FORUM : Nicole is a pediatric oncologist.
At the end of the outbreak of coronavirus, which has changed our lives more than reason, you hesitate to choose which title among the novels of Sophie Rostopchine corresponds better to the situation of Ségur of the Health … “After the rain, the weather” ? Not sure, because the thinning of the reporting health care providers-government does not seem to have lasted the time of a few applause on the 20th, a draft of the medal and basta. Finished, the paramedics were not even invited to the interviews scheduled. So instead of “the memoirs of a donkey ” or “two nigauds ” ? Each one will choose that may well be referred to.
“A good little devil “
What do we expect from the Grenelle of health, which already looks like as two drops of water to the pseudo-consultations in the previous screening of breast cancer, or on the law health, Marisol Touraine, in 1995, the rapporteur of which was the current minister of Health O. Véran and the advisor, the current director-general of health (note 1). Recall that in the closing session of the consultation on compulsory vaccination, the decisions were contrary to the conclusions of the working groups, which prompted the resignation blaring from its promoter (note 2), Thomas Dietrich (note 3) ?
First deception. Oblivion of the paramedics. The heroes are they too tired ?
It starts strong. On may 25, to kick off the Segur of health, the government was prompted by visio-conference of many organizations, medical and paramedical, representing the whole field of health and medico-social : medical organizations, organizations and unions of the field nurse (nursing employees, nurses, liberals, nurses, anaesthetists, nurses, operating theatre, nurses in advanced practice, frameworks of health) and caregivers, and the “collective inter emergencies” (a group of paramedics, emergency physicians), at the forefront of the claims, protests and strikes for many months. Not all of them could not express themselves.
Immediately, Olivier Véran, published in a press release, the organization provided for the consultations of Ségur of Health for the next few weeks to come. Two working groups are set up to “reflect” on the themes chosen by the government and not by the invited to the videoconference, and oddly, the paramedics are forgotten ! The doctors will they accept this contempt and this “set aside” of those with whom they have struggled hand in hand, always and especially during this epidemic where they were all abused, ill-treated, by the absence of protection, masks, outfits, equipment, etc… How to accept this attempt of division of the caregivers through what appears as a masquerade of pure communication ?
The only decision that is acceptable to the medical representatives would obviously require the presence of equivalent representatives, paramedics, and boycott this travesty in the case of refusal of government. How far will the submission already highlighted by the lack of overall reaction to the decree of march 26, prohibiting the prescription of chloroquine by the physicians of the land, and the injunction not to transfer the elderly sick in the hospital (while many beds were available in most French regions) and euthanized without their consent or that of their families by the Rivotril ? These decisions are contrary to the Hippocratic oath and medical ethics should have raised a revolt by the doctors.
The “Committee Segur national” and the group “careers and compensations” shall meet every week until mid-July and be animated by the ex-secretary general of the CFDT, Nicole Notat. She is well known for its betrayals successive already with Juppé in 1995, the moderator of a focus group to develop the hospital-business in which we measure the results, and the president of the association of The Century. It is famous for its dinners monthly for the elite, an oligarchy in power for more than 30 years, the elite that led to the sinking current of the healthcare system by encouraging the destruction of the social protection of our country. We take the same and we start again. Image of a new world that takes over the oldies older, the tsarina of the CFDT in the case. How long will this sham consultation ? In any case, the minister has not put all the good cards in his game.
The plan of work envisaged by the minister is the following :
- Transform trades and revalue those who care for them.
- Define a new investment policy and funding the care service.
- Radically simplify the organizations and the daily lives of the teams.
- Federate the actors of the health in the territories at the service of users.
Language of wood and smoke
How to turn it back again up the trades while the law Touraine-Veran is fought to destroy the specificities of each function ? The minister is willing to remove its law to return to a normal functioning of the hospital ? We doubt it. The only point to remember is “upgrading” but we can worry about the lack of overall figure so that it announces billion for Renault, Air France etc
In respect of a new investment policy and financing of hospitals, waiting…
The simplification of the organizations would be welcome, but can only be achieved if the government agrees to challenge the stranglehold of the regional agencies of health on all public and private structures, and therefore their total abolition as decision-makers.
