Already last February, at the entrance to the emergency room of the Pellegrin hospital, a disaster medicine tent was used to refer patients. Since Wednesday, May 18, the service has been closed to less serious cases. The Bordeaux University Hospital (CHU) wants to relieve access to adult emergencies, whose attendance has increased by 50% in two years – 121,000 in 2021, including 200 per day in the Pellegrin emergency room. With constant human resources – 20 emergency doctors, in particular.
→ INVESTIGATION. At the hospital, these emergency services which close at night for lack of caregivers
It is an understatement to say that the first emergency site in the Nouvelle-Aquitaine region is experiencing “tensions on human resources since the summer of 2021”indicated Tuesday, May 17 the director of the CHU, Yann Bubien, to South Westwith “a lot of resignations, non-renewed contracts, departures”. According to Pascal Gaubert, secretary general FO at the CHU, there is even a third of the staff, medical and paramedical, missing for the adult emergency service in Pellegrin to function properly.
“Railway yard”
Between 8 p.m. and 8 a.m., patients must now call 15 before going to Pellegrin Hospital. This should allow “thanks to the regulation provided by liberal and hospital doctors, to properly orient the patient in relation to his need for care”, pleads the CHU in a press release. Depending on the analysis of the situation, the patient may “benefit from medical advice over the telephone, be directed to the on-call doctor, be directed to the hospital emergency room, or have a medical team sent to the site”.
Those who nevertheless go to the emergency room will find a telephone connected to the Samu-Centre 15 and can be referred by civil security personnel. “About 30% of cases arriving at the emergency room can be treated by city medicine”estimates Pierre Hurmic, mayor of Bordeaux and president of the supervisory board of the CHU, questioned by The cross. “The diagnosis is therefore divided on the fact that regulation via 15, which acts as a marshalling yard, is necessary. Let’s experiment with it and then evaluate this device. »
However, the adult emergencies of the Saint-André hospital, in the city center of Bordeaux, as well as the pediatric emergencies of Pellegrin and cardiology of Haut-Lévêque, the third site in the metropolis, remain open, permanently.
Use of private
The ARS also highlights the opening, from this Thursday, May 19, of an additional emergency service in the Bordeaux metropolis, within a new private clinic, in Floirac. Open “7 days a week and 24 hours a day”il “will allow the population of the right bank to benefit from appropriate care” and discharge Pellegrin’s emergency room.
But will the regulation of emergencies by the 15 and the distribution to other sites be enough to respond to the crisis? No, answers Benoît Elleboode, director general of ARS Nouvelle-Aquitaine, questioned this Wednesday by South West. He fears in particular the summer period, with the departures on leave of caregivers. To cope with this, the CHU is recruiting – the number of emergency doctors must be doubled – and is counting on the increase in salaries recorded by the Ségur de la santé.
“For years, health professionals have been warning about understaffing, pay gaps with the private sector, suffering at work… The State has also poorly anticipated the demographic explosion and the aging of the population of a large metropolis like Bordeaux », criticizes Pierre Hurmic. He is waiting for answers from the new government, in particular on the numerus clausus and the installation of new doctors.
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A bigger problem
Everywhere in France, hospitals limit the hours or conditions of access to emergency services. This is particularly the case in Laval (Mayenne), Draguignan (Var) or Orléans (Loiret). About sixty hospitals are in white plan due to the lack of personnel, leading to the closure of certain beds or services, in particular emergencies.
In the Nouvelle-Aquitaine region, several establishments are concerned, mainly in medium-sized towns: Jonzac (Charente-Maritime), Sarlat (Dordogne), Orthez (Pyrénées-Atlantiques)… SAS (care access services), supposed to guarantee “a 24-hour telephone response to users for unscheduled care and proven emergencies”, are already operational in Gironde and Vienne, and three will open in 2022 (Limoges, Bayonne, Agen).