Emergencies are overloaded, and this summer is no exception. A situation of “very great fragility” which could quickly become « explosive », warns the Samu-Urgences de France union in a survey published on Wednesday August 3, carried out in 331 establishments in 92 departments. This update follows the implementation since July 10 of the 41 recommendations recommended by the “flash mission” on unscheduled care, led by François Braun – President of Samu-Urgences de France until July 4 and his appointment to the Ministry of Health.
Among the measures intended “facilitate the management of this high-risk summer period” : medical regulation prior to access to Samu, an information campaign on the proper use of emergencies or territorial mutual assistance when a structure is closed. Judged Instructions “insufficient” by the report, only 20 days after the start of their implementation.
23 emergency services forced to close
During the month of July, the 331 emergency reception services responding to the union’s survey recorded an increase in activity of 12.3%, or 180,000 more visits than in 2021 over the same period. . An influx requiring 88 of these establishments (26%) to establish a restriction of their access, including 67 via systematic medical regulation by the “15”. On these sites, 42 were even forced to close at night – for a total of 546 nights – and 23 to total closure – 208 days.
“There is no closure, there is medically regulated access or access by emergency services in places where there are no longer the human means to operate without this regulation”, distinguished Minister François Braun on Wednesday, visiting the Nantes University Hospital. The day before, before the Social Affairs Committee of the National Assembly, he had refuted the term « tri » and considered that “regulation is a much more modern mode and appropriate to pathology”.
“The minister is in his role: to hold a reassuring position when the system is shakingobserves Doctor Marc Noizet, new president Samu-Urgences de France. But even if there is no permanent closure, there are partial closures, sometimes over several days. Services closed the door and did not welcome anyone. »
Pressure on the Samu and SMUR
Witness of a “unusual overactivity”from “lack of staff” and of the“unavailability of beds”his union fears a “rapid evolution towards an explosive situation”, with a flight of medical and paramedical workers. 90% of establishments surveyed are already experiencing “difficulties” of human resources, 73% resorting to interim solutions this summer.
Beyond the reception services, the pressure is imposed on the Samu-centres 15: increase in activity of 21.5% in July, human resources difficulties for 95% of them and implementation of systematic medical regulation by the Samu-Centre 15 in 42 departments. On the SMURs (mobile emergency and resuscitation structures), 75 SMURs out of 269 respondents were forced to close a line for lack of personnel, 18 to completely stop their activity.
“The toolbox offered by the “flash mission” contains good ideasrecognizes Doctor Marc Noizet, also head of the emergency department of the hospital group in the region of Mulhouse and South-Alsace (GHRMSA). But the field often shows the difficulty of implementing them and making them effective. It’s good to be able to urgently mobilize retirees or liberals, but it’s often impossible to do so in a few weeks. »
End of hospital funding for activity, reopening of beds, recruitment… the president of the union is firmly calling for the next major health reform. François Braun seems well aware of the expectation: “Emergencies suffer, but not only emergencies. To see the systemic crisis of our health system only through emergencies is to treat a symptom, not the whole of the disease. »