The simplification of the daily life of caregivers goes through the immediate removal of the thousand and one meetings imposed for everything and nothing, the removal of many standards are unnecessary and costly, and the equipment sufficient to care in order to prevent the personnel to run it continually to borrow a pump here, a scope there, etc
The fourth point also leaves you breathless. “Federate the actors of the health ” ! While since the orders Juppé then the laws Bachelot and Touraine, the agencies of hospitalization impose merger, joint meetings required etc It may be feared that bureaucratization is getting worse instead of alleviating, both the willingness of the state to impose its solutions is reflected in the very statement of the working groups.
“Little girls models” the “misfortunes of Sophie” soon
If the nurses were the small girls of the models, the time of an epidemic and applause vespéraux organised by the media (to make believe in the miracle ?), they were soon the misfortunes of Sophie, rejected interviews at the ministry, and sidérées ads persistent closures of hospitals nearby.
“The evil genius” : the straitjacket of bureaucratic
This requires a real political will to change and not adaptation of the same techniques waste, such as continuity of the current governance desired by the prime minister the fact fear.
Fully release the medicine in the bureaucracy. Change heavy and capital
The policies that promettront the freedom to care and be cared for, without deciding that complete removal will not be credible. The sad experience that we are experiencing with the government ban of the prescription of chloroquine by the physicians of the land is dramatic for patients and demonstration of the interference of political power in our prescriptions, which is contrary to the Hippocratic oath and medical ethics.
It is necessary to completely remove the Regional agency of health (ARS) and their discretionary powers. Economics possible for the ministry of health : 3 to 5 billion euros annually !
We have all seen the damage of the disruption of the agencies that have diverted supplies of masks to a region that had been ordered on another. What are the regional agencies that have blocked the transfer of patients in the private beds released, preferring to transfer the patients to other provinces or abroad. These are the same agencies that block the normal reopening of the private clinics and public hospitals that remain in the white plan, that is to say, reserved for emergencies, estimated on the basis of their criteria is ultra restrictive. (Note 5)
Many patients suffering from cancers of the evolutionary are waiting for interventions and even radiation therapy and are very anxious and worried about their future. Other patients of other specialities are also waiting for care, and very overdue. These measures inappropriate and are not justified on the medical plan are decided by the regional agencies of health without consultation with the professionals. Surgeons are demanding through their unions to reopen quickly the institutions, but as their sick are not being heard. Hospital doctors and liberals should regain their freedom to treat their patients in waiting. (Note 6)
For the other agencies that are duplicates, or even triplons, and the numerous observatories, it is necessary to remove a good number, grouping, or better, reintegrating them in the department with which they are also duplicates at excessive cost (salary capped at the ministry versus salary free in the agencies for seconded officials).
It is absolutely necessary to degrease the mammoth agencies that ruins the State (Note 7), discourages caregivers enslaved by this predator ! Remove all of these stakeholders, cross-cutting, which are interposed between the patient and the doctor and/or nurse, have to implement the orders come “from the top” established by the énarques or sub-énarques miles away from the clinical reality, and who, although sometimes well-intentioned, does not produce standards, a wasteful, inappropriate to real life !
It would remove many positions of administrative enforcement orders, all those responsible of “control” that we had given the orders, all those who come to monitor the effectiveness (!) and are evaluated in turn.
The level of services, put the caregivers at the bedside of the sick, by removing the meetings multiple and unnecessary, where everyone plays with his laptop, when he’s not doing his personal e-mail, waiting for the one who is listening speaking stops, finally, to tell the same thing as the previous week. It turns the most often on the how to save money …
Of additional unemployed persons ? Among these “administrative” how many caregivers transformed into bureaucrats, including many doctors and nurses become ” managers of health “, that we will be able to provide contact with patients, for their greatest joy, probably.
On the way, one removes the multiple directions of agencies and hospitals, redundant, each of which have their secretariat and their assistants, their communicators and sometimes their housing function, if not their driver etc
As for the real administrative, accounting, secretaries, librarians or other, the justice is completely under equipped, the records of the individuals littering the ground at the tribunal of Bobigny, for example, or the pavers in a small provincial town, the police and the army are also at the bare minimum.
Let us not forget, that despite the limitations in care, seen by everyone, and aggravated of the quinquennium by quinquennium, the proportion of our GDP allocated to health is still high at almost 11 %. II is necessary to feed the ogre administrative, always inflated, never evaluated on relevant criteria, such as the balance of direct costs (salaries, benefits-in-kind) and indirect (tasks useless for the care that they require, the cost of standards) / efficiency (improvement of the care and/or satisfaction of our fellow citizens).
