His first gesture was eagerly awaited. Nicolas Revel, who took the head of the Assistance Publique-Hôpitaux de Paris (AP-HP) before the summer, in a very difficult situation for the forty hospitals in the Ile-de-France region which depend on it, has just set the scene. In a letter addressed to the community of the Ile-de-France institution, Wednesday September 14, the director general and former chief of staff at Matignon puts thirty “courses of action”.
One more consultation, while the government has just inaugurated a cycle of discussions on all health issues. That of the AP-HP is taking shape in a shorter format – four to six weeks – when the government allows itself four months.
Among the priorities are, unsurprisingly, human resources, the lack of which is glaring, particularly among nurses. Other challenges highlighted, the functioning and organization of work in the structure with 100,000 staff members. Or, the return to a sustainable financial trajectory, in a group that faces significant deficits.
At this stage, the displayed method is that of questions, rather than decisions. “How to recreate the conditions of attractiveness and the ability to build loyalty? », “How can we promote simpler, smoother and more efficient operation?” », “How to rethink the model with regard to health needs? » Levers are nevertheless clearly identified – for example, on the “HR” side, the stabilization of schedules or access to housing in a particularly expensive region. But no question, at this stage, of tackling ready-made solutions. In any case, this is the message sent by the head of the AP-HP, which could disappoint some within a medical community which has been sounding the alarm for months.
Exacerbated ailments
Closed beds, vacant nursing stations, operating theaters that are idling… The ills of the hospital, exacerbated by two years of health crisis, are no longer at the diagnostic stage in the field. In this new school year, 18% of the beds are still closed at the AP-HP, more or less the same situation as a year ago, and more than double compared to before the Covid-19 crisis. The document provides other updated figures: the nursing workforce is “at the lowest point for five years”, with 1,830 fewer full-time equivalents compared to June 2018. “It is to be expected that despite the recruitments already secured thanks to the collective mobilization – 1,200 recruitments and 215 job returns [congés maternités…] –, the fall of 2022 and the first half of 2023 will see continued strong tensions on paramedical HR”can we read in the mail.
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