“Hospital workers are all experiencing a deterioration in the terms of wage exchange”

Tribune. Is it possible to talk about the salaries of hospital staff by going beyond the well-known discourse of the indecent low salaries of nursing assistants and nurses, and without looking for who, the radiologist or the surgeon, earns the most? The current situation is the result of the evolution of multiple social relations of domination.

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Who says salary generally says work. However, the nursing professions of the hospital are historically characterized by the non-recognition of their work as such. For a long time carried out by the personnel of religious congregations “devoted”, living on the spot, very little, if not unpaid, the work of care of the sick is associated with the idea that it is not really one and that it does not exist. not cost much. The hour of a nurse, woman, in the hospital is not “worth” that of a worker, man, in the factory. Yet it is they, the nuns, then the nurses, the “wardens” then the nursing assistants, who ensure the continuity of the presence and care of the sick, at the cost of strict discipline and exhausting schedules for the sick. at the expense of private life: until the 1960s and 1970s, ten hours of work per day were frequent (and even more at night), daily overflows were too (it happens to work 24 hours in a row or be called back in the middle of the night), Sundays rarely exist, school holidays are hard to come by, and wages are low. “Female dedication” must compensate for the exploitation of female workers … The historian Yvonne Knibiehler nevertheless recalls that, in the 1960s, the average working life of a nurse was only five years (History of nurses in France in the 20th centurye century, Hachette, 2008).

Prestige hierarchies

At the same time, doctors are present at the hospital only in the morning. Like the nuns, they earn almost no income from this work. For a very different reason, however: their activity in private clinics where the upper classes are treated remunerates them. However, the hospital plays a crucial role: it provides them with the “human material” (the poor, for whom the hospital is reserved until the 1940s), living or dead, from which they constitute medical knowledge, teach and train. future doctors. But the progress of medicine, the technicalization of care and the reforming desire of young doctors engaged in politics led to a major reform in 1958: the hospital became the center of the health system and of scientific medicine seeking to compete with American biomedicine. With the creation of university hospital centers (CHU), the hospital is at the same time a place of education, care and research. Doctors become full-time employees there. The development of a state-of-the-art hospital also requires that certain specialties (surgery, resuscitation, anesthesia, etc.) meet new needs and continuous emergencies. But the status of employee forces doctors to deny part of the liberal identity of their profession, which some fiercely oppose. The reform is then negotiated at the cost of keeping the private sector in the hospital, where they retain a share of liberal activity which also makes it possible to inflate salaries.

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