“This hospital is doing better than its reputation suggests.”
Since taking the helm of the only public hospital on the French side of the island, Patrick Lambruschini has been drawing on a career largely dedicated to strengthening overseas hospital facilities. The new director, who has “chosen to begin by listening and observing,” discusses in this exclusive interview the social movement of June, the challenges facing the Louis Constant Fleming Hospital Center (CHLCF), and the projects he intends to implement at this facility, which sees more than 17.000 emergency room visits annually.
Faxinfo: After more than a month in charge of the hospital, what is your assessment of the situation?
Patrick Lambruschini What I've seen in a month is a establishment which holdsbecause there is here professionals who never gave up, including when the general management changed every six months.
What's wrong, three things at first glance. The first is la governanceSince 2023, this hospital has had a succession of directors. No establishment can be transformed under these conditions.
This instability had a very real cost: decisions not made, procedures not written down, commitments not kept. And in the end, a loss of confidence among staff towards their management and among the population towards their hospital.
The second one is the financial situationThe operating deficit has worsened over the past ten years and Cash flow is extremely tight. We have accumulated debts, particularly social debtswhich have a significant impact. This is not an abstract accounting problem: This is what prevents us from investing. and to renew our equipment.
The third one is the building and technical installations. (...)
So my diagnosis, in one sentence: it's an essential institution, with mostly solid teams and a real dynamic of activity that deserves to be strengthened, but which has been private for several years of the two things a hospital needs most – stability and method.
fax info What are your priorities for the coming months?
PL : At a short pace, that of first hundred dayswe need to put back the establishment in a state of “normal” operation. To achieve this, it is necessary to stabilize the management teams. reviewing the fundamentals of human resources, to ensure reliable payroll, write and disseminate the procedures and secure cash flow. (…)
Over a longer period, it involves to build the school projectwith a social, medical and care plan, as well as strategic directions adapted to the needs of the population and the expectations of the Regional Health Agency (ARS). This direction must be shared with the medical and care community, staff representatives, users, the local authority and the ARS.
My goal is to submit to the relevant authorities during the year 2027One thing that I will not announce measures that I cannot finance.This hospital has suffered enough from broken promises.
fax info : The June strike highlighted staff and resource shortages, and accusations of toxic management. How are you addressing this issue?
PL What I take away from the June conflict is the need to continue social dialogue.
We need to review the conflict resolution protocol point by point and address it in conjunction with the trade unions. This also represents a commitment to supportive management. The word “toxic” has been used, I’m not avoiding it. (...)
Management is not a matter of personality, it's a professionOur managers have sometimes been left to fend for themselves, without guidance, support, or training. Appointing them won't do them justice; they will be done justice by training them, supporting them, and establishing clear rules. But we must also to punish deviant behavior and to call them to order, which we haven't necessarily done.
fax info Attracting and retaining professionals remains a major challenge. How do you plan to address this?
PL Regarding non-medical staff, the hospital is not doing too badly: staff numbers have increased significantly since 2019. Our problem is not attracting, it's retaining and not depleting.The response must therefore be internal: stable schedules, respect for rest periods, career prospects, training, permanent appointments when justified, and sustained supervision.
Regarding medical staff, it's a different story. We are largely sustained thanks to contract practitioners., with situations of very high tension in certain specialties.
Therefore, I believe in Four levers to improve our attractiveness policy.
The first one is the partnershipWe need to build lasting agreements with services in mainland France or at the Guadeloupe University Hospital, with practitioners who would come for regular, scheduled missions. This isn't temporary work; it's a partnership.
The second one is university education and trainingA hospital that welcomes interns and students is a hospital that will recruit five years later. We must strengthen our capacity to welcome and supervise them, in conjunction with the University Hospital of Guadeloupe and the university.
The third one is the medical projectWe don't recruit a surgeon for a position, we recruit them for a project and for a technical platform that is functioning.
The fourth one is the conditions of life Housing, children's schooling, and the cost of living. Finally, The main policy for attracting people is reputation.A hospital that gets good reviews is attractive. Improving the image of the CHCLF is not a matter of communication, but of human resources management.
Interview by DR
Continued in our next edition.
