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6 September 2019updated 05 Oct 2023 8:54am

How austerity has caused an emergency service crisis in France

By Pauline Bock

The visit of French health minister Agnès Buzyn to La Rochelle’s public hospital on 13 July did not go as planned. As she walked across the building, 150 striking hospital employees who were protesting against their working conditions and demanding more hospital beds, staff, and funding, followed her everywhere, shouting “The hospital is angry!” Some had travelled from neighbouring cities and Buzyn had to use the back door to exit early. 

The effect of austerity policies on health access isn’t only a British problem. The La Rochelle staff are among the 217 emergency services in French public hospitals currently on strike, according to the Inter-Urgences group, which is coordinating the movement (according to the health ministry there are 195). Industrial action has spread across the country, with a third of French emergency services currently on strike. Some, such as the 25 emergency services in Paris hospitals, which declared an “unlimited strike” in April, have been mobilised for months. The number has doubled since the start of the summer.

Everywhere, hospital staff cite a lack of funding, deteriorating working conditions and rampant precarisation. A petition circulated by Inter-Urgences, signed by more than a million people, condemns the “slow destruction of our public health service” and warns of the “dangers” posed by the decline in access to public healthcare.

In June, as emergency service strikes proliferated, the French government allocated €70m to relieve the growing crisis, of which most was used to fund an emergency €100 wage increase for hospital staff. This was deemed insufficient: it answered none of the movement’s demands for 10,000 additional staff, a universal €300 wage rise and an end to cuts to hospital beds. The strikes spread. On 2 August, Buzyn admitted that she was facing an “enduring crisis”.

The situation has indeed become dire. Over the summer, a 70-year-old man spent six days on a stretcher in Saint-Quentin, eastern France, because there weren’t any hospital beds free for him. Another 72-year-old spent five days without a room in a hospital in Saint-Etienne, near Lyon. 

Matters are even worse in French overseas territories, such as Guadeloupe, a 629-square mile Caribbean island that counts only one public hospital for a population of 395,700. The hospital in Pointe-à-Pitre, the Guadeloupean capital, was ravaged by a fire in 2017, which left the building in an “antiquated” condition and the hospital deep in debt. Difficult working conditions have become “catastrophic”, staff told AFP. One recalled to French media having been examined by an “exhausted” doctor (who “may have been the only one there”) who used his phone’s torch and offered water straight from the tap as the building had ran out of paper cups. Several thousand people have marched in Pointe-à-Pitre in support of the strike. A union representative summed up the movement’s demands: “to obtain more funds in order to have correct access to healthcare”.

 “The plan to reorganise the healthcare offer and the structural situation of hospitals should be stabilised in 2020,” Buzyn, the health minister, has said. Until then at least, the island of Guadeloupe — which has a terrifyingly high number of cancer patients due to toxic pesticide used in plantations — will retain just one dysfunctional hospital.

At La Rochelle, Buzyn had a similar response to the aggrieved staff’s demand for more funding: “the organisation should be rethought”. Identifying a management crisis when the root of the problem is clearly austerity is a risky move for Buzyn: it is unlikely to appease the growing anger, and exhaustion, of the emergency services. “This is no time for a war of attrition”, an editorial in Le Monde declared in August. “Action must urgently be taken to find a solution to the crisis before tragedies happen.”

Buzyn has announced new measures for September but a recent radio appearance has already sparked distrust over her willingness to compromise. “We were never invited to negotiate or discuss”, the Inter-Urgences group stated in its response to the interview, noting that the minister had so far been silent on how to improve the “central question” of the lack of hospital beds “This interview made us think that the current talks on hospital budget will lead to an announcement just as disappointing,” it concluded, calling for “everyone” to mobilise. Protest fever appears contagious these days in France. 

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