Shortage of staff, lack of attractiveness of the professions, deterioration in the quality of support. For several months, disability professionals have warned of the gravity of the situation and families fear tragedies.
” We hold on, but until when? »The situation described by Sandra Guitton-Philippe is a reflection of what has been going on for several months in many establishments welcoming people with disabilities. “ Out of four day nursing positions, I only have one incumbent », Says the director of the Institute of Motor Education (IEM) Saint Thys in Marseille. To compensate, it calls in particular on temporary workers. With all the drawbacks that this entails: staff who change all the time and who do not know the 80 children with multiple disabilities welcomed within the IEM. And the consequences: “ This harms support, teamwork … », She enumerates.
People “sent back” to their parents
Worse, this situation endangers the outright reception of some residents. “ I have an obligation to have a permanent infirmary, continues the director of the establishment. So when it happens that this holder is arrested for one reason or another, I am obliged to tell parents of children requiring special care, such as gastric tube feeding or blood sugar monitoring for diabetics, to do so. to resume. It has happened three times since September. “
However, in an attractive territory, it does not consider itself so badly off considering the difficulties of other establishments in France. In October, the Unapei federation of Haute-Savoie reported more than 150 people returned to their families. In question, 125 positions remained vacant. The federation Cerebral Palsy France reports difficulties all over the country. In an establishment in the Lyon region, a rotation had to be set up, with a work-study welcome, every other week.
“ The context is also hypertensive on rehabilitation positions, such as physiotherapists, which are much better paid in private and in the hospital., continues Sandra Guitton-Philippe. But what is new are the problems of recruiting educational personnel: specialized educators, instructors-educators, medical-psychological assistants (AMP). I find myself in situations where I have to recruit non-qualified temporary staff… Again, this affects the quality of the support. I had to end trial periods because some people did not live up to our expectations. ”
The coup de grace of Ségur de la santé
Low remuneration, which has not kept up with the evolution of the cost of living, lack of attractiveness of low-valued professions, increasingly difficult working conditions … The reasons for the difficulty of hiring in the sector are known and old. ” But for the past year there has been a big problem. In September 2020, we had zero vacant positions, today we count them by ten », Indicates Julien bernet, general secretary of the Hapogys association, which manages several types of establishments welcoming 300 people suffering from multiple disabilities or cerebral palsy in Gironde, in the south-west of France. He hasn’t had to close yet and greets ” commitment and inventiveness “From its teams,” but we asked the parents who wanted and could take their children back more often, to relieve the teams. And we stopped admissions to temporary reception places », He specifies.
The Covid crisis has been there, but ” the straw that broke the camel’s back », He explains, these are theségur health measures taken in the summer of 2020 to deal with the pandemic. These measures have enabled a net revaluation of 183 euros in the salaries of nursing staff in the public sector, leaving aside those working in establishments in the field of disability under the private sector. “ We ended up with salary differences of 500 to 800 euros net between a nurse in the medico-social and a nurse in a hospital or nursing home », Specifies Sandra Guitton-Philippe. A ” competetion ” who created ” an additional leak »Staff, comments Stéphane Lenoir, coordinator of the Handicaps Collective, which brings together 49 associations.
Faced with the mobilization of the medico-social sector which denounced a “ unfair treatment “, the Prime Minister Jean Castex announced at the beginning of November the extension of the Ségur premium to medical and social health professionals. But the educational staff (instructor-educator, specialist educator, etc.) remain excluded from the system and feel forgotten.
” We don’t want to become like the nurses in the hospital who wash in 5 minutes “
“ How to justify this division of employees in the area of support? », Indignant Lucie Stirer-Choubrac, instructor-educator and member of the office of the federal union CGT of social action (UFAS-CGT). Far ” to extinguish the fire “, She explains, these measures have aggravated the discontent and tensions within the teams, with situations” ubiquitous », Underlines Julien Bernet, where a nursing assistant (Bac level), may be better paid than a specialized educator (1350 euros at the start of his career, for a Bac +3 level).
