Temporary: is the government able to fight this phenomenon?

Paris, Tuesday, November 8, 2022 – The number of vacancies in French hospitals, whether for doctors or nurses, continues to increase and reaches 30%. To cope with this, hospital management regularly turns to temporary work; this solution is now used by all types of institutions, including university hospitals.

DGFIP’s survey from October 2021 projects that the temporary job application rate will reach around 20% for healthcare workers (including serious medical respite and short-term non-prescription contracts). social security financial law for 2023. The situation is not new: when he was still only a deputy (socialist), Olivier Veran dedicated a remarkable report on the subject in 2013.

Since then, successive governments (including those who placed Olivier Vera on the avenue de Segur) have tried to take measures to limit this phenomenon due to the very high costs for hospitals, while the use of temporary workers can change the quality of continuity. . However, due to the difficulties faced by enterprises to ensure normal operations without the use of temporary workers, the measures have often been suspended.

Blood and tears

Today, Francois Braun seems determined to face all slings and even wants to go further than the already recorded devices. Thus, we recall that a law passed in 2016 under the auspices of Marisol Touraine, from 2020, the maximum gross salary for a twenty-four hour effective working day for doctors will be 1,404.05 euros (the first ceiling) against 1,170.04 wanted to limit it to euros. in 2018.

However, this provision is applied differently in practice. Also, the government of Edouard Philippe adopted a new provision under the Rist law, which makes it mandatory for public accountants to systematically refuse to pay premiums that exceed the ceiling. This text was supposed to enter into force a year ago almost to the day. However, facing concerns from a large number of businesses, the government postponed its application.

However, the new health minister is determined to end the procrastination and has announced that Rist’s law will be properly implemented next spring. He has little illusion of the challenges he will face, and so he recently warned senators on the Social Affairs Committee: “It will cause problems, that’s obvious”.

He already predicts: “Temporary workers will strike or refuse to work. It will last a month. Institutions must be able to look ahead and cooperate with each other. But we have to act, and we have to act now.”. While the minister’s determination is admirable, the precedents raise fears of a difficult future. In October last year, some businesses noted a situation “very serious” Rist law enforcement agencies as seen. Since then, the hospital crisis has not worsened, at least not improved, as evidenced by the current strain on children’s wards, for example.

A battle of charms

However, along with the introduction of the Rist law, the government has planned to deal another blow to the temp era by restricting the ability of young graduates to practice temporarily, regardless of whether they are doctors or nurses. However, the PLFSS text is still imprecise regarding the minimum training period needed to function temporarily. Young graduates are now a minority among temporary workers: the Agency for Healthcare Employment (AGEMS) shows that “Graduates less than two years old make up only 20% of our tasks”.

However, it is not impossible that these new provisions will harm the attractiveness of certain careers. Indeed, the intermediate is regularly used by the youngest to increase experiences before moving more firmly in one direction. This was revealed by a survey conducted by AGEMS among 1047 temporary nurses.

Among the 19% of participants who started acting after graduating from nursing school, “desire to discover new services before taking up the position” it is the second most cited reason for this choice after planning freedom. The latter is the first motivation of nurses, long before salary conditions, whether they choose to do temporary work right after their education.

Likewise, those who worked a full-time job at a government hospital before their temporary marriage left it to elope. “imperatives” of planning. A lack of control over work schedules, including days off with increasingly frequent call-backs, makes for an increasingly difficult working environment for these nurses, who then prefer flexibility to maintain a work-life balance. intermediate.

These elements are the main line of thinking as the government seeks to combat temporary employment. Indeed, the surest way to limit this phenomenon is to increase the attractiveness of a career in the hospital: but in this case, the issue is not only financial, but also organizational. I’m not sure everything is done at the moment to accommodate these different requests.

Aurelie Haroche

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