L’Express: A few months ago, you told us that there was an upsurge in violence against healthcare workers, that not a day goes by without one of them being physically or verbally attacked. What about the current situation?
Agnes Firmin Le Bodo : First of all, I would like to reiterate our deep support and our deep emotion towards the victim and the family of the victim attacked at the Reims University Hospital, and also towards the medical secretary who is in serious condition but who, fortunately, is out of danger. I also want, more generally, to reiterate the government’s support for all health professionals, because on Monday the entire healthcare community was affected.
The National Observatory of Violence in the Health Environment (ONVS) has not yet published its complete figures for 2022, but we know that 37% of health professionals say they regularly suffer physical attacks. And for caregivers, this figure can rise to 80%. The ONVS noted, in 2021, 19,328 attacks on persons and property, this represented a substantial increase.
The declarations given by the Order of Physicians corroborate the phenomenon: we are witnessing an increase of more than 20% in declared violence between 2021 and 2022. Taken in the long term, the figure is striking: we have gone, in space 20 years, 638 and 1,244 reports, reflecting both an increase in acts of violence and better reports.
It was therefore time to be concerned about this evolution of attacks…
We do not react in an emergency, there is nothing worse than a hot reaction. As soon as I took office almost a year ago, François Braun entrusted me with this subject, which I took to heart and which we defined as a priority.
In the light of what has just happened, it is important to say that the causes of violence against health professionals are not always of the same order: this is due to structural phenomena, linked to the overall rise in violence in our society; annoyance due to the problem of access to care; and others, more difficult to understand, because they involve people suffering from mental disorders, which raises other questions and other issues.
On February 1, you entrusted a mission to the president of SOS Médecins Jean-Christophe Masseron and to Nathalie Nion, senior health executive at the Assistance Publique-Hôpitaux de Paris (AP-HP), on violence in Health. What lessons can you already draw from this?
This work, which concerns both the liberal city sector and the hospitals, is going well and Jean-Christophe Masseron and Nathalie Nion will give me the conclusions of their mission on June 1. From the 80 people interviewed, the analyzes of the two missionaries, of my own travels and of the work carried out by my office, several hundred proposals result. We are in the process of prioritizing the actions we will have to take so that the government’s action plan quickly translates into concrete results for our caregivers.
What are the lines of work?
The first is to raise public awareness and train caregivers. It is important to remind our fellow citizens that respecting those who care for us, like those who protect us, is a non-negotiable point. We are going to launch an awareness campaign, with a main message which will be: zero tolerance! Our goal is to launch it at the start of the next school year, both in public establishments and in the liberal city sector.
In addition, it is necessary to train caregivers in the face of verbal and physical aggression: distinguish the signals, learn to manage this aggressiveness… There are specific training courses and it would be appropriate to offer them to students in initial training. I also hope that “violence” referents can be created in the orders of health professionals so that we can mesh the territory.
And on the ground? Can we better protect caregivers in their workplace?
Yes, we must ensure that we better prevent violence and secure the exercise of the work of health professionals. For this, we must improve the safety of structures, buildings, we must be able to design as quickly as possible, imagine how to do it. This must be part of the specifications when opening, for example, a multi-professional health center. That we immediately integrate video protection cameras, emergency buttons… This must be discussed.
All this must be done in close collaboration with law enforcement and the prosecution. The links with the police and justice are already strong and their action is essential, but we still need to intensify and strengthen the health-security-justice agreement. In particular, we can imagine extending them to group practices and nurses’ practices. We must also share and generalize good practices! I will take two examples: the Bichat hospital, which has created very interesting patient flow management; or SOS doctors, where there are devices to geolocate the professional when he moves.
One of the problems that we also see is that health professionals do not always file a complaint…
Indeed, not everyone necessarily declares acts of violence. And this for several reasons: because it is still complicated to file a complaint, because some people think that behind it will be useless… This is why we want to make it easier to file a complaint, for example by allowing the hospital to do it in place of the caregiver, strongly encourage the reporting of violence. We must also ask ourselves about the penal response! The violence against elected officials has challenged and led to the definition of a specific criminal response, should we wonder about a new response concerning violence against health professionals? The question remains open. We can engage in a reflection on the subject.
For some representatives of the nursing staff, the increase in this violence is also, and above all, due to the lack of resources allocated to the hospital. That this is the first priority to settle…
Some of our fellow citizens react violently when they consider that the waiting period is too long. Some secretaries are assaulted on the phone because the appointment is not immediate. Minimizing the waiting time in the emergency room reduces the anxiety related to the disease, the fear of an injury. On the other hand, I do not subscribe to the speeches which explain the violence by the lack of personnel. Violence is unacceptable and its trivialization against caregivers must mobilize us all. Having trained and numerous personnel on the ground is a central issue for the government’s action, but it is also by reassuring young people of their safety that we will be able to recruit more caregivers and keep them. Making healthcare professions attractive also means protecting our fellow citizens who exercise them.