In response to Martin Hirsch: “The hospital cracks because its supports are running away from it”

“I have never experienced such a difficult comeback,” said Martin Hirsch a few days ago. In an interview that we published on November 18, the director of the Hospitals of Paris (AP-HP) spoke at length about the hospital crisis, the recruitment difficulties, the salaries of nursing staff and the relations between doctors. administration. The head of the largest CHU in Europe – and the largest employer in Ile-de-France – expressed both his desire to make the hospital more attractive, but also to continue with the reforms. The interview prompted a reaction from sixty doctors, nurses, orderlies or technicians, most of them members of the Inter-Hospitals collective (CIH), who transmitted this forum to L’Express.

In an interview published in L’Express, the director general of the AP-HP reviews the causes of the hospital crisis and the measures implemented to treat it: difficulties in attracting young people who have lived through the Covid crisis, funds created to improve working conditions, continuing education leading to diplomas … However, several hundred nursing assistants from the AP-HP passed the nursing exam in 2020 and 2021 and were refused funding for their training. . It is put forward pay increases of “300 euros”, but “with increased overtime”. A hospital version of working more to earn more?

There are also omissions in the analysis that deserve our attention. In 2016, the AP-HP opted for a new organization of working time which makes it possible to reduce the hourly time of agents by a few minutes, thus intensifying their tasks, especially reducing RTTs and in fact, the job table, forcing the alternation of working hours 15 days in the morning, 15 days in the afternoon (it’s obviously a little better than the three-eight …). This new organization was to be compensated by the strengthening of replacement teams, but the efficiency sought in recent years has rather melted these replacement pools like snow in the sun. Two years later, we doubled the stake by asking for a “adequacy of the personnel to the capacity”: where a nurse took charge of eight patients, it was necessary to go to one for twelve. And patatras! Staff savings, increased workload, no more room to train, replace or meet, staff flight …

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A Marshall plan for recruitment

We now perceive more caution: the disappearance of the ode to the versatility of agents previously acclaimed by management. Because yes: a hospital requires trained, experienced staff, forming stable and united teams. Sudden illumination? Awareness? We nevertheless perceive, despite the precautions of fireworks, the rejection of “uniformity”: it is a question of not touching the status, but of individualizing the courses, the bonuses, detaching oneself from the constraints. The hospital cracks because its trimmers and topsails shun it: nurses, lab technicians, radio manipulators, physiotherapists and basic doctors … 30% of positions are vacant in public hospitals, but administrators believe that promises of individual gratification are apt to attract. They definitely did not understand the collective aspirations to work better together as the staff were able to experience during the storm of the first wave of the Covid, which saw the public hospital treading on its feet again.

Hospital workers hope to be able to work better and well, to have time to do their work correctly and therefore that they will be guaranteed replacements in the event of stoppages, stable teams, decent staff ratios, that we hear them, that ‘we remove the strata between the field level and the decision level. That no project can be implemented without informing those who will bring it to life and that we collect their criticism. These decisions do not come under a call for projects giving access to an improvement fund. They must and can be clearly stated and immediately implemented. It is about the return of confidence in administrative and executive authorities who no longer have any credit within a community of caregivers and hospital staff. They want a new vision of human resources to be put in place without delay as part of a genuine Marshall plan for recruitment.

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Signatories: Ackermann Oanez (PH), Amador Maria del Mar, Arotcarena Ramuntxo (PH), Banes Noémie (IDE), Baruchel André, Benoit Guy (PH), Benzouid Cherine (PH), Bizouarn Philippe (PH), Boboul Yann (IDE ), Boisson Véronique (PH), Bourmaleau Julie (Nursing Executive), Caillebot Muriel (Nursing Executive), Catalano Salvatore (Tech Labo), Chanchou Jérémy (AS), Charron Cyril (PH), Costa Olivier (AS), Crozier Sophie ( PH), Debrie Justine (IDE), Dougha Abdel (AS), Dupic Laurent (PH), Gajewski Estelle (IDE), Ghander Cecile (PH), Gaudric Julien (PH), Gembara Laurence (PH), Gervais Anne (PH) , Grabli David (PUPH), Guy-Coichard Christian (PH), Hartemann Agnès (PUPH), Hentgen Véronique (PH), Hernandez Yann (IDE), Nicolas Kazolias (AS), Jac Corinne (AS), Lafarge Candice (AS) , Lafaurie Mathieu (PH), Laugier Joelle (PH), Martin Marie-Pierre (IDE), Maes Yann (AS), Mahalaine Lyasid (Childcare assistant), Marguet Christophe (PUPH), Mariette Xavier (PUPH), Martin Marie Pierre (IDE), Melica Giovanna, Melki Isabelle (PH), Mignon Mélanie (Nursing manager), Milleron Olivier (PH), Mourman Vianney (PH), Negre Isabelle (PH), Papas Anne (Nursing manager trainer), Pavie Juliette (PH), Pelloux Patrick (PH), Pecard Sylvie, Phung Bao (PH), Pinsard Florence (Nursing manager), Rousselot Philippe (PUPH), Salachas François (PH), Sartori Eric (PH), Schwob Pierre (IDE), Simon Isabelle (PH), Simon-Pescard Sylvie (IDE), Soulay Carole (Pharmacy Assistant), Thiollier Anne-Françoise (Childcare worker), Thomas Catherine (PH), Travouez Aline (AS), Trivalle Christophe (PH), Trosini-Désert Valéry (PH), Vigneau Cécile (PUPH ).



Frédéric Filloux is a columnist for L'Express and editor of the Monday Note.Frédéric Filloux

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