"Regulation" becomes the rule. Since Monday in Mayenne, it is "necessary to do the 15 before accessing the emergency (...) from 18:30 to 8:00", according to the regional health agency (ARS) Pays de la Loire. Decision justified by the "tensions on human resources" which "force to adapt the operation" of the three services concerned, in Laval, Mayenne and Château-Gontier.

Filtering also, day and night, in the Channel where "only people previously referred by the 15 are welcomed to the emergency" since Monday, to "limit the overload" in period of "high tourist attendance", explains the ARS Normandy. The seven hospitals in the department (Avranches, Cherbourg, Coutances, Granville, Saint-Hilaire, Saint-Lô, Valognes) are in the same boat, "whether they are in a situation of tension or not".

To the great evils the great remedies: generalized last year to avoid a disaster announced - 20% of emergency services were in great difficulty before the summer of 2022 - the "regulation" by the Samu has imposed itself as the universal panacea, during the epidemics of the winter as during the arm wrestling over the medical interim in the spring.

Still convalescent, small hospitals cannot escape the summer relapse. In Redon (Ille-et-Villaine) the night closure of emergencies - from 20:00 to 8:00 - has been extended until early September. Those of Meulan (Yvelines) will remain closed from 17:30 until the end of August, while those of Vouziers (Ardennes) have been definitively demoted to the rank of "unscheduled care center".

The title is also used in Vittel (Vosges), where the curtain will fall at 18:30 at least until mid-July, as in Manosque (Alpes-de-Haute-Provence) where are also planned on certain dates a "day regulation" or even a pure and simple closure.

"Dry closures"

A case far from being isolated: just over the past week, occasional closures of 12 to 24 hours have been reported in Ambert (Puy-de-Dôme), Guebwiller (Haut-Rhin), Argentan (Orne), Lisieux (Calvados) and La Ferté-Bernard (Sarthe).

At the risk of contradicting the Minister of Health, François Braun, who said at the end of June that "there are no closed emergencies, except in exceptional cases".

His former emergency room colleagues disagree at all. "There are dry closures," said Monday Agnès Ricard-Hibon, head of the Samu of Val-d'Oise, when Jean-François Cibien, in post in Agen and president of the inter-union Action Praticien Hospital (APH), bluntly denounced "a lie of state".

A battle of arms against the backdrop of a strike of hospital doctors to demand upgrading, especially on guards and on-call duty that crystallize their discontent. Negotiations with the Ministry on this point remain unresolved to date. Despairing of an arbitration of Bercy and Matignon, the APH now asks to meet Emmanuel Macron.

A nurse takes care of a patient in the emergency room of Mulhouse, January 16, 2023 © SEBASTIEN BOZON / AFP/Archives

After all, the subject has become sovereign since Covid. And the head of state has made it a priority of his second term, promising in January to get the hospital out of an "endless crisis", then in April to "unclog the emergency room" by the end of 2024.

A perilous bet, which relies heavily on the "access to care service" associating Samu and liberal doctors, supposed to be deployed throughout the country before the end of the year.

Except that the medical regulation assistants, the first to win the calls to the 15th, have also just entered into an "unlimited" strike to demand wage and staff increases. Movement followed in sixty departments, according to their national association Afarm, which warns: "The next few days will be very difficult".

© 2023 AFP