” Colleagues are at their wit’s end », Insists Lucie Stirer-Choubrac, who, like others, draws a parallel with the degradation of the public hospital in recent decades. In the CGT office in Montreuil, she brought together two of her colleagues who also testify. ” We don’t want to become like the nurses in the hospital who wash themselves in 5 minutes and no longer have time to listen to the sick », Abounds Martine Villalard, educator specializing in a home of life in Caen. Close to retirement, she feels that her job has lost the essentials. ” We have less and less time to have a coffee with them, discuss their life, their aspirations, what they want, how they see their life at home. Yet our job is first and foremost them, the human being. “
“ We are not at the factory! », Adds his colleague Christophe Climaco, who says he feels« like the character of Charlie Chaplin in Modern times. He has been working as a monitor-educator since 2006 in the Perpignan region and he is no longer found there. “ I asked for training for professional retraining. “He is going to become a freelance hypnotherapist, his establishment does not have the budget to hire him.
►Also listen: Caregivers exhausted and increasingly in demand
” It’s an impossible mission, regrets Sandra Guitton-Philippe. We are in paradoxical injunctions: policies in terms of disability are more and more innovative, but the more we personalize the support, the more we talk about inclusiveness, the more resources are needed, i.e. money and posts. And it does not follow. “
” Our children are in danger “
Loss of meaning for professionals. And for those welcomed, a daily life affected: late risings, staggered meals, spaced toilets, reduced cultural and social activities. “ The consequence is a lack of support for people with disabilities, with a breach of fundamental rights, denounces Stéphane Lenoir of the Collectif Handicaps. It’s unbearable. “In Marseille, Sandra Guitton-Philippe sums up:” We are losing the sense of a job well done. Today, the professionals in the medico-social are in the frustration, the dissatisfaction with not doing what they should be doing. “
At the end of the chain, there are families in distress. ” I cry at night, I don’t sleep anymore », Testifies the mother of a young multi-handicapped girl who lives in a nursing home (FAM) of Vaucresson, in the Parisian suburbs. The establishment has been operating for several months with a third less staff. “ Our children are in danger, considers this mother who prefers to remain anonymous. On wonders when the tragedy will occur. “As was the case in an establishment in Villenave d’Ornon, in the southwest of France this summer, where three people died” lack of sufficient care », Acknowledged the director of this MAS (specialized reception center) in an article by Street 89 Bordeaux. She describes a situation where the professionals who remain are at the end of their strength and those who come and go insufficiently trained in the face of polyhandicap or specific complex autism disorders. “ Residents do not feel secure so this increases behavioral problems, there are more epileptic seizures », She reports. To lend a hand and try to overcome the shortcomings, parents have no other choice but to take turns volunteering. Here, too, it was a question of “sending” people home. “ But we can not. This home is their home! she is indignant. Some of us are too old and there are single-parent families. “
More resources and upgrading of all staff
” Today there is anger, explains Stéphane Lenoir, a feeling of contempt for the families and professionals concerned. The associations warned the government at the time of Ségur which did not budge, we wasted time. “For the CEO of Hapogys, Julien Bernet, it is a feeling of waste that dominates. “ It is no longer an uneasiness, it is a cry of alarm. The damage that has been done will take years to repair itself, he sorry. All the old-timers who left that we had spent years training in very specific techniques, because polyhandicap requires great finesse to analyze, to enter into a relationship … All this experience, we lost it with the departure of the professionals. We have endangered an entire sector. ”
This anger has been expressed through demonstrations almost every week since September, and the movement seems to have accelerated further with the national mobilization which brought together medical and social professionals on December 7. In the wake of the Prime Minister’s announcements, a conference on social and medico-social support professions was announced to be held before January 15. But associations, unions and professionals are skeptical: what will be its objectives? The diagnosis has already been made. Now we must move on to remedies. What they are asking for is an upgrade for all staff working with disabled people as well as resources.
The office of the Secretary of State for People with Disabilities did not respond to our requests. Several organizations are already calling for mobilization for the trades conference.