Por the first time since 1996, that is to say since Parliament examined the Social Security financing bills, the bill for 2023 was adopted at first reading in the National Assembly across the 49.3 of the Constitution. The discussion on the text therefore only took place in the Senate, for a very short week, when the stakes are high – the sums at stake, 600 billion euros, are greater than the State budget – and the decisions to be made, strategic.
If 49.3 is used again when the text returns to the Assembly on Monday, November 21, the national representation will once again not have been able to debate the substance of the measures necessary to deal with the serious situation. in which our healthcare system finds itself, and more particularly the public hospital, its professionals and its patients.
However, today we have many works that allow a clear and shared diagnosis of the situation. Research work – still too few in number as access for researchers to establishments remains difficult – has highlighted the sharp deterioration in the working conditions of caregivers, visible in the publications of the research department of the Ministry of Labor from 2014. and confirmed by the most recent exploitations of that of the Ministry of Solidarity.
While some of this work has highlighted the role of importing methods used in the private sector into hospitals (the « New Public Management ») in the malaise of nursing staff, others have underlined the weight of atypical working hours and in particular the lack of predictability, increased by the shortage of staff, in the “lack of attractiveness” of the public hospital, a modest term that hides a real crisis.
” Breathless “
A remarkable Senate report has not only confirmed but accumulated the testimony and evidence of the very worrying situation of a public hospital ” breathless “. Written on behalf of the commission of inquiry into the situation of hospitals and the health system in France, which met at the end of 2021 at the request of Senator Bruno Retailleau and his colleagues Les Républicains, we can consider this report as consensual since the rapporteur belonged to the LR group and the president to the socialist, environmentalist and republican group. The report highlights in particular the too late and insufficient character of the Ségur de la santé, the chronic and dysfunctional under-investment due to a rate of increase of the National Health Insurance Expenditure Objective that is too low, undebated and unfounded. on the health needs of the populations, the need to review the governance of the hospital, to revise the allowances for night work (ridiculously low), to increase salaries and to considerably improve the quality of life at work…
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