Never has the Saint-Jean-de-Luz polyclinic caused so much ink to flow. Since September, its emergency department has been in slow motion. A deficit of 700,000 euros, the need to adopt a strategy to replenish the funds and a reorganization of the service planned by January 2025 have scared away its employees. The director, Stéphane Fagot, and Marc Dib, president of the establishment medical commission (CME), opened the doors of the polyclinic to the press on Tuesday November 26 to clarify things.
An operational polyclinic
“The current news puts emergencies in the spotlight,” recognizes Stéphane Fagot. But the South Basque Coast polyclinic is not just that,” he wants to clarify. Between an extension of approximately 1000 m² additional, a chemotherapy department completely renovated to offer a personalized offer and the refurbishment of the operating theater for prosthetic surgery, the director recalls that the establishment “continues to operate” despite the difficulties which he crosses.
As a “denial” to the hypotheses delivered by our colleagues at South West Last week, director Stéphane Fagot and Marc Dib put an end to any fantasy by stating: “There is no planned sale of the polyclinic. It has never been considered, on the contrary.” To convince, the duo insists on the “independent” character of the polyclinic, which “always encourages the confidence of its shareholders, all doctors or former doctors”. A sum of 2.2 million euros was invested by them, in addition to 10 million euros, to expand and modernize the structure. Between 2023 and 2024, the annual turnover was around 24 million euros and the establishment currently employs 208 full-time equivalents.
Heavy deficit and drop in activity, reorganization is necessary
Emergency services are becoming precarious throughout France. “The relationship between patients and emergency doctors is evolving,” underlines Stéphane Fagot, particularly following the Covid-19 epidemic. Telemedicine, use of SOS doctors, facilitation of making an appointment with a general practitioner enabled by the Doctolib website contribute to this transformation of relationships between the population and emergencies. The activity of the polyclinic has decreased significantly due to this development, according to its representatives. “The clinic's desire is to maintain emergency rooms open 24 hours a day, 365 days a year. We have never deviated from this path,” assures Marc Dib. With a deficit of 700,000 euros last year, which has been accumulating for three years, the priority is balance.
According to management, for two and a half years, discussions have been held between emergency physicians and the board of directors to find a solution. Presented as “the best” possible strategy, last September they announced to emergency staff the reorganization of the service by relying on an emergency doctor during the day and an emergency doctor at night, outside of the summer peak. A “coherent” solution, in the words of Marc Dib, who emphasizes that the service has returned to a level of attendance close to that observed between 2010 and 2015, based on this operating model. This was without taking into account the repeated departures or sick leave of around ten emergency doctors who contest this measure.
Looking forward to
“Recruiting emergency doctors today cannot be found under the hoof of a horse,” laments Stéphane Fagot. To the question “Is this mode of operation effective?” », the pair responds positively. An external audit carried out by the ARS last October should answer these questions in the days to come, and possibly lead to a lasting outcome. If the answer is no, Stéphane Fagot hopes that “this report will open other avenues, which will require different support from the State”. Discussions are also underway with the Bayonne hospital, which is awaiting the results of the ARS before taking a position. An agreement which could, according to the director, stabilize the team of emergency doctors in Luz.
