French emergency room personnel walk out over a ‘healthcare system in dysfunction’

The French system of emergency care “has reached an unprecedented breaking point”, says François Braun, president of the ambulance workers’ union, who issued the call last week for the five-minute walkout. Tuesday’s action comes as hospital closures and other cost-cutting reforms have provoked national concern over the state of France’s renowned public healthcare system.

In Nantes in western France, about 60 paramedics and other personnel participated in the brief work stoppage, reports AFP.

The momentary walkout marks the latest chapter in a strike campaign that began in Paris’s Saint Antoine hospital in March and has since spread to 65 hospitals across France, according to organisers. The strike remains largely symbolic, however, as emergency room personnel cannot legally walk off the job. Instead they continue to treat patients while draping their emergency rooms in protest banners, wearing armbands and emblazoning their uniforms with slogans.

Abdel Dougha, a 45-year-old nursing assistant who works in the emergency room at Saint Antoine, says the symbolic nature of the strike is one of its virtues. It shows the workers’ deep commitment to caring for their patients, he says.

Aura (last name withheld), a nursing assistant at Paris’s Bichat hospital, agrees. “You have to be passionate to do this job,” she says. “But we can’t provide care if we ourselves aren’t being taken care of. You can’t have one without the other.”

The striking personnel say they face low pay and a relentless pace in emergency rooms that are “saturated”. According to the French health ministry, emergency room visits have doubled over the last 20 years, reaching nearly 21 million in 2016 (the latest year for which figures are available).

The health ministry’s figures show that from 2012 to 2016 alone, emergency room visits in public hospitals (which make up the bulk of France’s hospitals) climbed by 12 percent. Over this same period, the number of paramedic care personnel increased only by 5 percent.

‘Give us the means to be human’

This problem of “chronic understaffing” was highlighted in a 2017 report by the French Senate titled, “Emergency rooms: mirror of a healthcare system in dysfunction”. Remedying it is a top priority for the striking paramedical personnel. They also demand an end to cuts in the number of hospital beds and a €300 per month pay hike.

The Inter-Urgences collective, a group formed in early April by paramedic personnel at several Paris hospitals to coordinate the strike campaign, presented these demands at its first national meeting on May 25. “Give us the means to be human,” read a banner on stage.

The meeting was attended by about 200 paramedic personnel from 33 French cities including Marseille, Lyon and Strasbourg but also from smaller cities and towns, where the closures of hospitals and other public services became a focal point for Yellow Vest protesters last fall. The Inter-Urgences group is backed by three of France’s major labour unions.

“What we lack is recognition,” Dougha tells FRANCE 24. “We’re dealing with psychological issues, with poverty and precarity, with infectious diseases – with all sorts of issues. We’re the point of entry to the hospital, and we don’t get any recognition for it.”

Danger to patients and staff

Insufficient staffing has created dangerous conditions for patients and staff alike, says Candice Lafarge, a 33-year-old nursing assistant who works with Dougha at Paris’s Saint Antoine hospital. Patients can wait hours for treatment, and their frustration sometimes turns to physical violence. An assault on staff at Saint Antoine in March was the “straw that broke the camel’s back”, Lafarge says, prompting emergency room personnel there to launch their ongoing protest.

The long waits have also taken their toll on patients. The death of a 55-year-old patient awaiting treatment at Lariboisière hospital in December prompted an investigation from Paris hospital authorities. Their report, published in January, shined a harsh light on the lack of resources in the city’s hospital system.

Altogether, these factors are responsible for a mortality rate 9 percent higher than it would be in adequately resourced emergency rooms, says Christophe Prudhomme, spokesperson for the Association of Emergency Room Doctors. He told Europe 1 in March 2018 that for patients in critical condition, that number can reach as high as 30 percent.

‘No miracle cure’

French Health Minister Agnès Buzyn addressed the striking workers’ concerns during a hospital visit in Corsica on Monday. She acknowledged their “fatigue and frustration”, but said there was “no miracle cure” for the problems they face as there aren’t enough trained emergency room personnel in France to meet current need.

“This is an international problem,” she said.

Buzyn said that the government had put in motion a plan to train 400 new emergency room staff in the coming years. She also called for a “major effort to better organise emergency services in hospitals” to give personnel “the time to focus on the most urgent needs”.

The Inter-Urgences collective responded in a social media post expressing its disappointment with the health minister’s “scarce” attention to their grievances. The group plans to continue its strike campaign, calling for another national day of action on June 6.