Chronic ills of France's Health Ministry: Entire system 'must be rebuilt' under stable leadership

Now, it’s been four years since the French government launched a plan to revitalize the healthcare sector. Some changes, include things like more pay have been made. But as our Delano d’souza reports now Francis public health sector is still far from being in good shape itself. This was the height of the COVID-19 pandemic in France. Each night at 8:00 PM lockdown residents across the country applauded healthcare workers. After years of austerity cuts, the sector had been buckling under the weight of the coronavirus pandemic. A shortage of surgical masks, gloves and personal protective equipment highlighted the bleak state of French healthcare. It was a grim reality which forced the government to act. We need to and want to go quickly. Looking at all the shortfalls. The calendar is tight. French healthcare workers were feted on the national stage in 2020 and were honoured during the 14th of July celebrations. But after months of gruelling work during the first COVID wave, medical staff wanted the applause to cease and the government’s action to start. After holding consultations with professionals in the sector, the government announced an overhaul to public health care. Among the pledges made was a €19 billion investment, which included taking on €13 billion in debt from public health institutions, the hiring of 15,000 personnel, as well as the allocation of €8.2 billion to boost pay. Yeah, the demand. There are demands which exist and are legitimate, which we need to listen to. While the Macron government continues to meet hospital staff to learn how conditions can be improved, nurses and healthcare workers, faced with an increasing workload and low pay, continue to leave the sector. Today we’re asking ourselves questions if it’s worth sacrificing our personal lives for this job which we all love. But can we in a few years continue to do this beautiful job? We don’t know. Despite this shared sentiment, the government insists public health remains indispensable. Our hospitals and our health workers are a national treasure. While doctors in French public hospitals admit there has been a slight improvement to working conditions and pay, they say the government’s goal of making the sector desirable in the face of competition from private institutions remains over ambitious and is unlikely to happen overnight. Now, France 24 did attempt to reach out to the health ministry here in France to find out how much money had been poured into public health, as well as to gauge how many new recruits have been hired. We have not received a response at the time that that report went to air. Well, we’re going to talk more about the healthcare here in France now with Doctor Philippe Amoueil, who’s a public health professor at the University Hospital in the northern French town of Leal. Philippe, thank you so much for taking the time to speak to us four years ago, tomorrow, May 3rd. That marks the end of the lockdown in France. Now before we talk about the healthcare situation today, what are your memories of that time? Oh, that was one of my best time at the hospital I must say because everybody was working together. The hospitals listen to what the physician says because we don’t know how to do anything And it it was a great times and we saw that all this could give a momentum that could allow a new organisations of the healthcare system in France. We had some project some elements but really not enough. So here we are four years later, I mean you’re talking about that momentum. Did these promises for reform actually come to fruition? Are things better today? Oh, not not so much. Unfortunately, we had some progressions, especially with what happened during the COVID and the lockdown. But as you saw probably in France, we had five Ministry of Health during that time during the last six years, which is not enough to build up a new politics in healthcare. So we have three major problems. One major problems is the availability of human resources to take in charge the healthcare system. So that’s the first. What are the other two? The other two is the organization of the public hospital. Some of the hospitals are very old. People have a differential in salaries, which is very large with the private sector. They are working hours and hours, especially our resident and we heard the resident presenting there and they are just questioning their motivations to go forward as a medical professional and that that’s a that’s a big risk. The third one is the state of mind of the populations. I’m not sure that the French populations as is really aware that we are going through this crisis well, just imagining that they just have to take their phones, call their GPS and come to the hospitals. It’s not anymore possible because of the lack of availability of human resources for for the healthcare system. OK, there’s a lot to unpack there. Let’s start with the money. I mean money is always a bit of a taboo subject, particularly in France. But just to give our viewers an idea, one kidney specialist we spoke to in the public sector says he makes about €4000 a month, but that in the private sector in France he would make five times that much, perhaps 20,000. I mean I hate to be crass but but given those numbers, why would anyone stay in the public sector? I stay in the public sector for other reasons because for the interest of the works, because you have some quality of works, you see different things to do this to have these high salaries, it’s more, how would I say, rentability. You need to have written on investment very quickly for the clinics and you never precisely do what you need and what the patients exactly need. So that’s the limitation and that’s one of the motivations. The 2nd motivations is to teach. You need to have education of these physicians and it’s only the public sector. Of course, some private sectors are participating on the practical positions, but all the theoretical elements and the research are done on the public side. So there’s also different motivations, indeed, not only the money. Then let’s talk a bit more about the resources, the human resources, like you said. I mean, we know that there are these, what they call in French desert medical, these medical deserts. And one part of this healthcare puzzle is, is how hard it is to become a doctor. In France, there are certain quotas for the number of medical students who could even become doctors. What’s been done to increase those numbers to get those doctors in place? Just to give you an idea, in the early 70s with friends produce about 12,000 to 13,000 new physician each year. At the end of the last century, it was only 3500 each year. Now with the new government, the last government, sorry, we are back to the 12,000 to 13,000 new physicians. But to have a physicians, you need about 15 years to have a physician which is really operational. So actually the lack of human resources is linked to 10 or 15 years ago where we reduce the government, reduced significantly the number of of physicians. And now we’ll have, let’s say, a hole that will last about 5 or 10 years where it will be very difficult to have new physician. Felipe, we only just have a few minutes left just for you. What is really the key issue, the thing that the government still needs to fix to get the health care system in France back on track, I think you need to discuss more continuously with the physicians, with the nurses, with all the staff involved in healthcare. That’s very important. They will not find solutions immediately. We need to work together. We need also to work and educate better the populations, especially for all the question of the emergency, which is now the limitations in the system actually and then to build up a new healthcare system. I think we’ll not find any satisfying solutions with one or three or measures or even new billions of EUR, because it’s a whole system we have to rebuild now. And unfortunately with the Ministry of Health lasting about 1 1/2 year, it’s very difficult to build up such a system like that, right? So you think we just need to have a stronger health ministry, perhaps, and then things might get back on track? Yeah. Not not necessarily stronger, but it can give him, that’s the government giving more times to develop his hypothesis and his models. All right. Philippe, thank you so much for taking the time to speak to us. Doctor Philippe Amoya speaking to me from Leo in northern France. Thank you.