Agence France-Presse reported that the emergency departments of public hospitals across France are overcrowded, and "accidental" deaths of patients are frequent, and parliamentarians and heads of trade unions and associations have called for the immediate formation of a parliamentary commission of inquiry to investigate; Medical workers believe that it is impossible to quantify the high mortality rate caused by the overcrowding of the health care system, but it is true.
On 14 February, a patient in Toulouse committed suicide after lying on a stretcher in the waiting area of the psychiatric emergency department for several days. According to the representative of the hospital union, "because there was no bed, he was 'placed' in an office". This tragedy illustrates that "the situation in the hospital is catastrophic".
During a visit to Toulouse on 20 February, the Minister of Health, Frédéric Valletoux, noted that there were problems with the functioning of public hospitals, partly due to poor coordination between public hospitals and private clinics in some regions. He pledged that efforts will be made to better distribute the different roles of public hospitals and private clinics in the healthcare system.
In October last year, Lucas, a 25-year-old young man from Hyères, in the Var department in southeastern France, died of septic shock (Choc septique) after a long wait in the hospital. Since the beginning of the year, families in Nantes and Eaubonne have sued patients for their deaths.
Marc Noizet, president of the French Association of Emergency Care (SUDF), said that because there are no statistics, it is difficult to tell whether there has been a significant increase in such avoidable patient deaths. However, "all people feel that the health system has become extremely fragile and dysfunctional".
According to France's Haute Autorité de Santé, some health workers, who asked not to be named, said the rate of serious accidents reported due to a malfunctioning health system was very low. From January 2022 to March 2023, another 136 patient fatalities were reported due to overcrowding in emergency departments.
On 21 February, a large number of parliamentarians and representatives of trade unions and associations asked the President of the National Assembly to quickly form a parliamentary commission of inquiry into the crisis in the emergency departments of public hospitals and the loss of the patient's chance of being rescued.
In the summer of 2023, due to a shortage of staff, the number of emergency departments closed at night reached an unprecedented record, and many areas required patients to call 15** before seeing a doctor, and there was a selection to reduce the pressure on the hospital.
According to the Ministry of Health, 63 provinces currently use SAS (Improved Emergency Service) to select patients, allowing patients with less severe conditions to go to the city doctor (Médecine de Ville) instead of going directly to the hospital for emergency care. This practice will be further promoted between now and the summer to reduce the pressure on public hospitals.
However, another problem is becoming more and more serious: because of the lack of beds in the various specialties of the hospital, patients waiting for admission have to wait on stretchers, sometimes for days. Novazek said that because the patient's condition could not be monitored properly, these waiting areas became "danger zones".
He said that the problem was getting worse mainly because in 2004 public hospitals introduced a performance-based funding model, which led to hospitals having to eliminate some beds in order to make a profit and ensure that the beds were 100 per cent full. Originally, due to the shortage of **, the hospital implemented an outpatient strategy (virage ambulatoire) to cancel many beds, so the number of canceled beds has increased significantly.
According to the Ministry of Health's Bureau of Investigative Research, Evaluation and Statistics (DRES), nearly 40,000 complete inpatient beds were eliminated across the country from the end of 2013 to the end of 2022.
A study in late 2022 showed that patients over the age of 75 who spent the night on a hospital stretcher had a 40% increased risk of dying in a hospital. Agnès Ricard-Hibon, an emergency physician and spokesperson for the French Association of Emergency Care, said: "This is what leads to a lot of ** resignations: not being able to work without ensuring the quality and safety of care. ”