Let’s work the doctors and caregivers, without putting a “frame” behind each nursing, sub-managers under each director, a head of the pole behind the head of each service etc, When we fought to try to save the existence of the unit of oncology of the hospital of Garches (APHP), it was necessary to write each time to the director of the hospital, to the director of care, the head of the Pole, to the president of the CME, local, of the hospital group and headquarters, the director of the group, the director general of the headquarters, and we forget… Like everyone thought maybe it was for the other to respond, we receive, in total, that very little response to our mails.
Yarrow administrative or mexican army who had, supposedly, more generals than soldiers. That time, nursing lost, via the réunionnite chronic resulting. That post expensive and unnecessary.
Remove the procedures of authorizations and accreditations. Savings are possible for hospitals and clinics between 3 and 8% of their budget.
The elimination of controls performed by the ARS must be the result of the deletion mandatory for these agencies. Other agencies types HAS and INCa, in addition to their fusion and their degreasing is essential, and should not be agencies of controls, but the rigour of reflections and proposals. Let us not forget that our health system has lived before this flood of bureaucratic exponential since the end of the XX-th.
Before the appearance of these ARS, the INCa, etc, we were the first system in the world, a reputation that is still alive for some today, while our free fall we are rather currently to the 25 th largest in the world.
The state diplomas must remain the only degrees recognized by the nation, the degrees of the university shall, in no case, replace them. They need to regain their legitimate authorization to exercise. Accreditations withdraw any value to the diplomas, since, in spite of these, the ARS may, by its sole discretion, you withdraw the right to practice in a domain.
These accreditations and authorizations are also a considerable source of rights, conflicts of interest and potential corruption. The removal of the accreditation process will allow healthcare organizations to save 2% to 5% of their budget, which will enable them to live a little better and modernize.
Remove the majority of the standards set by the agencies in medicine
Infinitely, few have proven of any use to the sick. Many of them are stupid. A lot of them only exist to satisfy the request of a lobby wishing to obtain an advantage over its competitors.
For the ones that seem really useful, the issue as a simple non-binding recommendations, and implement public access to the internet with the bibliographic references that justify them, as well as the full reports of the meetings of the editorial and links of interest, if any, of their editors, as it is practiced by our colleagues in English of the NICE (Note 8). In case of accident, health, non-compliance of these recommendations will have to be medically justified. In giving freedom to the professions of health, we will make them again truly responsible for their actions, and they will be allowed to re-create the treatments of tomorrow.
“An evil genius ”
A system out of whack all the floors, perverted and perverse. “The research clinic industry funded : a system to be jammed “.
Some of the great names of anglo-saxon countries, such as the ex-editor-in-chief of the New England Journal of medicine, and his successor in this position Jerome Kisserer (Note 10), professor Peter Gøtzsche, oncologist Danish chef of the famous network Cochrane, the Pr is Even and Debré in France, in the years since 2000, try routinely to alert the medical world and policy the scale of the disaster, in all respects, and especially for the sick. Many other, less well-known in Canada, and the USA, in France, Dr M. Girard, ourselves (Note 11), and many other whistleblowers have made to seem, since the beginning of the new century, many works often ignored by the media, or mocked, or defamed.
Despite everything, this recent crisis has shown to all French people glued to their television sets, the magnitude of the disaster of misinformation, teachers, related to Gilead in the hiding, in succession over the trays to defame a team that cared for the sick and non-profits, that of Marseille, with the success that we know : the five-times fewer dead in the South of France and serenity of the inhabitants, knowing that they could be treated effectively in case of need, contrasting with the anxiety lingering in the paris region. Two worlds…
Hippocrates ordered the doctors to be rigorous, honest, calm, understanding and serious, to respect the medical confidentiality and the interests of the patient and only the patient. His oath of office (Note 12) summarizes the ethics of the medical practice of the time, and was recently the basis for the commitment of any doctor at the entrance in his ” art “.
The practical humanist is fought for over thirty-five years by the bureaucrats and official decision-makers who govern us. They want to reduce the clinical practice of medicine, which is beyond their control, to a mechanical application of recipes, techniques standardized, standardized, designed, among other things, to promote the sale of medicines at gold prices, of medical devices (including prostheses of all kinds and robots of any kind, including surgical).
