Read news from:
Austria
SHARE
COPY LINK

HEALTH

How can France increase hospital ICU capacity to 10,000 beds?

French health professionals have greeted with scepticism President Emmanuel Macron's pledge that ICU capacity in the country's hospitals would increase to 10,000 beds to cope with rising Covid-19 hospitalisations.

Published: 2 April 2021 16:36 CEST
How can France increase hospital ICU capacity to 10,000 beds?
Health personnel at the intensive care unit of the Andre-Gregoire Hospital in Seine-Saint-Denis, outside Paris, treat a Covid patient on April 1st. Seine-Saint-Denis is the area suffering the highest pressure from the epidemic on hospitals. Photo: BERTRAND GUAY / AFP

On Wednesday, Macron outlined plans for an “extraordinary mobilisation” of the health sector in the coming days. 

Since the start of the pandemic, the number of hospital intensive care beds has been brought up to 7,665 beds from its usual base of 5,000. Of those, 7,053 are now occupied – 5,109 by Covid patients, according to Covid Tracker.

Health Minister Olivier Véran said the number of patients in intensive care could peak at 10,000 at the end of April. In comparison, at the peak of the health crisis last spring, on April 8th, 7,148 people were being treated in intensive care units across France.

During the second wave, intensive care patients peaked at 4,919 on November 16th. 

Healthcare issues

Increasing the number of beds to cope with rising Covid infections comes at the expense of non-Covid patients who needed medical help, several senior doctors have said.

“Theoretically, it is feasible, but to achieve it concretely it would take at least three weeks or a month,” said Alain Ducardonnet, a doctor and health consultant for French TV channel BFM.

Bruno Mégarbane, head of the intensive care unit at Paris’s Lariboisière Hospital, told French news channel LCI: “It can be done by transforming recovery rooms, operating theatres, or other sectors of medicine into new, temporary intensive care beds.”

The issue is not finding the beds.

Mégarbane explained the cost to staffing: “Doctors, nurses and anaesthetists would need to be redirected from operating theatres to these new beds.” 

It is estimated that 40 percent of non-Covid related surgeries have already been postponed to allow treatment for the number of patients with the virus. The health minister said last week that the aim was to increase this number to 80 percent in the greater Paris region Île-de-France, where hospitals are struggling to cope.

REVEALED: Just how bad is the third Covid wave hitting France compared to previous spikes?

Thierry Amouroux, spokesperson for the National Union of Nursing Professionals and a nurse at Saint-Louis hospital in Paris, described the knock-on effect. 

“When you postpone 5 percent of the operations, it is only cosmetic surgery [that gets cancelled], but at 40 percent, it starts to get serious, and when the [regional health authority] posts a target of 80 percent deprogramming, it touches on oncology (cancer treatment),” he told French daily Le Parisien.

Staffing and training 

Mégarbane said that, as well as current staff, the health system in France would have to mobilise its healthcare reserve, a list of 26,000 retired doctors, military medics and students at the end of their studies to be able to care for the number of people requiring the level of treatment and monitoring involved in intensive care.

But, then there is a question of training. Intensive care is highly specialised.

“In normal times, we can take less trained people and supervise them. Here we cannot, everyone is at the limit of what they can do,” Nicolas Bruder, head of the intensive care unit at La Timone hospital in Marseille, told BFM TV.

“So we need fully-trained people from tomorrow and we do not have them.”

Jean-Daniel Lelièvre, head of infectious diseases at Mondor hospital in Créteil told Le Parisien: “It seems completely unrealistic. We have the equipment and the physical space in the hospitals, but what will be lacking is the staff. 

“The president seems to say that we will find reinforcements, but will he learn resuscitation himself in two weeks? It is not my habit to criticise, but you should not announce anything.

“Going to 10,000 beds is a third more than the peak of last year. We do not know how we did it [then] and today staff are exhausted, while patients with other diseases are in a much more serious state because of breaks in care.”

