Jean Castex responsable de la casse de l’hôpital public? Ces soignants inquiets

Jean Castex responsable de la casse de l’hôpital public? Ces soignants inquiets

Salué par la droite et une partie de la gauche, le successeur du très populaire Édouard Philippe est vu par certains comme l’artisan de réformes qui ont cassé l’hôpital.

En 2006, il voulait “obliger tous les établissements à se regarder avec lucidité.” Jean Castex, le nouveau Premier ministre, inconnu du grand public, n’est pas un petit nouveau pour tout le monde. Le futur-ex-maire de Prades connaît bien notamment les professionnels de santé, particulièrement remontés ces derniers temps.

C’est lui qui était par exemple l’un des fervents promoteurs de la tarification à l’acte et de la restructuration du système hospitalier entre 2005 et 2007 quand il était directeur de l’hospitalisation et de l’organisation des soins au ministère de la Santé (DHOS). “C’est lui qui a été à la manœuvre pour introduire la notion d’objectifs dans l’hôpital et une rationalisation des coûts”, résumait Patrick Bourdillon, de la CGT Santé à Society en avril 2020.

Un tournant vu par certains comme le point de départ de la casse de l’hôpital public. Car cette tarification à l’acte, surnommée T2A, a induit “une course absurde à la rentabilité” selon Hakim Becheur, chef de service à l’hôpital Bichat à Paris par exemple. À tel point que beaucoup de responsables politiques se sont engagés, au fil des années à corriger les effets pervers de ce système, sans que cela n’aboutisse réellement.

“On leur crache dessus”

C’est d’ailleurs une des revendications de la communauté soignante après la pandémie de coronavirus, crise qui a mis en lumière les failles de l’hôpital public. Alors, en apprenant la nomination de Jean Castex comme Premier ministre, certains sont tombés de leur chaise, prenant la nouvelle comme un affront. Pour d’autres, ce choix d’Emmanuel Macron pose de nombreuses questions.

“On prend les soignants et on leur crache dessus”, fulmine Fabrice Di Vizio, l’avocat de trois médecins qui attaquent Édouard Philippe, Agnès Buzyn et Olivier Véran en justice pour leur gestion de la crise. “Tous les maux dont se plaignent les soignants à l’occasion du Ségur ont une origine. Et au départ, au commencement, c’était Jean Castex. C’est ce haut-fonctionnaire à la DHOS qui était chargé de mettre en oeuvre deux réformes: la tarification à l’activité, qu’il a défendu en long en large et en travers et la gouvernance administrative de l’hôpital”, explique-t-il au HuffPost.

Et Fabrice Di Vizio d’insister: “vous ne trouverez pas plus fervent défenseur de la gouvernance de l’hôpital telle quelle est actuellement que Jean Castex. Je trouve que c’est une offense aux soignants quand on connaît un peu leurs revendications.”

Force est effectivement de constater que, derrière les créations de postes et les revalorisations salariales, la communauté soignante veut aussi changer sa hiérarchie et modifier en profondeur la façon dont l’hôpital est géré. Céline Laville, la présidente du syndicat Coordination nationale infirmière, décrivait en juin dernier “un système est verrouillé” au HuffPost: “quand un service doit être réorganisé, ce n’est pas des agents de terrain qui réfléchissent aux solutions, c’est la direction qui réfléchit avec l’administratif.”

Lire la suite sur huffingtonpost.fr

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