They have legislated by laws and decrees in multiple, to arrange hospitalization in private or public to maximize the profits of large financial groups, and in the end get rid of annoying doctors, and if possible also of the nurses, physios etc
Their dream mephistophelean of robots, created by their start-up miracles, the fantasize. Finally, the medicine without the doctors ! The treatment of the crisis Covid19 by the government was a perfect illustration of the drift digital desired, dreamed up and imposed through the containment. The relative failure of the telemedicine leaving behind the thousands of patients waiting for treatment and clinical examination is the only positive point of this experience as that of the digital school, dream of our academics, including graduate studies. Cambridge tries to impose to the start of September, 2020.
The commodification of health is no longer a hypothesis, but an evidence.
How sad it is to see, in a contracted establishment suburban so-called disadvantaged, the pricing of the rooms only to levels -solo, solo+, great comfort – from 110 to 250 € per day, price-worthy hotels very good, which these places don’t look ! Doctors of sick heavy in their pathology, we have known the time, when isolation is required, it led us to a medical prescription taken in charge by social security, the possibility of which has disappeared at the beginning of the century. It has changed in that time !
MONEY, PROFIT, KEYWORDS
The specific notion of support, “medical” was developed before the bankruptcy of this academic medicine, which transforms the patient into an object of research, and the doctor in robot. The determination of this fraction medical décideuse to quickly get rid of the patient, when it is no longer “useful” to therapeutic trials, pushing it quickly towards the care of so-called ” palliative “, when this is not to euthanasia, has done the rest. This desire to end it is sometimes ultimately desired by the patient who can no longer be denied in its specificity of human and to feel ” too much “. And, if he does not demand anything, it is his family who is pushed to leave the “doctor” to push the syringe.
How many perverse effects are-they come to complete the picture of the disaster linked to the case of the health system, to the development and propaganda for the deep sedation, irreversible, institutionalized by decree in August 2016 ? Finally, the decree of 26 march 2020 came complete the table by prohibiting both the transfer in hospital of an elder in long-term care Facility, its initial processing to be limited to paracetamol and the injection of Rivotril, euthanasia is not required, neither by the patient nor by the family.
When a company wants to, in fact, get rid of old or of his chronically-ill (Note 14):in the environment of cost too much to safely, that the hospitals are filthy and the personal suicidal, and at the same time as the dividends paid to the shareholders of big pharma have never been higher, it is that something is rotten in the kingdom of France, and it is in urgent need of repair. How callous current of which it treats the elderly long-term care FACILITY by refusing their visits normal ! A 99-year-old refused to kiss his daughter or his grandson under the spurious pretext of protecting the Covid19, who can believe in it.
It is time to bounce back, to straighten, to exclude the products of health of the market system !
Freedom therapeutic doctors with their freedom of installation, of their financial freedom and of their membership or non-membership in a convention is the prerequisite for a reversal of the dramatic fall in the number of doctors that are installed, and even new entries to the order and the flight abroad of trained practitioners, such as experienced surgeons.
It is a big project of legislation that will require the abolition of laws Touraine and Bachelot, and executive orders governing the cancer confined in the straightjacket of the sterilant of the cancer plan. It is obvious that it requires a big political courage, because he will have to reverse a trend in bureaucratic developed for nearly 40 years (the 80’s).
Difficult or not, there are more choices. It will be important, of course, that this major reform of medical practice to be associated with the redesign of the research and education to give our young students animated by the desire to take care of his training at the height of their ambitions (Note 16). Don’t transform into robots obedient, but to give to their imagination, their sensitivity, their creativity, the opportunity to express themselves, without denigrating the achievements of their elders, should become a permanent objective of the future leaders of the universities.
Before ” the holidays “
Do you think that the Ségur current to be able to implement these major reforms ? In any case, we can ask how to continue a negotiation with a minister, supported by a scientific council, closely linked to Gilead, who lied constantly and imposed on France the measures are inhumane and unnecessary ? Their resignations should be imposed promptly after the last episode of chloroquine, the icing on the cake. The minister has allowed a general prohibition of the only treatment currently effective on the Covid19, supposedly on the words of a study published in the Lancet completely sloppy, biased, if not possibly invented.
