What are the objectives of Ségur de la santé, launched in the midst of the health crisis?
It is the largest investment plan for hospitals and nursing homes in the history of our country. 19 billion euros will be used to reduce debt in hospitals, for day-to-day investments, in order to provide financial resources directly to healthcare teams in hospitals so that they can modernize or buy essential equipment. 3,000 hospitals and nursing homes will be supported, deleveraged, modernized and rebuilt thanks to this money from the European recovery plan and from taxpayers.
How much of the pie will go to Brittany?
For the Brittany region, these are 855 million euros, including 773 million for the health sector. They break down into 451 million euros of priority investments, to rebuild or modernize hospitals, 248 million to reduce their debt, and 74 million for daily investments. We must also add 82 million euros for the medico-social sector, including 71 million for investment aid and 11 million for daily investment.
Besides the future hospital center near Saint-Malo financed to the tune of € 100 million, what are the major Breton projects registered with Ségur?
I hope that we can rebuild the Villeneuve site, in Quimperlé (29), for an amount of € 18 million in Ségur aid, so as to simultaneously modernize the medical services, consultations, functional exploration, and re-education. The new hospital will be built in such a way as to make the area more attractive in order to encourage the installation of liberal practitioners, within the Quimperlé basin. A second big project concerns Rennes. € 80 million have been released for the CHU in order to bring together on a single site all the activities of medicine, surgery and obstetrics, with a logic of sustainable development and better reception for users. This investment will make it possible to strengthen the medical attractiveness of the CHU. There are many other projects that I would have the opportunity to present, in Brest, where I am going this Friday.
How much could the new hospital project in Guingamp receive?
I confirm to you that it is indeed a file which is under investigation. The ARS and the supervisory board of the Guingamp hospital appointed its director last year to rebuild the establishment thanks to the Ségur de la santé. There is a mission entrusted to a very good expert, Mr. Rossetti, who is studying to what extent an evolution in architecture could provide a response to the multiple difficulties encountered by both the Guingamp hospital and many establishments in Côtes-d’Armor. Among them, the dilapidated buildings and above all a lack of attractiveness for medical staff and major structural budget imbalances. The current expert mission relates generally to the organization of care in this area and the conclusions are awaited for the second half of 2022. But we can already say that in view of the positioning of the hospital of Guingamp, the surgical activity will be maintained, which therefore excludes labeling in local hospitals. As soon as this project is validated, the ARS will be able to support it, Ségur credits have been reserved. I am not advancing the amount today because the instruction work is still in progress.
Another Breton establishment is in great difficulty: the Center hospitalier du Center-Bretagne, in Noyal-Pontivy (56), which lacks staff to ensure continuity of care. What is planned to help him?
I have received the motion sent by the president of the Pontivy establishment medical commission, who is indeed worried about the future of the hospital, with difficulties in recruiting temporary staff. There are ongoing exchanges between the Regional Health Agency (ARS) and the hospital and the Groupement hospitalier de Bretagne Sud, in Lorient. Work is underway on building a team of emergency physicians who could eventually be shared by the two hospitals. From January 2022, there will be a regular participation of doctors from the GHBS in the emergency planning of the CHCB. On anesthesia, the heads of department of the two hospitals are also discussing to define the modalities of cooperation between medical teams. Similar collaborations may also develop for other specialties.
You talk a lot about real estate investment, but isn’t the biggest problem the unhappiness of the caregivers, the lack of consideration, the loss of meaning in their profession?
One section of Ségur deals with governance and the organization of care within hospitals. We provide them with a toolbox. We invite all hospital directors and presidents of establishment medical commissions to take it up, in order to rethink their internal organization: recreate services, reduce the administrative burden in favor of care, improve the representativeness of the various bodies of profession for decision-making, recreating more proximity, improving all that is quality of life at work. All these tools are available to hospitals, there is no longer a need for a law or a decree, everything is on the table. A large number of establishments have already signed majority agreements with all the unions, on the basis of a new internal organization within their establishment.
How many jobs do you plan to create when the hospital is clearly lacking in staff?
There are several emergencies, first to fill positions that are funded but vacant. You don’t have a magic wand to create doctors by the thousands in three days, it takes time to train them. There are also attractiveness solutions to attract doctors. Then there are caregiver positions to be filled. I have increased by 6,000, or about 30%, the number of nurses and orderlies in training this year. I will continue in this way so that all available positions are filled. Finally, Ségur allows the financing of 15,000 nursing posts.
Midwives promise “a dark weekend” despite promised salary increases. They are asking for more staff in maternity hospitals. Are you going to make proposals in this direction?
My proposals have been made. In my opinion, the consultation carried out with midwives, leading to a signed majority agreement, has taken a very favorable turn.
I remind you that all midwives, employed in the public or in the private sector, will benefit from 500 euros net more than the period before Ségur, from March 1. It never happens for any employee, in any professional body.
I also accepted the sixth year of training, created the status of referent midwife. I hear that of the seven social partners that I had in front of me, five have now called to stop the movement. I think that considering the nation’s effort – 100 million euros in compensation alone – everyone can understand that the movement is stopping. We will continue to make progress with midwives, as I have undertaken to do, on the development of their missions, professional skills and training issues.
The death of a man injured in the hand, at the end of 2020, in Lanfains (22), despite five calls to the emergency services, highlighted dysfunctions in the communication between firefighters and Samu. How to cure it ?
We have started a lot of work. There is in particular a law which has just been adopted on the interaction of the emergency services between the firefighters and the Samu. I believe that now everyone is really around the table to move forward and find solutions that are operational, consensual, adapted to each territory. This is the state of mind of the law which was passed almost unanimously by parliamentarians. Now you have to be able to apply it. At the same time, I developed the access to care service which allows for joint regulation between city medicine and hospital medicine at the service of patients.
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