Border workers. The Jura sees its caregivers leave for Switzerland: the figures of a crisis

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A recent study entitled “Caregivers, care provision and staff training in the Franco-Swiss Jura Arc” made public during the month of October by INSEE Bourgogne-Franche-Comté, reveals the figures for the exodus of French caregivers towards Switzerland.

The analysis scans the entire the Franco-Swiss Jura arcthat is to say this cross-border region which extends from Franche-Comté to the canton of Bern, populated by approximately 1.7 million inhabitants, united by geography, language, culture, but which straddles two States and two very distinct economies.

The statistical study, carried out following the entry into force in October 2019 of the framework agreement on cross-border health cooperationgives a realistic photograph of the demographics of healthcare workers in this region and distribution of care provision. The exodus of French caregivers to Switzerland weighs heavily on the provision of care in the rural areas of Haut-Jura.

Gradual erosion in the Jura

The study thus establishes that the Franco-Swiss Jura arc employs nearly 58,000 caregiversor more than 4% of the territory's workers, and that the workers concerned are mainly women (90%) with an average age of 40 years on the French side and 42 years on the Swiss side.

The Jura alone has around 7,000 caregiversor a density of 16 per 1,000 inhabitants. This is higher than the French national average but lower than the Swiss part of the Jura Arc (20 per 1,000). Nurses represent 60% of this workforce.

However, the French Jura faces a gradual erosion of its medical staff. Over the past 10 years, the number of general practitioners has fallen by 1.2% per year, reaching an average age of 49 years with 20% of practitioners over 65 years old. This lack of local doctors has a direct impact on access to care for populations, particularly the elderly.

The proximity of the Swiss border certainly exacerbates these difficulties. Around 16% of caregivers residing in Jura work on the other side of the borderor almost one in six. This phenomenon has become more pronounced in recent years, with the doubling of the number of cross-border workers in 10 yearsattracted by better pay and conditions.

Young cross-border caregivers, on average 5 years younger than their French counterparts, contribute to weakening the provision of care on the French side. THE Jura establishments are indeed struggling to recruit and retain their staff, weakening local health care.

The Jura Arc also has nearly 13,000 doctors in practice at the end of 2022, more than half of whom are specialists. However, there are disparities with a lack of general practitioners and pediatricians in rural and mountainous areas. The high average age of local practitioners, reaching 53 years in Switzerland with 16% over 65, accentuates the risks of medical deserts.

The scale of the challenge of access to care

To try to overcome these challenges, the authorities have put in place various measures: installation aid, cross-border cooperation, career development. But Switzerland's attractiveness remains strong, especially since medical training is more developed there.

This new statistical study from INSEE reveals the scale of the challenge facing local elected officials and health professionals to maintain a local medical network and guarantee access to care in rural areas, marked by growing needs of a aging population.

Guy Monneret (CLP)

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