“Jean who laughs and Jean, who growls ”
Cease to be children under the bogeyman during the protests, and the father of the Nation far away from our daily reality, and insist relentlessly on the back to a health system that is free and responsible, without the involvement of technocrats or economists, sociologists, anthropologists of all kinds. Money will not suffice, even if it was granted, because it will fall into a pit without funds if the governance remains intact and always predatory.
Free to them, sometimes frustrated of medicine, we look like the savage tribes in the depths of a deep forest, but let’s leave medicine to the physicians, clinicians and caregivers. The curious composition of the famous scientific council which requires week after week of aberrant measures, dictated in part by their conflicts of interest major, should you be challenged, as the multiple seminars of reflection on the redesign of the health animated almost exclusively by non-physicians, except sometimes a public health physician, who does not see patients…
Note 1 : Jerome Solomon, who égrena every night
Note 2 To justify its decision, Ms. Buzyn is based on the conclusions of the steering committee of the citizen consultation on vaccination, the operation of which has been denounced as ” a real propaganda (…) undertaken to encourage the French to vaccinate “ by the former general secretary of the national Conference of health Thomas Dietrich. During his resignation shattering, February 19, 2016, this senior civil servant was alarmed for the consequences of the absence of democracy on health issues : ” more and more parents will be discouraged to vaccinate their children, predicted it, because they can provide information that is not tainted with suspicion of bias and conflict of interests with the pharmaceutical laboratories “.
Note 3 : Thomas Dietrich, ” Democracy in health. Lost illusions ” (PDF), contribution to the report of the general Inspectorate of social affairs on the monitoring of the democracy in health within the ministry of social affairs and health delivered on 19 February 2016.
Note 4 : We have developed in “Heal or Obey” Editions Fawn 2016 election period, the observation that seen from the inside of the sinking of the healthcare system and proposals to meet it, the intention of the policy, and citizens. The suggestions remain valid more than ever as the healthcare law is the Wine – Touraine passed enacted in 2016 and its various implementing decrees, have only served to destroy a little more of our public and private hospitals and the medical profession. It is time to get out
Note 5 : www.economiematin.fr/news-ouverture-bloc-operatoire-danger-malades-confi… ?
Note 6 :https://youtu.be/eay-Txlr-GQ
Hospitals & Clinics : Prohibition of operation” Dr N Delepine, May 16, 2020
Note 7 : http://docteur.nicoledelepine.fr/bureaucratie-mammouth-inca-cancer-liber…
Note 8 : the Acronym for National Institute for Health and Clinical Excellence, comparable to our HAS
Note 9 : Pr Marcia Angell physicist and ex-editor-in-chief until 2004 the renowned New England journal of medicine, who was sacked for refusing the false test, and to have it denounced. As will be his successor Jerome Kisserer. (” the hand in the bag : medical + business Ed) as Cited and translated by Pharmacritique 2009
Note 10 : Jerome Kisserer, “the hand in the bag : medical + business “, Ed, Cited and translated by Pharma critics, 2009.
Note 11 : My freedom to care for N. Delepine 2006, editions Michalon.
Note 12-Updated many times. his version is the most common disseminated by the World Medical Association, known as the Oath of Geneva, and that some fundamental points are threatened by the latter act health said Touraine published in the official Journal in January 2016.Updated many times. his version is the most common disseminated by the World Medical Association, known as the Oath of Geneva, and that some fundamental points are threatened by the latter act health said Touraine published in the official Journal in January 2016.
Note 13 : https://www.agoravox.fr/tribune-libre/article/decret-rivotril-compassion…
Note 14 :In the Japan of the 18th they were at least seniors over 60 years of age, who decided their death, starting in ” The Ballad of Narayama “. But the future risk, if we are not careful, to look like the age of crystal where the limit of the useful life is 30 years
Note 15 :https://www.mesopinions.com/petition/droits-homme/ehpad-stop-aux-mesures-drastiques-inadaptees/91110 Petition
Long-term care facilities : a Stop to the drastic measures inadequate, illogical and cruel confinement ! Let us see humanly all of our veterans !
Note 16 :Read the book of PR Even on medical research
Note 17 : This they call ” scientific “. The sick need physicians land and not of scholars or pseudo-scholars who legislate from above, from another planet.
Author(s): Nicole Delpine for FranceSoir