Vaccination centers: salaried and retired caregivers less well paid than their liberal colleagues

Since the start of the year, tens of millions of French people have flocked to vaccination centers, without suspecting the annoyance that was behind the scenes around the remuneration of caregivers.

To speed up the vaccination campaign, health professionals were in fact requisitioned or volunteered to work in these centers.

Caregivers, employees, retirees or having ceased their activity therefore work there alongside their liberal colleagues.

Problem, the first are a priori less well paid than the second for the same acts and the same skills.

So much so that some find it difficult to digest the difference in treatment.

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Nadine (*), a retired nurse, currently works at the Espace Encan vaccination center in La Rochelle.

She sent a letter to Olivier Falorni, PRG deputy for Charente-Maritime, to ask for the situation to be regularized.

This was signed "

by about fifty doctors and nurses from the center, out of the approximately 70 people who work there,

" she explains to

Le Figaro

.

€ 24 per hour for salaried or retired nurses, € 55 for liberal staff

By reading the salary scale published by the Directorate General of Health on the Ameli.fr site, we see that the salaried or retired nurses who participate in the vaccination campaign are paid less than their liberal counterparts. The first category thus receives 24 euros per hour during the day - and up to a maximum of 48 € between 11 p.m. and 6 a.m. and on Sundays and public holidays. For their part, liberal nurses are generally paid by the half-day, but the comparison is final. Compensation is € 220 per half-day of more than four hours - rate which can reach € 240 on Saturday afternoons, Sundays and public holidays - or € 55 per hour if the shift lasts less than four hours , it is more than double that of their colleagues on daytime schedules.

As for doctors, the same difference can be observed, with a remuneration for the liberals of 420 € per half-day of more than four hours - or 105 € per hour - against only 50 € for employees, retirees or doctors without activity.

"

We come to the aid of the State in the vaccination campaign, and we have no feedback from it

" testifies Nadine.

If the caregivers understand that there are differences in remuneration between doctors, nurses or even students, they testify to their incomprehension on the differences which exist within the professional bodies according to the mode of practice.

High charges and an opportunity cost for the Liberals

The pay gap could however be justified. The national union of nursing professionals considers that it is explained in particular by the difference in nature between the remuneration of liberal caregivers and others. Liberals must therefore subtract from their income the contributions due to URSSAF and their pension fund, which reach a maximum of 50% of their turnover. With this high estimate, it would then be necessary to divide the remuneration received by 2, ie compensation of € 27.5 per hour for liberal nurses. But salaried or retired nurses must also pay social security contributions of 19% of the 24 euros they receive. The gap is therefore reduced without being completely canceled out.Once the contributions have been deducted, liberal nurses always earn 8 euros more per hour than their colleagues during the day.

But another factor could explain the differences in compensation. Employees, retirees or caregivers without activity "

do not neglect patients

", unlike doctors, nurses or other liberal health professionals, explains to

Figaro

a retired doctor practicing in a vaccination center in Essonne. Liberals therefore suffer a loss of earnings resulting from the non-exercise of their usual activity, often busy, during the duration of their vacations at the vaccination center. Their higher remuneration would then be used to offset these costs, even if according to the nurse at the La Rochelle vaccination center, this explanation does not hold water. "

Most of the time, the Liberals do vaccinations on their days of inactivity, so there is no loss of turnover for them,

”she assures us.

Finally, on night shifts, salaried, retired or unemployed nurses win the salary match with compensation of 48 euros.

They end up receiving nearly 39 euros - after deduction of the 19% contribution - against 27.50 euros for the Liberals who do not benefit from advantageous rates during the night.

The same observations can be made for doctors, veterinarians or dentists.

A tax exemption proposal abandoned in the Senate

Another inequality persists, however. Liberal doctors and nurses are paid an additional 5.40 euros per injection to enter patient data in the “

Covid Vaccine

” health insurance software

. A task that is not officially requested of salaried and retired nurses. "

This remuneration is capped at € 3,000 per month but represents, even with 50% of contributions for URSSAF, a not insignificant sum which widens the inequality with the other caregivers

", explains the nurse of the vaccination center of La Rochelle. Beware of the subtleties, however, "

substitute liberal physicians practicing in their own name are not entitled to this seizure package.

»According to the president of the ReAGJIR union, Agathe Lechevalier.

The remuneration of caregivers in vaccination centers is therefore far from being harmonized and leaves the main concerned perplexed.

According to the caregiver who took up the issue in La Rochelle, "

even caregivers working as a liberal share the misunderstanding

".

“

There is no will to go against each other,

” she explains.

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The debate on the remuneration of caregivers in vaccination centers had even been brought to the Senate. An amendment had in fact been tabled within the framework of the corrective finance bill in 2021 in order to exempt from taxation the allowances of voluntary or requisitioned personnel for vaccination. However, this had been withdrawn at the request of the government and the general rapporteur of the finance committee who considered the proposed device too complex. Olivier Dussopt, Minister Delegate also considered that such an exemption created "

a breach of equality before public charges

" to the detriment of vaccinators outside the vaccination centers. The senator who tabled theAmendment then promised to "

rework this question

".

This is precisely what the La Rochelle nurse asks the deputy Olivier Falorni.

His proposal: to compensate for this difference, the former nurse who spoke with

Le Figaro

proposes to exempt from income tax the remuneration of caregivers who vaccinate in the centers.

"

Our pensions are not huge, with this additional income, some people change bracket and find themselves having to pay housing tax, for example,

" she laments.

The question of the remuneration of caregivers in vaccination centers is therefore not definitively settled.

With the increase in immunization coverage, these centers could however soon disappear, taking with them the debates they animate.

(*) The first name has been changed