The French health care system is regularly touted by right wing commentators as superior in its performance to that in England – ignoring its considerably increased level of spending per head (€200 billion per year), superior availability of scanners and higher provision of beds.

But a major ongoing dispute in hospital emergency departments underlines the fact that inadequate staffing levels and funding can wreak havoc there too.

On June 10 emergency workers staged a national day of action, following on from strikes and protests which began in Paris back in March, and which have now reached to 95 emergency departments in hospitals across France. The strikes have been backed by French unions CGT, Sud and Force Ouvriere.

The strikers are complaining of funding cuts, a government reduction in the number of beds and a serious lack of medical staff leading to dire working conditions for emergency room staff. The health ministry’s figures show that from 2012 to 2016 emergency room visits in public hospitals (which make up the bulk of France’s hospitals, and almost all of the emergency provision) increased by 12 percent, while the number of paramedics increased only by 5 percent.

The lack of resources has led to a mortality rate 9 percent higher than it would be in adequately resourced emergency departments, according to Christophe Prudhomme, spokesperson for the Association of Emergency Room Doctors, who warned last year that for patients in critical condition that number can reach as high as 30 percent.

François Braun, president of the ambulance workers’union said the French system of emergency care’ has reached an unprecedented breaking point, as he issued the call for a five-minute walkout.

The stoppages have been restricted because it is illegal for emergency department staff to strike in France.

As a result their protests have taken various forms, with large numbers of staff taking sick leave to deal with ‘burnout’ after working excessively long shifts. In St Antoine hospital Paris, RFI reported 16 out of 19 staff members went off sick after having to work a marathon 18 hour stint the previous Saturday.

In Lariboisière hospital in Paris, 65 percent of the emergency night team reportedly took sick leave shortly before their shifts were due to begin at 9pm.

But management have retaliated: hospital chiefs in Jura, eastern France sent gendarmes with requisition orders to the homes of healthcare workers, demanding they turn up for work.

1.00am knock from police

According to an angry emergency doctor: “The police came to the door of a nurse at 1.00 am. She had already worked 72 hours that week.”

Emergency staff say they are being forced to work long hours to compensate for staff shortages, and warn that this is putting patient care at risk. An investigation into the death of a 55-year-old patient a Paris hospital last December while awaiting treatment has found that the emergency department was overwhelmed with patients that day.

The emergency staff are demanding more beds, 10,000 more staff, and a €300 per month increase in pay. They have forced action from Health Minister Agnes Buzyn, herself a former hospital doctor, has refused to condone spurious taking of sick leave, but said that she “understands the impatience of emergency workers” as a result of the “unbearable everyday existence” they face.

She has announced five immediate measures to tackle the situation, including accelerating the renovation of dilapidated emergency department buildings, the creation of a bonus for paramedics who carry out duties normally carried out by a doctor, and the extension of another bonus which already exists for paramedics to cover more staff.

She has also asked MP Thomas Mesnier, who was previously an emergency doctor, and the President of the National Union of Emergency Services to come up with a plan to restructure the country’s emergency services, with their proposals expected by November.

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John Lister
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