This is not the first time that he has rubbed shoulders with “health subjects”, and as former director of Jean Castex’s cabinet at Matignon or former head of Medicare, Nicolas Revel is a regular. complicated projects. But the one he opened on Tuesday, December 13, as director of the Public Assistance-Hospitals of Paris (AP-HP), by making public 30 “courses of action”, enjoys a particular echo. A decisive step for this 56-year-old senior civil servant, who succeeded Martin Hirsch in July at the head of the AP-HP, and better known, until now, to the unions of liberal doctors than to the hospital community.
However, it expects a lot from its first commitments: while, for weeks, alerts have been going out from all or almost all departments (paediatrics, psychiatry, emergencies, etc.), while the epidemic “triple wave” is raging, mixing the viruses of bronchiolitis, Covid and the flu, and weighing all the more on caregivers, Nicolas Revel’s roadmap is aimed, first of all, at 100,000 staff in need of strong gestures.
Strong, the diagnosis is: it is at “unprecedented difficulties” that the juggernaut of 38 establishments in the Ile-de-France must face, recognizes, from the introduction of the document presented to the press on Tuesday, Mr. Revel. Guest of France Inter, he gave these difficulties a numerical translation: in the largest hospital group in Europe, 16% of the beds are closed, that is to say nearly 2,000 out of 12,000; that’s twice as many as in 2019. In 2022, 2,800 nurses left the hospital system’s flagship, when 2,200 were hired. Fewer hands means fewer activities and therefore, also, less revenue: the AP-HP is preparing to complete a third consecutive financial year with a deficit of more than 200 million euros.
“Making you want to come to the AP-HP”
“There is a post-Covid effect, even if it does not explain everything, stressed the senior official on the radio. Some staff want to go to the provinces, others want to change jobs. They feel that their work is heavier, more difficult…” The “dynamics of departures”, as we say at the AP-HP, preferring this expression to that, hammered out on the ground, of“hemorrhage of caregivers”, was greater in 2022 than in previous years: Parisian hospitals saw the departure of 2,400 nurses in 2021, 1,900 in 2020, 2,300 in 2019, etc.
To break the trend, the challenge for the institution is to recruit new caregivers… and keep them in its ranks. But what to do, when you don’t have the wage lever? Nicolas Revel sends the ball back to the State on this point. “I worked on other levers to improve daily working conditions, to make people want to come to AP-HP, to make them want to stay there. »
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