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Ségur de la Santé: Mayotte far behind other territories

A massive plan but unevenly distributed

“Give our health care system a serene, peaceful and united future. This is the stated ambition of the Minister of Health Olivier Véran in the introduction to the press kit concerning the Ségur de la Santé. And to recall how Ségur was launched in 2020 when the health crisis was in full swing.

“A year ago, all the players in our health system sat down around the table. While traveling to Mulhouse, the President of the Republic had promised “a massive investment and upgrading plan for all careers for our hospital” “

A massive plan for the hospital is what has long been expected by healthcare and administrative staff in Mayotte, faced with a high turnover and a lack of attractiveness which, beyond insecurity, affects also to working conditions.

However, we can see, of the 19 billion euros, Mayotte only collects a very relative envelope of 65 million. This is less than half of the budget granted to Corsica, which with approximately 340,000 inhabitants, has only about 25% more inhabitants than us (according to the 2017 census which had 256,000 inhabitants in Mayotte ). Guyana, barely more populated than Mayotte according to INSEE (294,000 inhabitants) collects double our budget with 138 million euros.

At least Mayotte is distinguished by the creation of “seasonal beds” to deal with bronchiolitis. A way of adapting resources to needs

“At the CH in Mayotte, the bronchiolitis unit of the pediatric department was able to benefit from the device. A total of 8 beds were opened over a 90-day period, from April to the end of June. The Mayotte hospital team plans to use this device again if necessary, insofar as it has made it possible to take charge of an increase in activity linked to the seasonal episode of bronchiolitis ”indicates the document.

Mayotte is thus cited as an example of the beds on demand system, funded to the tune of 50 million euros for an assessment of “2,686 additional beds opened in 279 beneficiary establishments”.

Mayotte has a very low medical density in relation to its population

But beds aren’t much without caregivers. And here again, Mayotte is lagging behind. The figures provided indicate the upgradings granted to staff, and we can see that our department is sorely lacking in doctors, interns and other staff.

Thus, there are 226 “upgraded” hospital doctors in France, against nearly double in Guyana (414) or Corsica (465).

And with 134 interns and health students upgraded, the gap is widening further with the French department of South America (284) or the Mediterranean island (403).

“Put an end to the medical interim”

A situation pointed out by the report which, without citing Mayotte, strongly echoes the situation we know.

“Without being problematic in principle, the medical interim has been overdeveloped for several years in conditions that have become unsustainable for the health system, hospitals and staff. In some extreme cases, the medical interim has become the main or even the only method of recruiting practitioners. The result is often the same: hospitals, in a situation of dependency in view of the scarcity of medical resources, which have to resort massively to temporary employment to ensure the continuity of their activity and, ultimately, often exorbitant costs for patients. health institutions, when they are already in a difficult financial situation. The consequences are deleterious for the cohesion of the most exposed medical teams and affect the resources of certain establishments, and even the quality of care when the use of temporary staff and the turnover of medical personnel exceed the norm. “

An accounting vision of the situation has led to a law which, instead of focusing on the attractiveness and retention of staff, will allow “from October 2021, the ARS to denounce local situations before the administrative courts. and accountants
public to block the payment of remuneration exceeding the ceilings
regulatory ”.

In Mayotte, where the recruitment of practitioners often involves exorbitant salaries, advantages (tickets paid for, accommodation and company car) and this, despite short contracts (sometimes no more than three months), it is not safe. that this budgetary saving measure comes to rectify an already calamitous situation.

Y.D.

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