“Relieve pressure on emergency rooms before the end of 2024.” Emmanuel Macron’s promise was beautiful, but purely incantatory since it was not accompanied by the major structural measures essential to get hospitals out of the rut they have been sinking into for years.
This summer, the list of emergency rooms closed at night, every day or on a recurring basis has become a long litany, and the waiting times for patients who need to be hospitalized urgently are often measured in days, even weeks. Unthinkable just a few years ago, this observation of a major deficiency no longer seems to shock certain political leaders, as evidenced by the self-satisfaction, in mid-August, of the resigning Minister Delegate for Health, Frédéric Valletoux, explaining that with a “fifty hospitals under pressure”the situation is better than in 2023…
How can we get used to such figures, probably far from reality, which hide so much suffering for patients and their loved ones, so many complications and anxieties, and increasingly losses of treatment opportunities which risk resulting, unfortunately, in deaths that would normally be avoidable? Not to mention the working conditions of all hospital staff, on the front line facing the dysfunctions that they try to alleviate through unwavering commitment, but who cannot be asked to make unrewarded efforts and to find solutions to problems for which they are in no way responsible.
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Summer is a difficult time because of the holidays, but the epidemics of autumn and winter cause, every year, the same congestion in the emergency room and in pediatrics. The psychiatric or geriatric services, however, are overwhelmed in all seasons. The crisis is deep and in no way cyclical.
Crucial question of staffing
The saturation of emergency services is the consequence of the dysfunctions of the entire hospital system, or even of the health system as a whole. The three stages of the care pathway are affected by failures: upstream, by the inadequacies of early and regular care leading to increased recourse to emergency services; within emergency services, by staff shortages; downstream, by the lack of beds to hospitalize patients.
It is therefore imperative and urgent to build and deploy a major recovery plan for public hospitals, with the needs of patients as its primary objectives, and the defense of its staff as its lever for action. All institutional, organizational or technological reforms, however relevant they may be, will never be enough to get hospitals out of the crisis if caregivers are not considered at their true value, that is to say the vital resource and essential wealth of any health establishment. Care is above all human and, even more than any other public service, the hospital can only play its role with a sufficient number of staff, recognized for their skills and commitment, and equipped with the necessary means to implement their know-how.
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