In a report commissioned by the Senate Social Affairs Committee, the Court of Auditors urgently recommends the improvement or even the closure of thirteen small maternity hospitals, deemed unsafe in terms of health.
“A new stage in the restructuring of maternity hospitals is both inevitable and necessary,” said the Court of Auditors. “The weakness of public authorities’ interventions borders on passivity and amounts to waiting for serious accidents to initiate ad hoc restructuring. She therefore criticizes the government for closing non-compliant maternity hospitals only when tragedies occur there, as in Orthez notably, where a mother died in September 2014 shortly after giving birth.
However, it was established in 1998 that maternities below the threshold of 300 deliveries per year were not sufficiently safe and therefore had to close. But the initial plan was not fully carried out, and this is what the Court of Auditors deplores. Thirteen small maternity hospitals kept alive by exceptional exemptions in view of their geographical isolation would pose a problem. “Keeping in operation establishments carrying out less than 300 deliveries per year for reasons of proximity requires that it be rigorously verified that their operation offers a complete guarantee of quality and safety”, warns the Court, which regrets that this is not always the case in the field.
Continuous monitoring required
If the Court reacts so harshly, it is because it considers the situation to be critical. “France ranks first in terms of birth rate with two children per woman, but we are in 17th place in terms of the risk of neonatal mortality (children who die after birth)”, warns Senator Jean-Marie Vanlerenberghe, at the initiative of the report. “So there are great efforts to be made. “
The senator specifies, however, that “the report does not say that maternities. He says that we must ensure continuous monitoring of maternity security. “He adds that the closure of these establishments will, however, be considered” in the absence of immediate compliance. “
In Saint Girons in Ariège, no compliance visit has been carried out since the exemption was obtained in 2001. The Court also notes that in other cases, “the non-compliance has been noted on several occasions without the ‘activity has been interrupted’.
Modest maternity hospitals above the compliance threshold of 300 births are also in the sights of the Court of Auditors. “A number of small maternity hospitals operate in spite of significant difficulties” she writes, estimating that in general and with exceptions, “the maintenance of the smallest maternities is far from essential”.
The Court thus recommends “re-examining the minimum activity threshold” of 300 births per year and asks Minister Marisol Touraine to take all these recommendations into account in his Health bill.
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