Closures of services even in the areas most frequented by tourists, mobile SAMU units stopped: this summer, the emergency crisis “is worse” than in 2022, alert the emergency workers who are struggling to cope in the services “who resist”.
Very present in recent days in the media, the main representatives of emergency physicians, from the Association of Emergency Physicians of France to SAMU-Urgences de France (SUdf), have expressed concern that the crisis now affects “all departments”, from small to large services, to “extremely touristy areas”. Invited on Franceinfo, the Minister of Health Aurélien Rousseau repeated on the contrary that the situation was not “more serious” than last summer, assuring that “the hospital will cope”.
“We have never experienced such a scale of emergency facility closures,” said Agnès Ricard-Hibon, spokesperson for the French Society of Emergency Medicine. Emblematic case, the emergency reception of Saint-Tropez (Var), a star seaside resort on the Côte d’Azur, remained closed for three nights in August, the hospital assuring in a press release that it had “tried everything” to avoid this “situation extreme “.
Shortage of emergency physicians, temporary workers, paramedics, downstream beds… “The alerts are coming up from everywhere,” laments Dr. Ricard-Hibon. Head of the Val-d’Oise SAMU, she “learned on Tuesday of the night closure, for fifteen days, of an Ile-de-France service”.
Psychiatry ‘collapses’
A SMUR (mobile emergency and resuscitation service) from Hauts-de-Seine transferred an infant with bronchiolitis to Rouen on Sunday, for lack of a bed in pediatric intensive care in Ile-de-France. The situation has since “returned to normal”, according to the Regional Health Agency. “There are few beds because fortunately there are few needs. There, we were in a period where holidays and sick leave combined, explained the Minister of Health to Franceinfo, referring to this case.
“The worst days were the August 15 bridge,” says Dominique Savary, head of emergencies at the Angers University Hospital and SUdf representative: in Pays-de-la-Loire, “four services were closed”, in addition of “six lines of SMURs stopped” and a “not functional” helicopter in Nantes.
“The pressure falls on the services that resist, at the cost of major overtime”, the SMURs having to move “much further” and deal with “the most serious”. In an area where psychiatry is “collapsed”, emergency workers also saw psychiatric patients “in serious condition arriving from Sarthe, 100 kilometers away”, says Mr. Savary.
“In certain sectors”, particularly in tourist areas, “the tension is extremely high”, acknowledged Monday the Minister of Health Aurélien Rousseau. “I’m not saying that the situation is satisfactory” but “compared to last year, (…) we managed to anticipate some of these situations”, “today we don’t have an emergency service which closes every hour,” he said.
To maintain “the essentials”, vital emergencies, the authorities enjoin the population to “always call” the town offices or 15 before moving.
Filtering has become the rule
While the figures vary greatly, the Minister Delegate for the Health Professions, Agnès Firmin Le Bodo, indicated on August 3 that services “really closed” remained rare, “18%” operating “with regulation”, i.e. say with the obligation to call 15 to be taken care of.
Filtering has become the rule in all hospitals in Mayenne, Manche, in several Breton towns such as Carhaix (Finistère), or at night in Dax, Pau or Niort. At the CHU Pellegrin in Bordeaux, it is applied 24 hours a day and patients presenting spontaneously are turned away, notes Julien Dulou, caregiver and representative of Sud-Santé Sociaux. Among these patients, serious cases but also “people who try by all means to enter, by overplaying”. By sorting patients, “we are not immune to an error”, laments on condition of anonymity an emergency doctor from the CHU.
The hospital is “no longer attractive”, claim emergency workers for a long time, pleading to bring about the revaluation of night and weekend guards, promised by Emmanuel Macron.
For Jean-François Cibien, president of the inter-union Action practitioner hospital, regulation “is a solution”, provided that the “living forces” are preserved: the medical regulation assistants – the first to drop out of the SAMU – on strike in the three quarters of the territory. Understaffed, they have in places “45% activity, without any valuation”, he laments, calling on the ministry to give them the “risk premium” they demand.
The heat wave expected over the next few days could further suffocate services. Nineteen departments are placed on Friday in heat wave orange vigilance by Météo-France, a heat stroke which should further intensify.