HASefore the new major consultation on health announced by the President of the Republic, the forums are multiplying to propose solutions and a model. The forum “To deal with the hospital crisis, let’s take inspiration from the hotlines for access to health care » published in the “Sciences & Médecine” supplement of the World of June 15 proposes to draw inspiration from the model of health care access points (Pass) intended for poor people in an irregular situation. The authors rightly argue “a global approach that transcends structural divisions”, between health and social, somatic and psychic, preventive and curative, city and hospital.
To generalize this model would thus amount to setting up and justifying, in the name of the “personalization of medicine”, poor medicine for the poor. Another forum “At a time when the government is looking for solutions to the caregiver crisis, it could draw inspiration from the trajectory followed by Air France” published in the ideas pages of the World of June 22 proposes to draw inspiration from the model of the airline companies.
Under the pretext that there are similarities in terms of safety procedures to be observed in the cockpit and in the operating room, that caregivers and flight crew members must benefit from validated continuous training, that teamwork presupposes in both cases compliance with basic rules (respect for people, listening, distribution of tasks, hierarchy of skills and not of power), that personnel in charge of administration and logistics should be at the service of caregivers as ground staff are at the service of pilots, and that both sectors are experiencing financial constraints, the authors propose to apply to hospitals the methods of organization, financing, remuneration and governance of airline companies.
The famous logic of “free and undistorted competition”
In doing so, they propose to develop the autonomy of public hospitals, by creating a “national hospital group responsible solely to the State for its territorial organization” and “free to conclude ‘performance contracts’ with the regions (as the SNCF does), with private hospitals and with first and second-line professionals”.
They also propose to end the “inequalities of subjection between public hospitals and private hospitals”, as well as the differences in remuneration between public doctors and those, two to three higher, of doctors in private clinics. In short, thus following the famous logic of “free and undistorted competition”, the authors propose that public hospitals become private establishments managed like commercial enterprises.
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