Emergency physician, LREM deputy from Charente, Thomas Mesnier co-authored a report on emergency reform in the hospital. He is also an internal candidate for the post of rapporteur for the Social Security financing bill, whose election is scheduled for Tuesday, May 19. Favorite of this vote, he campaigned to quickly restore real resources to the hospital and make his contribution to the "Ségur de la santé", which the government announced the launch for May 25, a consequence of the Covid-19 crisis.
What's wrong with the hospital?
THOMAS MESNIER. One of the problems that I could still see when I put my white coat on at the Angoulême hospital, is that, on the ground, the staff do not see what we vote materialize. In 2017, we voted to fund night nurse positions in each nursing home (Editor's note: accommodation for dependent elderly people) , but in Charente, only a quarter of the establishments have hired. We need decisions that really and quickly materialize.
This Health Segur will address the issue of wages. How far do you want to upgrade them?
Instead of a bonus, I proposed last year an increase in the salary of nurses and nursing assistants of 100 euros net per month, or 1,200 euros per year. I was told it was too expensive. This time, we will have to go further. Coming back to the European average seems to me a reasonable objective.
The former Minister of Health Agnès Buzyn had announced in November the resumption by the State of 10 of the 30 billion euros of hospital debt. Shouldn't we go further?
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We have to reopen the discussions. But there is no need to take over all the debt, as some hospitals are very well managed. To take back half of it seems necessary and sufficient.
Should highly criticized fee-for-service funding for hospitals disappear?
Today, just over 60% of hospital funding is based on fee-for-service. At the end of the five-year period, it will only be 50%. T2A (fee-for-service) has certain advantages, especially for routine care. But I am for differentiated funding. To treat chronic diseases, fixed-rate funding prevents the multiplication of acts and a share of funding is needed which promotes the relevance and quality of care.
Shouldn't spending on health be sharply increased?
Ondam (national target for health insurance expenditure) , which sets the annual envelope for health insurance expenditure, was forecast at + 2.4% for 2020. With the pandemic, expenditure increased by 6%. Sustaining such an effort would make it possible to respond effectively to all challenges.
Many caregivers criticize the part taken by the administrative on the medical, do you support them?
We must think collectively about a new governance that breaks down the barriers with city medicine. And to a different governance for the municipal hospital, hospitals, teaching hospitals ... The Covid crisis forced us to remove brakes, let's preserve this agility which has given back to the hospital the efficiency we know today. hui.
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Should we increase working time in the hospital?
The first thing to do is standardize working hours and standardize the number of caregivers per department. There are too many disparities between hospitals. Then, I think that it is necessary to value the additional work to find medical time and to settle the fate of the medical interim, so expensive. On a voluntary basis, and with safeguards, of course.
