Threats of closure of the emergency department at the Agen Nérac Hospital Center

The fire has been simmering for a long time at the Agen emergency room. Between pay cuts and endless overtime, the cup is full. "Without a response from management, we will close on August 21st."

" There's no way we're going through a summer like this again." Even before August is over, Laurent Maillard, head of the emergency services at the Agen and Marmande hospitals, has had enough. This has been rumored for several weeks. Now, a date has been set: "Without a response from management, the Samu 47, the Smur, and the Agen emergency services will close on August 21."

Of course, there is a shortage of emergency doctors all over France. "But in addition to these shortages, which we are trying to find solutions for, there is a denial on the part of our management and the State."

Since the beginning of spring, the emergency room at the Esquirol Saint-Hilaire clinic has been regularly regulated . Even when going through the 15 center, it is Agen, most often, which takes up this workload. Also closing are the emergency rooms in Auch, the mobile emergency services (Smur) in Moissac, and Nérac. It is therefore mainly towards Agen that patients are referred.

The emergency physician also denounces, alongside this work overload, a drop in pay. "An hourly rate of €33.76 gross for more than 48 hours, lower than the basic hourly rate of an entry-level practitioner," states a press release from the emergency physicians' unions.

Seven emergency physicians are preparing to leave the department.

This time, Agen professionals are no longer alone in crying into the wilderness. Samu Urgence de France and the Association of Emergency Physicians of France, chaired respectively by Marc Noizet and Patrick Pelloux , take the situation at Chan as an example, symptomatic of the situation in emergency rooms in France.

They point to excessive working hours and failure to comply with the legal framework for calculating working time, "a system that relies solely on volunteering." They add: "Emergency doctors at the Agen-Nérac hospital center (Chan) have accumulated more than 10,000 hours of additional working time in 2024, the equivalent of 30% of the medical workforce."

"Management is opposing us with a sovereign position, of not going beyond the framework of the law, while other centers go well beyond this and, therefore, are more attractive. In the meantime, the teams are suffering and not supported," says Dr. Maillard.

The hospital's management, for its part, declined to comment while discussions were ongoing. "Yes, compensation is the key. But the problem is also national."

Dr. Maillard agrees, but not for the same reasons, still supported by the press release from the emergency physicians' unions. "We no longer have the means to have 650 emergency services in France. We need 24-hour regulation. Today, doctors, caregivers, but also medical regulation assistants, we are all on a knife edge." With a knot in his stomach as he goes to work in the morning: "Are we going to find solutions for every patient?" The answer is clear: not in this situation.

And things aren't going to get better. The Chan team is preparing to lose seven emergency room doctors "who no longer want to work in these conditions." "In all the discussions, it's not pay that's at the center of the issues; it's the icing on the cake."

Hence the growing risk of the Chan emergency room closing. "As of August 17, all doctors have completed their annual working hours." The question arises: will there still be emergency rooms on August 21?

This Tuesday, August 19, the Chan management informs that access to the emergency room will only be possible after regulation by the Samu from 2 p.m. until 8 a.m. the following day, Wednesday 20. Users are therefore invited to contact the 15 center.