With the suspension of the civil service, the reforms carried out under the General Public Policy Review [RGPP] in 2008 and the SSA 2020 plan, which originally called for the elimination of 2,000 jobs [sur 16’000] and differentiation of its eight army training hospitals [HIA]Army Health Service [SSA] now represents only 1% of the healthcare supply in France. This has not prevented him from taking part – within his capacity – in the management of the covid-19 pandemic, focusing his actions on overseas communities and territories.
However, intensive operational activity in recent years [Afghanistan, Mali, Centrafrique, etc] and a significant increase in the strength of the Land Task Force. [FOT] The Army decided in 2015 to overheat the SSA to keep doctors and nurses overwhelmed by outside operations. [OPEX]. This situation was described many times in parliamentary reports … And this worried even the High Commission for the Assessment of the Combat Condition. [HCECM] for whom it could not last indefinitely.
“The intensity of SSA’s commitment to external operations and the limitations the service faces in terms of human resources has led it to scale back its support for mainland French operations,” he summed up in 2019, to the point of mentioning “the degradation of access to medical care for soldiers and their families.
According to many, the SSA 2020 plan has gone too far… In addition, in October 2020, determined to end the deflation of its workforce in 2017, Florence Parley, then Secretary of the Armed Forces, introduced a new roadmap for the service with the aim of “bringing a coherent its facilities and organization in line with the Army Model 2030.” And insist: “SSA is a bit like life insurance for our armies, and it’s the cornerstone of the full army model.”
Hence the new SSA 2030 strategic plan, which aims to reaffirm SSA’s identity and militarism, redefine its relationship with public health, and purposefully invest in key areas. [recherche biomédicale, transformation numérique, approvisionnement en médicaments, etc]increase its attractiveness and staff loyalty, as well as review its internal organization.
And this is in order to guarantee “the soldier a health offering unique to the military profession and focused on excellence, the military, the mission, the authorities, his own resilience and his participation in resilience.” nation and defense community, enhanced access to its medical offering.”
During a Senate Foreign Affairs and Defense Committee hearing last week, Secretary of the Armed Forces Sebastian Lecornu paid tribute to the SSA…before assuring it would have new resources thanks to the next military programming law. [LPM] In preparation.
“We need a big investment in the Armed Forces Health Service. As a former Minister of Foreign Affairs, I am indebted to this service, without which much of our health care capacity in these territories would collapse, including in French Polynesia and New Caledonia, where health care competence was transferred to sui generis communities. It also raises the issue of the relationship between the Health Service of the Armed Forces and the city’s medicine or civilian public hospital,” Mr. Lecornu said.
Apparently, the suspension of conscription forced the FSA to refocus… and reduce the airfoil by not being able to rely on conscripts who, after graduating from medical training, trained in the Candidate Patch unit before eventually being paid into the reserves.
“For the duration of military service, a trainee could be granted the badges of a doctor-captain, a doctor-commander, or even, for specialists, a doctor-lieutenant colonel, and he was obliged to serve in the reserve for the rest of his life. The suspension of the civil service professionalized the Armed Forces Health Service, but also refocused it on certain tasks,” Mr. Lecornu explained. [sur ce point, le ministre s’est sans doute laisser emporter par son propos : les médecins ayant effectué leur service militaire avec les galons de capitaine ou de commandant ont dû être très rares…].
In any case, the FSA had 4,500 conscripts in 1996, including 835 doctors, who then made up 25% of the medical staff, and 443 conscripts with paramedical training. [soit 15% des infirmiers, 25 % des laborantins, 51 % des kinésithérapeutes et la totalité des orthoptistes].
Be that as it may, Mr. Lecornu remarked that “many units [du SSA] tired after a lot of stress due to operations and the covid crisis.” In addition, he argued, “we cannot continue in this vein indefinitely” and “no army can operate without the assurance that medical personnel will follow it, no family will let a soldier go without a guarantee that we will give everything to accompany the wounded and sick.” .
In addition, the minister stressed the need to invest “more in certain specialties”, for example, in relation to “mental injuries as severe as some physical injuries.”
In addition, “I asked the Chief Medical Officer of the armies, who runs the Army Health Service. [le MGA Rouanet de Berchoux, ndlr] make us suggestions. We have a strategy for 2030, but COVID should prompt us to speed up the process. We must tighten the timetable on some aspects and soften it on others,” said Mr. Lecornu.
Meanwhile, a Senate report released during deliberations on the original 2022 finance bill said the SSA is still “fragile in the face of high intensity,” the strengthening of “forces medicine.” , launched two years earlier, was considered “too slow”, with several important specialties under a lot of pressure.