“Always improving the offer for the population”: the objectives of Amandine Papin, director of the Thau Basin Hospitals

Amandine Papin arrived a year ago at the head of the Thau Basin Hospitals. Midi Libre – Patrice Espinasse

After announcing the reconstruction of the Pergolines and the modernization of the Saint-Clair hospital for 64 million euros, Amandine Papin, director of the Thau Basin Hospitals for a year, takes stock of the budget, emergencies, recruitment, her priorities…

You took over the management of the Thau Basin Hospitals a year ago. What is your view of the establishment ?

We talk a lot about the difficulties. This is not necessarily the most important thing for me. I would like to recall the strengths of this hospital: its 1,800 professionals who work every day to provide the best service to the population, its emergency reception service which never fails in its mission, its very beautiful maternity ward and its pediatrics department, its 22 medical and surgical specialties, its medico-social structures whose dynamism is recognized at the national level, its training institutes, Ifsi, Ifas, which lead all our students to succeed in their studies every year.

What type of manager are you ?

I am convinced of public service. My leitmotif is the strength of the collective. I rely on it a lot to move forward. I drive the directions but I take them in consultation. I am very attached to the benevolence of management.

The reconstruction of the Pergolines and the modernization of the hospital were announced for 64 million euros. Sixteen months ago, the unions were nevertheless sounding the alarm about a 12 million euro deficit and the ARS threatened to stop the aid. What happened in the meantime ?

We have managed to stem the curve of increasing deficits. The establishment's deficit is structural. This refers to general problems of financing hospitals that have been particularly affected by inflation in a recent period. All our expenditure items have increased. And there have been welcome salary increases for professionals that have not all been offset by the rates. This has increased the difficulties of the establishments, especially ours.

We have major health issues in this territory

How did you get back on track ?

We have worked hard and presented to the ARS a plan for developing activities and strengthening our performance. In addition to the national, structural issue, we have room for maneuver internally on which we are working with the trade union organizations and the medical communities. Returning to balance requires, on the one hand, developing our activities to increase our revenues and better cover our expenses and, on the other hand, controlling our expenses. We have major health issues in this territory. We have an aging and growing population, and some of its fringes are in precarious situations. In this context, the hospital must be strong, solid, efficient, modern.

What room for maneuver do you have ?

The goal is not to call into question the quality of care or to cut staff. We are vigilant about the evolution of all expenditure items. And we work a lot on social responsibility issues. This helps reduce absenteeism and thus the volume of overtime. And also on sustainable development to achieve gains in terms of waste reduction and energy savings.

There has been no reorganization?

We are of course working on the performance of our organization, our patient pathways with the ambition of improving our response to the needs of the population, our activity and therefore our revenues. The objective is really to place the Thau Basin Hospitals in a logic of future and development.

What is the 2024 budget ?

We are close to 175 million euros. With the ARS, we have projected a deficit of around 8 million euros, down from previous financial years (*). The goal is to gradually return to balance.

Despite the tensions in the emergency department, there have been no closures or regulations

As in many other hospitals, the emergency department has been under pressure this summer in Sète. Where are we at ?

The situation is certainly tense. Our teams have been reinforced. They have worked a significant number of overtime hours. But they have held on all year long. There have been no closures or regulations here. I would like to sincerely thank all the medical and paramedical teams who are on deck 24/7, 365 days a year, without closures, to provide both pediatric and adult emergencies. We can of course improve. Despite the difficulties, we are still working on the patient pathway to try to reduce waiting times.

A partial closure of the emergency room in Sète is therefore not a current issue ?

This is not a topic.

What are the waiting times today ?

They vary greatly and depend on the types of pathology, the time of day and the period in which one registers.

Does the service have to deal with incivility, as elsewhere??

Yes. The number of incivilities and attacks, sometimes serious, is increasing. It is in other sectors of the hospital but even more so in the emergency room, which is the gateway. On this point, I really alert the attention of the public authorities and the population. We must take care of our caregivers.

Do you feel helpless in the face of this phenomenon ?

We try to provide the best possible support and strengthen security measures. We work closely with the police and the justice system. But it is a concern. I have two primary missions: ensuring the safety of patients and ensuring the safety of my professionals.

After Gilles d'Etorre stepped down as Chairman of the Supervisory Board, how was the institution reorganized??

For the time being, Ms. Gyzardin (Deputy Mayor of Sète, Delegate for Social Action and Health, Editor's note) continues to chair the Supervisory Board. Depending on the outcome of Mr. d'Etorre's case, the ARS will appoint another qualified person to replace him. But the life of the hospital and the projects continue.

A hospital that provides good care is a hospital where it is good to work

What are your priorities ?

The goal is to always improve the offer, which is modernized and innovated, for the population of the territory. The offer must also open up and fit into its territory, with all the stakeholders. I really hope that we will intensify the links with private medicine, private and public offers, to together provide the best response to the needs of the population. The other challenge is to improve the attractiveness, working conditions and loyalty of our professionals. I am convinced that a hospital that provides good care is a hospital where it is good to work. Finally, the last priority is to realize our real estate projects, essential both to provide patients with modernized reception conditions and to improve the working conditions of our professionals.

Do you have a lot of difficulty recruiting??

Like everywhere. Our geographical position helps us. However, we are experiencing tensions, which vary depending on the sector. We have managed to consolidate our teams well, including in sensitive disciplines: anesthesia and imaging, thanks to the creation of a joint team with the Montpellier University Hospital. We will consolidate the orthopedics, ophthalmology and cancerology offerings. We will recruit an infectious disease specialist and a pulmonologist. In the end, more than 25 doctors have been recruited since 2019.

Where do the tensions remain ?

On the paramedical staff, it's new in Sète, and the nursing assistants in nursing homes.

The future of maternity is not in question ?

No. And having given birth to my third child there two months after my arrival in Sète, I recommend it! I had a great experience there.

Apart from the reconstruction of the Pergolines and the renovation of the hospital, what project would you like to launch ?

One of our wishes would be to rebuild the training institutes on another site, whose premises are too cramped and unsuitable.

(*) The forecast budget was 12 M€ in 2023, reduced to 9 M€.

From Nanterre to Sète via Cayenne

Director of the Thau Basin Hospitals for a year, Amandine Papin began her career with large delegations. From 2016 to 2019, at the Nanterre hospital, she had to manage a merger and the reconstruction of two establishments on a new site. She then crossed the Atlantic to join the Cayenne hospital as deputy general director. There, she managed the Covid crisis that hit French Guiana very hard, tripling the territory's critical care capacity. She was then tasked with supporting the transformation of the hospital into a university hospital, scheduled for 2025.

She therefore joined Hérault before seeing the project come to an end, but with experience in heavy files and large-scale real estate projects.

Amandine Papin, 41, is the mother of three children. The youngest was born in the maternity ward of the Thau Basin Hospitals in November 2023, two months after she took office.

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