Decongest emergencies, avoid the race for profitability, the Minister of Health wants to put an end to the hospital-company to restore public service missions. Doctors wait for action to believe it.
“The hospital is not a business”, proclaimed loud and clear the Minister of Health during the presentation of the main orientations of her hospital policy. Concretely, Marisol Touraine wishes to mark her difference from the previous government. She insisted on her desire to reintroduce the notion of public service, a notion that had been abolished according to her, by the Hôpital Patients Santé Territoire (HPST) law of 2009. She wants to put an end to the establishment, in this same HPST law. , a “single boss” for health establishments. According to her, trust between politicians and the public hospital must be restored, but also that between the French and their health care system. “Allowing everyone to take care of themselves is to consider health as a public good and not as a market” declared the Minister.
Listen to Marisol Touraine, Health Minister : “The French are worried about the increase in healthcare prices, about the lack of doctors… it is a policy which will meet these expectations which will decline over the coming months. “
On the one hand, it seems that the Minister wants to go quickly, by burying as quickly as possible the “market approach” to health that she criticizes the previous government. But at the same time, Marisol Touraine gives herself the time for consultation. This is also the objective of the mission that it has just entrusted to Edouard Couty, former director of hospitals, who will be responsible for steering this broad consultation between patient representatives, professionals and qualified individuals.
Two measures from the fall to bury the “business hospital”
While waiting for the consultation to lead to concrete measures at the end of the year, Marisol Touraine has already announced that in the fall, in the 2013 Social Security finance bill, it will put an end to price convergence between the public and the private sector. It thus marks the end of the gradual harmonization of tariffs between clinics and hospitals. This device, according to its detractors, did not take into account the specific missions of the hospital, such as, for example, the reception in emergencies.
Another measure, the Minister of Health confirmed once again that she intended to reform the T2A. This activity-based pricing consists of putting a price on each act performed. This accounting tool has made it possible to provide transparency on the hospital’s accounts, but it has perverse effects. It leads to a form of race for action, and does not adequately finance the management of chronic diseases. “We will complete T2A, which is no more than a financial management tool. Pricing must be at the service of the quality of care, ”explains Marisol Touraine.
The reorganization of emergencies, a priority
In this upcoming health system reform, the Minister recalled that she wanted to put an end to endless waiting times, but also to the overcrowding of patients in the corridors. “We can remedy this,” explains Marisol Touraine, upstream, by streamlining the links with city medicine; downstream, by introducing new functions in the hospital: I am thinking, for example, of bed managers. »A first meeting with all the representatives of the world of emergencies will take place at the ministry on October 16.
Listen to Dr Patrick Pelloux, president of the Federation of hospital emergency physicians of France: “Finally, a Minister who dares to say that waiting in the emergency room is not inevitable, it’s very interesting, we’ve been talking about closure for 5 years. I am very optimistic. “
After the presentation of the pact of confidence, some professionals in the hospital world seemed rather reassured vis-à-vis the political line chosen by the Minister of Health. For others, these are just words, they are now waiting for action.
Listen to Dr Rachel Bocher, president of the National Intersyndicat des Praticiens Hospitaliers: “All this was already in the promises of the candidate President. Now, what we are waiting for is something concrete. This is the last time the government can make this kind of speech. ”
The consultation between the various protagonists who “make” the hospital should last until December to lead to the implementation of the first measures from the beginning of 2013.
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