Marigot Hospital: a key issue for the ARS

Paul Guibert & Philippe Luccioni-Michaux

For the new director of the ARS, this first visit to the field was essential in order to meet elected representatives, healthcare professionals and institutions to better understand the realities of the two regions. At the heart of his roadmap: hospitals, where he believes swift progress is necessary.

CH Louis-Constant Fleming: an urgent need to stabilise the management

Following the director’s dismissal, the hospital is once again being run on an interim basis, this time by its finance director. The job vacancy was published last week via the National Management Centre. Philippe Luccioni-Michaux has given himself a month to gather applications and select the person best suited to fill the post and rise to the challenge. Following a meeting with the unions and management on Tuesday morning, he believes the priority is to stabilise the management team quickly, as there are high expectations from the staff, who have expressed a need for clarity, transparency and established working processes. During his visit, he described a hospital that meets the needs of the local area and has scope for development, but which requires a clearer organisational structure. Once the director has been appointed, a roadmap will be drawn up addressing the key challenges.
Governance remains, in his view, a necessary prerequisite and a priority in the coming weeks and months. Next come investments; the Ségur de la santé (national investment plan to modernise the healthcare system) can be utilised, with several avenues already identified by the hospital that appear relevant, such as improving the storage and security of medicines, or developing day care and outpatient services. These projects will need to be launched swiftly once the management team is in place, in order to make use of the available funding.

Better organising the coordination between the two hospitals

The director also wishes to clarify the respective roles of the Saint-Martin and Saint-Barthélemy hospitals within the Regional Hospital Group (GHT), in order to strengthen their complementary roles. For example, the A&E department in Saint-Barthélemy does not have a blood bank, unlike the one in Saint-Martin. A clear protocol must therefore be established to organise the transport of blood supplies when needed. The two hospitals are expected to work extremely closely together. At the same time, the director of the ARS anticipates a ramp-up of the new Guadeloupe University Hospital, particularly through the development of advanced consultations in the Northern Islands, in order to minimise patient travel.
He notes, however, that he has been pleasantly surprised by the momentum already in place across the territory.

Human resources: a major task ahead

Among the other topics discussed was the case of Dr Tchero. Having recently taken up his post, Philippe Luccioni-Michaux stated, in all transparency, that he wished to take the time to examine all the facts. For his part, Paul Guibert, Director of the ARS Saint-Martin, clarified that this was an isolated case, whilst acknowledging the need for fundamental work within the human resources department.
He emphasised the importance of rebuilding working and management procedures, and of addressing these issues holistically, without limiting the focus to individual situations. The challenge is to re-establish a clear operational framework, which could be implemented swiftly once management has stabilised.

New care home: a project under consideration

A team from the NAP (New Projects Agency, a support structure for hospital planning) is in the area this week to work on various construction scenarios and refine the overall financial planning for the new care home. As public funding does not cover the full cost, additional funding must be secured. The issue of the site (the Morne Valois plot) was discussed on Tuesday with President Mussington. Things seem to be well underway; “we simply need to ensure we agree with one of the projects proposed by the NAP and confirm the site,” said Philippe Luccioni-Michaux. Once these details have been finalised, the project could be completed within three to four years, with a capacity of around 70 places.
In the meantime, work is underway at Bethany Home: the installation of a lift for residents and a goods lift for staff use. Measures are also being developed to expand the range of services and enable older people to remain in their own homes for as long as they wish and are able to.
Following this initial visit, the Director General of the ARS announced his intention to return to the area regularly, visiting every two months to review progress.