Others have been rather more direct. These medics at the CHU de Nancy demonstrated their professional opinion of Macron’s statement in a tweet:

“We obey our president:

 – we make the effort

 – we move the walls to accommodate 10,000 ICU beds”

 

Member comments

Log in here to leave a comment.
Become a Member to leave a comment.
For members

HEALTH

The different ways you can make a doctor’s appointment in France

Booking a medical appointment in France can be time-consuming – especially if you are new to the country and are looking for an English-speaking doctor.

Published: 13 May 2024 16:52 CEST
The different ways you can make a doctor's appointment in France

You do not need a carte vitale to book a doctor’s appointment in France – anyone who needs medical help while in the country is entitled to it, but you may not be entitled to any reimbursement if you are not part of the social security system.

Booking a GP’s appointment can be as simple as phoning up your friendly neighbourhood GP, or using an online service such as Doctolib. 

It helps a lot, if you have a médecin traitant – an attending GP, who adds you (and your family, if they can) to their list of patients. 

READ ALSO Explained: How to register with a doctor in France

It is not always easy to find one. Some parts of the country are short of GPs, which means doctors’ lists can fill up very quickly. But it is important that anyone who lives in France is registered with a named GP, especially if they have a carte vitale.

As well as being the main point of contact between patients and the medical profession in all its guises, it is financially responsible to be registered with a GP in France.

Reimbursement on consultations is typically 70 percent through the French healthcare system, but just 30 percent for anyone without a declared doctor. Meanwhile, top-up mutuelle health insurance companies usually require you to declare a médecin traitant and if you don’t, you may not be able to receive reimbursements on certain treatments.

Bear in mind, it is your responsibility to register with a local médecin traitant. But, even after you have done so, you can still make an appointment with any doctor, anywhere in France, and arrange specialist treatment, if you need it. 

READ ALSO 5 things to know about visiting a doctor in France

How do you go about making a GP appointment in France?

There are several options.

Some health centres – more often in larger towns and cities – operate a walk-in policy. But expect waits to be lengthy. Do not, however, assume that your GP operates a system like this.

You can phone for an appointment. This is another very common method. Your GP will have their own system for making appointments – which may even include something that looks, to the uninitiated, very much like a casual walk-in policy. 

Some may have an assistant to deal with booking appointments and other administration. Others may deal with appointments themselves, and may – for example – operate some sort of triage system based on voice messages from patients. 

What about online booking systems?

And many practitioners are now attached to websites, such as Doctolib. As of 2023, about half of all GP appointments in France were made using Doctolib.

READ ALSO How to use: French medical website Doctolib

Be aware that other online booking systems are available. Doctolib is one of the best known, but your GP may be attached to another system, like the health ministry approved site ‘LeMedecin.Fr’.

This website also has a feature where you can take an immediate online consultation with whatever doctor is available at that moment. By clicking ‘Consultez en vidéo maintenant’ you will be connected to the next doctor who is free. This option may involve an additional charge between €5-10 on top of the price of the consultation, and you will be expected to pay when booking.

If you have any trouble with either of these websites, you can go through the list of registered generalists per département on the ‘Ameli’ website. If you use this option, you will need to call the doctor to see if they are open or available for appointments.

In terms of wait times, online systems have helped to significantly reduce the delay between booking and getting an appointment.

According to a 2023 study by Doctolib, about half of all GP appointments were available within three days from the time of booking on their platform.

Similarly, you can use online platforms to check the medical professional’s qualifications and languages spoken, as well as filter based on the doctor’s English abilities. However, this should be taken with a grain of salt because not every medical professional with English listed on their Doctolib page speaks fluent English. 

An increasing number of doctorsoffer video consultations, known as télémédecine in France. This allows professionals – particularly those in more rural areas – to diagnose less serious conditions remotely. This type of consultation is usually only available from those medical practices that are attached to online booking systems. 

Some pharmacies have also begun offering walk-in télémedicine consults, using ‘Medadom’ machines. More information here.

What about specialists?

In France, you book your own consultations with specialists, even if you are referred by a doctor (your GP may offer a recommendation, but won’t always). The good news is that many specialists do use online booking services. Those that do not usually have assistants to take care of the appointments.

READ ALSO: Urgent care: How to get non-emergency medical treatment in France

SHOW COMMENTS