As the Covid-19 virus epidemic in France appears to be largely contained and hospitalisations for the disease steadily decrease from a mid-April peak of more than 32,000, hospital staff are hoping that the public and official praise and recognition they received during the crisis will result in concrete measures to meet their longstanding demands over pay and conditions.
During the coronavirus crisis, the government announced a one-off bonus payment of 1,500 euros for frontline doctors and nursing staff involved in caring for Covid-19 patients in the worst-hit regions (essentially the Paris region and in the north-east of the country) in both public and private establishments, and in care homes. Those similarly involved in less affected regions are to receive 500 euros.
But the move, accompanied by a decision to organise a national tribute to healthworkers during this year’s July 14th Bastille Day ceremonies, was a stopgap measure ahead of roundtable discussions on a reform of hospital funding which opened last month.
Staff unions and the government began negotiations on May 25th in a month-long consultation process called the “Ségur de la santé” (so-called after the name of the avenue on which the health ministry stands), centred on improving salaries and providing new funding for the hospital system. Opening the process, which began as a vast videoconference with more than 300 participants, Prime Minister Édouard Philippe announced that it would be “the occasion for radical change”, promising “ massive investment” and recognition for healthworkers which he said would see “significant” pay increases for staff across the health sector, including those working in care homes.
As the “Ségur de la santé” consultations enter their fourth week, one militant union, Sud, which demanded an immediate across-the-board monthly pay rise of 300 euros for staff as a pre-condition to the negotiations, has already left the talks. The extra monthly 300 euros is a demand common to all staff unions who say that this would bring French nurses in line with the EU-wide average pay, which in France is currently around 2,000 euros net per month.
This Tuesday, nationwide demonstrations will be held by hospital staff in 80 cities and towns in support of pay increases, more personnel and an end to bed closures (around 17,500 beds have been lost in France’s public hospitals over the past six years) and the turnout is expected to be strong.
Enlargement : Illustration 1
Already, in early May, personnel began papering walls at night around some hospitals in the Paris region, sticking up posters with slogans like “Masked but not muzzled” (see Mediapart’s picture report, in French, here) to push on with their demands, subsequently mounting weekly demonstrations outside hospitals in the capital and in other cities and towns.
Throughout 2019, hospital staff, and notably those in A&E departments, were engaged in a rolling campaign of largely symbolic strike action – when they continued to treat patients but with “on strike” marked up on badges and on corridor posters. They held numerous street protests over their working conditions and what has been a steady sapping of financing of public hospitals, resulting in the shortages of beds and equipment.
“During the [Covid-19] crisis, the means were at last freed up, staff numbers were increased, we obtained the equipment we needed,” said Anne Gervais, a hepatologist at the Bichat hospital in Paris and a representative of the Collectif Inter-Hôpitaux, a hospital staff pressure group demanding improvement of pay, working conditions and funding, speaking at the opening of the consultations. “We don’t want to return to the past, to the abnormal. That’s already begun. Our nurses can’t put up with it, they’re leaving.”
Meanwhile, in the shadow of the healthcare workers are a section of non-medical hospital staff who have their own specific demands and who feel they have been forgotten for their contribution during the virus epidemic. These are what are called “hospital service agents”, most of them women, and who notably carry out the key task of bio-cleaning, disinfecting hospital rooms, offices and corridors, as well as providing meals for patients.
In the Paris suburb of Saint-Denis, to the north of the capital, around 150 of the service agents began campaigning in early February for an end to the insecure nature of their short-term, renewable working contracts and their replacement by permanent ones. Their movement was put on hold after the virus epidemic erupted soon after, when the importance of their role was highlighted. Their current average net monthly pay is 1,400 euros.
Across all French publicly-managed hospitals, an average of 13% of non-medical staff are on short-term contracts, according to official figures for 2017. While 10% of non-medical staff at the hospital structure in Saint-Denis, which includes a main general hospital and another dedicated to geriatric care, are on short-term contracts, the proportion among “service agents”, its human resources director confirmed, is 20%.
Unlike in other professional sectors, public hospital workers can be given recurrently renewed short-term contracts over a period of up to six years. All of the Saint-Denis hospital service agents interviewed by Mediapart asked not to be named. One said she had worked at the hospital structure since one year, another since four years, while one woman said she had just signed a full-time contract, and said she had cried over it, after working “five years and four months” on renewable short-term contracts. Another example was a woman who had worked at the geriatric hospital, Casanova, for a year on four three-month contracts, “and I’ve just signed a contract for one month”.
The Casanova hospital suffered badly from the Covid-19 epidemic. It is composed of a palliative care unit, another dedicated to cognitive diseases and also contains a care-home structure. “A Covid unit was created, then the palliative care unit was turned over to Covid, and then the whole hospital,” said Muriel Signor, an official with the Sud trades union. “The virus was everywhere,” she added, and because the morgue was full “there were three refrigerated trucks in the courtyard”.
Like all hospital staff, the service agents recall with emotion the chaos during the first weeks of the epidemic. But they also complain of being the last in line to be given protective gear. “At the beginning, we had just a mask and gloves, no mobcap to protect the hair, no visor or glasses to protect the eyes,” said one.
While their work was considered less exposed to contact with patients, their disinfecting tasks meant they were inside patients’ rooms and bathrooms, serving meals and cleaning their dishes. Some of those patients with cognitive problems were too confused to follow social distancing rules, or wear a mask.
In Saint-Denis, some of the service agents fell ill with the virus, although none developed a severe condition. Their workload also increased, with more frequent cleaning tasks, but also when called upon to fill in for colleagues who had become infected and others who were kept at home because of their underlying medical problems. One told Mediapart she had for a time worked a shift for two, from 7am to 7pm, another of cleaning “16 rooms per day, serving breakfast, cleaning dishes, replenishing stocks in the unit, running from one service to the other” adding that in the care-home unit, there were just three service agents for 75 rooms.
Despite official promises made to all hospital staff, their overtime has still not been paid.
At the beginning of April, they collectively put in a request to the hospital centre’s management that they be made fulltime with the status of public sector staff. The human resources director of the centre told Mediapart that a “plan” to appoint a number of the service agents as permanent staff was currently being studied, but that not all could be offered fulltime public sector contracts because of their foreign nationality.
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