French member Delegations:
National Report France - SNPHAR-e - Spring 2011
In October 2010 a significant provision of the "Hospital, Patients, Health, Territory" law was published. It establishes the concept of clinical consultant contract. The physician is directly recruited by contract by the manager of the hospital for a three years period, renewable once. The consultant commits himself to respect in particular quantitative objectives, exceeding if necessary the lawful obligations and perceives in return a salary bonus of 65% of the last wages level, i.e. 12,000 €/month (gross). This contractual framework seeks to answer the disaffection of doctors for the public hospital and to reinforce the attractivity of the public hospital trust. This measure was denounced as of its design and with its publication. This contract is against the Code of ethics and our organization called for the examination of each new contract by the Medical Chamber.
The government was reshuffled in November 2010, Mr Xavier Bertrand, former Minister for Labour, was appointed at the head of a large ministry merging: labour, employment and health. The former ministry for Health became a secretariat of state. Mr Bertrand will represent France and will take part in the work for the revision of the European working time directive (EWTD). The cantonal elections of March 2011, which name the departmental representatives at the General Council, were marked by a strong abstention, a push nationalist line and a defeat of the governing party (centre-right). Ministerial cutting was confirmed and the holders were taken back in their function.
A report on intermediate level health professions (task shifting) was submitted to the Minister of Health in February 2011 It’s objective is simple: recasting of the health professions for better answering the major changes in progress (ageing, dependence, chronic diseases, cancer and mental health) and adapting to the dramatic evolution of the medical demography of certain specialties. The innovation is the creation of intermediate health professions, built up from the current paramedic professions, which could with a master level in the long term enter with definite competence medical professions. SNPHARe recalled with force that any change in the field of health must be carried out by guaranteeing the quality of care, by ensuring the patients’ safety and consolidating the job involvement and satisfaction of all the actors.
SNPHARe sent its contribution to the European Commission within the framework of the consultation of the social partners for a revision of the 2003/88 EWTD. We reaffirmed our opposition to any introduction of inactive period into the calculation of the working time of resident on-call duties. We denounced misappropriation of the maximum duration (48 hours) of the working time. We underlined the absence of sufficient and compensatory rest after a night-shift.
SNPHARe thus proposed:
- the complete calculation in effective working time of all resident medical on-call duties,
- withdrawal of the opt-out clause,
- recognition as working time of the time of non-resident in hospital displaced duties,
- the compulsory and systematic compensatory leave following the working periods.
We addressed each French MEP, with a mail repeating our contribution and a drawing up of the on-call duty. In answer, two French MEPs, Bernadette Vergnaud and Catherine Trautmann (S&D Group) posed on April 12, 2011, a written question to the Commission about the respect by France of the EWTD as for the accounting of the time and the durations of the hospital doctors on-call duties.
SNPHARe (Enlarged French Anesthesiology and Intensive Care Consultants Union) continues its policy of overtures by receiving always more consultants of various specialities, from University and non-University hospitals. The General Assembly of SNPHARe of January 2011, confirmed this enlargement and re-elected Nicole Smolski as president for a second mandate.
National Report September 2010
Author: SNPHAR , Didier Réa
Retirement: the file of topicality
The current national social and medical trade-union scene is dominated by the file of the reform of retirements. It appears as the last file of the Fillon government before the announced cabinet reshuffle, but especially of the ultimate great reform of the five-year period of president Sarkozy before starting the presidential pre-campaign period of 2012.
The project of reform of retirements is carried by the Minister for Labour and was officially presented on June 16, 2010. It envisages a lengthening of the duration of contributions in 164 quarters in 2013 and 166 in 2020. It pushes back moreover the official age of retirement at 62 years and 67 years the age of full-rate retirement.
This reform generates a broad and strong social movement of protest in form of days of strike. On September 7 more than 2,5 million people gathered in the street and this is an increase of 50% compared to the last movement of strike for the retirements. A new strike, September 23 was fixed by the large trade-unions. It aims at influencing the decisions of the Senate, which examines the text now.
For the hospital medical trade-union organizations the retirement constitutes also the file of topicality of the summer and the autumnal back-to-business. Three out of four interunion groups signed a draft-agreement on July 6, 2010. It specifies measurements of accompaniment for the hospital physicians of the reform of their complementary pension fund (I.R.C.A.N.T.E.C). The protocol takes again the broad outline and the principal axes of the project submitted to the trade unions in October 2008. It will in the long term cause an average fall of 30% of the pensions of hospital consultants. At the time, the refusal related on the insufficiency of additional amount of the employer share, in the creation of on-complementary insurance and to the times of implementation of various measurements.
This agreement envisages: a liability of the totality of the non-resident on-call duties (according to a statement of decisions from March 31, 2005) over a 7 years period, an integration in the contributions of certain compensations (engagement of exclusive public service, sectoral and of connection activity, multi-hospitals activity, premium as head of Department and function of president of Hospital Medical Council) according to a variable calendar, a liability of remunerations of the attached and part-time consultants to a total value of 70% of their emoluments. The budgetary effort spread out over 7 years represents 80 million euros.
One Inter-union (the CPH) refused to sign the protocol and SNPHARe denounced this bad agreement which:
- differs in time (7ans) measurements relating to the night-work in on-call duty obtained on ministerial statement of decision in 2005,
- perpetuates the absence of payment at complete rate (70% of their emoluments) for the contributions of the attached and part-time consultants,
- delay integration with the contributions of the premium of exclusive public service,
- found a clause of annual revision of the adopted measurements according to the public financial statement,
- supports the over-dimension of retirement beyond the full rate retirement age,
- finally, ignores the principle of the painfulness of night-work for the doctors.
SNPHARe took the initiative as from september to engage a movement of protest relating to painfulness and invites since September 1st all the hospital physicians to strike of the resident and non-resident on-call duties and to take their turn of duty only on assignment of their administration. SNPHARe thus wishes to make recognize the concept of painfulness and request that for this reason the consultants contribute only 160 quarters for 1000 resident on-call duties carried out. September 23, day of nation-wide strike, SNPHARe required an audience with the President of the Senate to expose and defend these demands.