The president of the CRSA: “The territories must be associated with the organization of the health system”

Director of the Blois hospital center, Olivier Servaire-Lorenzet presided over the Regional Conference on Health and Autonomy (CRSA) for 14 months. Exclusive to Magcentre, it illustrates the institution’s priorities for action.

Interview by Jean-Luc Vezon

Magcentre.fr. What is the budget for this first year?
Olivier Servaire-Lorenzet. ba lot of work has been done. We convened a regional workshop to set the roadmap for our health democracy body. 80 participants, members of the CRSA plenary commission, entered into a logic of exchange and “thinking together”. Three keywords underlie our actions: federate actors, transform to change the daily lives of users and healthcare professionals, and innovate by proposing solutions in the field based on cooperation and not imposed by Paris. The territories must be involved in the organization of the health system. This roadmap will be available on our site in 2023.

Magcentre.fr. What are your priorities?
Olivier Servaire-Lorenzet. Seven strategic areas have been identified: promoting the “psychological well-being” of the population, improving healthcare pathways for cancer patients, promoting access to rights for people with disabilities, enabling users in the social and medical-social sector to benefit from well-being and curative accompaniments, develop the training and attractiveness of the health professions, develop the health offer for people affected by Neurodevelopmental Disorders (NDD) and Autism Spectrum Disorders (ASD) and promote patient “partners”. On all these issues we are working constructively with the ARS and an initial assessment was made during our general assembly on November 15th.

Magcentre.fr. What is the position on the issue of medical students?
Olivier Servaire-Lorenzet. Following our opinion of May 2022, which included an electric shock, a working group is studying the matter and will give its opinion in 2023. However, I warn you that 300 students do not seem to me to be enough. Five hundred would probably be more appropriate. We are going to analyze the determinants of this quota, to propose clues for the selection methods, the technical organization and the human resources of these formations. We will also discuss the issue of freedom of establishment. Opinions on the subject are very divergent.

Magcentre.fr. Do you already have any suggestions?
Olivier Servaire-Lorenzet. In fact, we expressed them on December 15 during the debate of our Extraordinary Assembly dedicated to the National Council for the Health Refoundation of the CVL Region. We call for the abolition of the numerus apertus decided at the national level. LStudent volume is to be decided regionally within a GPEC. The same goes for the paramedical professions.. We are calling for a real reform which must also concern Parcours Sup. Students from the region must be given priority and have access to an oral interview to evaluate their motivations.

Magcentre.fr. In the face of worsening emergencies, what is your position?
Olivier Servaire-Lorenzet. Healthcare workers are exhausted and users suffer from understaffing. We therefore call on the State to rapidly initiate structural changes for continuum of care: strengthen SAMU – center 15, improve liberal regulation, develop advanced practices, and increase the number of students trained because there are too many vacancies. These questions must be at the center of the Regional Health Plan 3.

Magcentre.fr. What about continuity of care?
Olivier Servaire-Lorenzet. We will issue an opinion on the matter. Our position is, on the one hand, to make all the players responsible (users, city doctors and health facilities) eand make cooperation mandatory in every territory. You should also look for better remuneration. In this area, more decentralization and decentralization of decisions involving local authorities is also needed.

Magcentre.fr. Did the widespread ill-treatment within the Orpea private group shock you?
Olivier Servaire-Lorenzet. Yes, absolutely. Taking care of our elderly requires more human and financial resources. We also wish that the vigilance rations are opposable in the private as in the public. Some federations, for example, require one agent per resident on average. We will also issue an opinion on the matter.

Magcentre.fr. After the health crisis, the question of health financing arises acutely…
Olivier Servaire-Lorenzet. You’re rightnotYour body is also concerned about funding the additional cost of the Ségur de la Santé. Who will pay? Our structures are in debt. I would add that some sectors, such as medical and social services, are not affected. This is a watch point.

Magcentre.fr. In addition to what has been said, what will be the plans for 2023?
Olivier Servaire-Lorenzet. We are about to launch a study on “partner” patients which will be coordinated by Dominique Beauchamps, CRSA Vice-President in charge of the user committee. The idea is to be a pilot region. We also want to create an interinstitutional conference on the theme of disability with Pascal Usseglio, regional director of the APF and Aude Brad, who chairs the commission for medical-social assistance and support. Similarly, a regional TND-ASD committee should be created under the leadership of Martine Vandermeersch, president of CTS 28. We will also issue opinions on regional health plans 3 2023-2028 and 4 (environment). In this area, we would like to work in collaboration with the CESER CVL.

Magcentre.fr. The CRSA, which has no legal personality, remains little known…
Olivier Servaire-Lorenzet. The CRSA wishes to make its action more visible and readable. We will implement adequate communication by encouraging debate, discussion and giving the floor to our fellow citizens. Public debates, conferences and citizens’ consultations will be organised, for example on freedom of settlement. The general states of mental health are therefore scheduled for 2023 and, on February 28, a debate on the end of life will take place in Blois in the presence of Professor Régis Aubry, rapporteur of the national ethics committee. The CRSA will finally have its own website.