosen the tap on remuneration a little, to retain them. In 2020, Ségur de la santé increased the salaries of caregivers and planned investments in the hospital. An additional expense for Health Insurance, estimated at 13.2 billion euros in 2023, according to the Social Security accounts committee.
-Recognition and sharing of skills are long overdue
But for many experts, these expenses are not financed, explaining a large part of the current Health Insurance deficit.
“For the most part, these long-term expenses have not been covered by the allocation of additional resources”soberly noted the annual report of the Social Security accounts commission, in October.
The paramedical professions, pharmacists and nurses in the lead, regret for their part that the promises of transformation and decompartmentalization of the health system – made at the heart of the crisis, when all hands were requisitioned to screen, vaccinate, treat – have not been fulfilled. all materialized.
The nurses, heavily involved and applauded every evening on the balconies like all caregivers during confinement, are still suffering four years later from a “lack of recognition”estimates the president of their Order, Sylvaine Mazière-Tauran.
The measures aimed at giving them more autonomy are being taken piecemeal (possibility of issuing death certificates, direct access to certain advanced practice nurses, etc.), but the overall reform of the nursing profession, promised by the successive ministers of health, is long overdue.
For Gérard Raymond, president of the federation of patient associations France Assos Santé, the world of health has returned “too quickly to its old corporatisms”.
https://www.whatsupdoc-lemag.fr/article/cinq-ans-apres-la-pandemie-de-covid-ou-en-est
“At the time of Covid, nurses, doctors, pharmacists, doctors were able to collaborate, coordinate, set up remote consultations… They showed that it was possible. But today, the sharing of skills does not go far enough, not at all fast enough,” he regrets.
WITH AFP
