Lhe pediatric emergency crisis, which provoked a publicized reaction from our supervisory ministry, is only the tip of the mountain of difficulties encountered by the various pediatric specialties. Pediatric surgery, a hyperspecialty that meets an essential health need, does not intend to be left behind in the alert that has just been sounded and must take its place in the concerns of the guardianship, well beyond the shortage paramedics and the emergency crisis.
French pediatric surgery – divided between visceral surgery and orthopedic surgery – is one of the rare surgical specialties that are identified as such in Europe. We have this historical opportunity of dedicated services children and specialist practitioners. Pediatric surgery requires high technicality. It is mainly exercised in public hospitals and in very few establishments (around 50).
It is dependent on the hospital system and the quality of its operation, and suffers from the difficult situation of hospitals in France, but with a particularity which exposes it even more: these services are most often small in size, with low medical staff and financial results well below other surgical specialties, which have more staff and patients. However, the service rendered is in the foreground.
A very worrying situation
This rare specialty responds to the management of almost all traumas and common or rare surgical pathologies in children. It is therefore a resort surgery, which less specialized doctors call upon, for the 12 million French people under the age of 15, even though the density of pediatric surgeons is ridiculous: 362 in France for 100,000 children under 15 years old.
During the recent pandemic, pediatric surgery departments paid their price for activity restrictions. The consequence has been the lengthening of waiting lists and, in many cases, a loss of opportunity for patients, due to growth, which aggravates the pathologies. The current crisis in turn requires operating under conditions of “degraded procedures”, further limiting the possibilities of surgery. The consequences are therefore serious.
If the general medical demographics are catastrophic, with a serious shortage of doctors expected for the next fifteen years, the situation is even more worrying in pediatric surgery. Almost all of the services are backlogged due to the burden of on-call care and the insufficient number of practitioners. However, there is no alternative, no sufficient replacement to expect from private activity, which represents only 13% of supply.
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