The unions had issued a report on emergencies, followed by a mobilization this Wednesday, January 15. Anne Ferrer, the director of the hospital, said she heard this alert, and even anticipated it. It presents measures.
Midi Libre – JEAN-MICHEL MART
Last week, the CGT made a report of serious and imminent danger to the emergency room of the Montpellier University Hospital, followed by social mobilization this Wednesday. What is the situation for you?
When they made the report, I had already gone to the emergency room. Because we had had an increase since December 23-25, during the very special period of the end-of-year holidays, with many bed closures throughout the city. Everyone takes vacations, both in and out of the hospital. General practitioners too. And that’s normal. At that time, we suddenly saw a very significant increase in elderly people, over 75, presenting with respiratory problems. There was a flu epidemic everywhere in France. Moreover, for the record, those who were vaccinated passed the test much better. So we welcomed up to 180 patients per day in the emergency room, including 50 elderly people who needed to be hospitalized behind. In fact, the problem was actually broader: a problem upstream and downstream of emergencies. And that, over an extremely short period.
But the holidays and the flu are things that come back every year…
Usually we have bronchiolitis. We’re used to it, we don’t close. But when you look at the numbers, the explosion of activity is striking. We speak of a critical day when two days in a row, we have more than 180 visits to the emergency room at the same time. And once again, there is an influx of over 75s, which we must keep by protocol.
Was the report of serious and imminent danger therefore justified?
No. A DGI, for imminent serious danger, is there, at the moment, when a professional reports a danger which jeopardizes his own health and it must be stopped immediately. That’s what a DGI is, it’s case law. But this DGI was more about saying: be careful, something is happening. And this is a real acknowledgment of receipt on our part. On the evening of January 3, I was in the emergency room with the president of the doctors, with the site director, with all the managers, the doctors, the liaison nurses and I triggered the first crisis unit. And all week, the deputy CEO had been doing the same thing. On January 3, we decided to give the emergency room a little breathing space by taking boxes from the pediatrics department, which is adjacent. We have freed up places in pulmonology and medicine, to facilitate the downstream process and streamline the pathways. Here again, I pay tribute to the teams: everyone was remarkable. The goal was for there to be no endangerment to either patients or staff, but activity remained very high.
The report came later, on January 9.
We are going down from 180 to 150 per day and, concerning elderly patients, from 50 to 20. The issue for us is the downstream. We must put all this into perspective to ask ourselves what sustainable solutions we can bring for the future. And we have already started working on it. We need to put the real estate master plan into perspective. We suffer from cramped emergencies, the stretchers play touch-and-go. The priority is to have more space, a large room, where we can put the stretchers next to each other. But we do not suddenly decide to increase the square meters.
Based on this observation, what do you plan to do?
We have accelerated the implementation of the real estate master plan. And there must have been a building built on the other side of the emergency passage, dedicated to endocrine activities, etc., on the current heliport side. There, we reviewed this project last April and we decided to install a footbridge. No need for an ambulance anymore, it’s easy with a stretcher. We are going to enlarge the current emergencies and this footbridge will connect the current emergencies to this building, it’s super easy. With plenty of post-emergency beds. And we have another building which is due to be built in 2028. Except that when we say 2028, in the middle of a period of crisis, that is far away. But initially, this was not planned. Furthermore, from April, we took the measure of aging together. In two ways: the laying, this Monday, for the wishes, of the first stone, of Balmès 2, dedicated to geriatrics, palliative care, algology… In a week, we will lay the first stone. And there, for once, the delivery is earlier: 2027. It’s real, it’s concrete. With devices that will make it possible to anticipate visits to the emergency room for elderly people. With an offer of reinforced palliative and geriatric care.
-What will happen to the workforce? Is there more space, more beds? And on a personal level?
The numbers will of course increase. The entire project I’m telling you about on post-medical and pediatric emergencies is ready. We are presenting it this Thursday (past, Editor’s note), to our entire community. Behind, we will be able to equip these beds by 2028 and we have already started to equip Balmès 2 by 2027. But we still want to accelerate around fifteen post-emergency beds on the other side of the bridge and here again, recruit the manpower required to arm this new unit as quickly as possible. This is all from spring until now and it’s the challenge of aging. When we look at the demographics of the territory, we see that, gradually, many people will enter a state of dependence. We are strengthening our offer to anticipate: we are in a development strategy and not redeployment. We are not closing beds, on the contrary we are going to open beds and create teams. We have a desire to develop the CHU.
Yet these solutions do not prevent patients from waiting up to seventeen hours in the emergency room today? And how can we reduce this support time?
5 p.m., luckily, isn’t everyone’s time. If seriousness requires it, patients are treated very quickly. What we experienced was an arrival in a very dense upstream sector and a downstream sector that was not fluid enough. Placement in CHU services must also be facilitated and accelerated. Emergency teams must also have the results of additional examinations quickly… There are plenty of measures to take into account. But once again, we experienced a period of crisis which was the final straw. We tried to provide additional and visible solutions, with more timely responses, while committing to follow-up. We will also meet again this Tuesday with all the union organizations to prioritize and classify the different actions to be implemented in a sustainable manner.
You arrived at the head of the CHU in April 2023. The crux of the matter is the budget. In 19 months, have the hospital and emergency budgets increased?
Both have increased. When I arrived, the budget was in deficit of €15.9 million. The overall budget was 1.3 billion. In this, we had €711 million in personnel costs. For 2024, we remained at 1.3 billion but with personnel costs of €740 million, because we have more staff. There is zero impact on staff. Efforts are focused on purchases, consumption, spending on the medicines we transport… We are careful.
This also affects the dilapidated premises and equipment…
No, look at the unique biology site that we are going to open in March. Our investments are of the order of €80 million per year. It was important that we had our Ségur subsidies promised by the State at the start of the period. We almost brought in the €230 million. We must be at €191 million as of today. Behind the single biology site, there will be economies of scale. The projects are progressing.
You present your wishes to the 12,000 employees this Tuesday. What are you going to wish them and what should you wish for in the hospital?
I am extremely proud of my hospital. We think what we want about the Point’s ranking but it is a mixture of activity, notoriety and over-expertise. Being ranked 4th, we are super proud of it. This really demonstrates the dynamic activity of our university hospital teams. We must continue to provide quality care as our professionals do, and be able to continue to develop. Find me a university hospital that has acquired three latest generation surgical robots in one year. We had one old one, now we have three new ones. The cost? A little below €4 million. I hope that we continue to develop as we do today. We will also announce every month what is being launched and what we are receiving. The teams will start to see what has been announced.
