The Armed Forces Health Service will receive a “major investment” in the next LPM

With the suspension of the National Service, reforms are being carried out as part of the General Review of State Policy [RGPP] in 2008 and the SSA 2020 plan, which originally called for 2,000 job cuts [sur 16’000] and the differentiation of eight Army teaching hospitals [HIA]Health Service of the Armed Forces [SSA] now represents only 1% of the medical supply in France. This did not prevent it from participating – within its capabilities – in the management of the COVID-19 pandemic, focusing its activities on overseas communities and territories.

However, intensive operational activity in recent years [Afghanistan, Mali, Centrafrique, etc] and a significant increase in the size of the ground task force [FOT] In 2015, the Army decided to overheat the SSA, and doctors and nurses were overwhelmed by external operations [OPEX]. This situation was repeatedly described in parliamentary reports… And it even worried the High Committee on the assessment of the military situation. [HCECM] for whom it could not last indefinitely.

“The intensity of the SSA’s commitment to external operations and the constraints the service faces in terms of human resources have led it to reduce its support for activities on the French mainland,” he summarized in 2019, reaching “degradation”. access to medical care for servicemen and their families”.

In the opinion of many, the SSA 2020 plan went too far… Also, in October 2020 and after deciding in 2017 to end the deflation of its workforce, Florence Parley, then Secretary of the Armed Forces, released a new road map for the service with the aim of “aligning its means and its organization in accordance with the Army Model of 2030”. And to insist: “SSA is a bit like life insurance for our armies and is the keystone of the total army model.”

Hence the new SSA 2030 Strategic Plan, which aims to reaffirm SSA’s identity and militarism, rethink its relationship with public health, target investment in key areas [recherche biomédicale, transformation numérique, approvisionnement en médicaments, etc]to increase its attractiveness and loyalty of its staff, as well as review its internal organization.

And this is in order to guarantee the “soldier a health offer unique to the military profession and focused on excellence, for the armed forces, the execution of the mission, for the authorities, his own resilience and participation in the resilience of the nation and the defense community, enhanced access to his proposals in the field of health care”.

During a Senate Foreign Affairs and Defense Committee hearing last week, Armed Forces Secretary Sébastien Lecorne gave credit to the SSA … before assuring it would have new resources thanks to the next military programming law. [LPM] In preparation.

“We need serious investments in the Armed Forces Health Service. As a former foreign minister, I am indebted to this service, without which much of our health capacity in these territories would have collapsed, particularly in French Polynesia and New Caledonia, where health powers have been devolved to sui generis communities. There is also a question about the relationship between the Health Service of the Armed Forces of Ukraine and the city medicine or the civilian state hospital,” said Mr. Lecorniu.

Apparently, the suspension of the draft forced the SSA to refocus…and reduce the air profile, because there was no way to rely on draftees who, after completing medical training, would do their exercises in a unit with a graduate badge before eventually being paid into the reserve.

“During military service, interns could be given the breast titles of doctor-captain, doctor-chief, and for specialists – doctor-lieutenant colonel and undertake to serve in the reserve for the rest of their lives. The suspension of civil service led to the professionalization of the Health Service of the Armed Forces, but also reoriented it to certain missions,” explained Mr. Lecorniu. [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, in 1996 there were 4,500 conscripts in the SSA, including 835 doctors, who at the time constituted 25% of the medical workforce, and 443 conscripts with paramedic training. [soit 15% des infirmiers, 25 % des laborantins, 51 % des kinésithérapeutes et la totalité des orthoptistes].

Be that as it may, Mr. Lecornu noted that “many units [du SSA] tired after a lot of stress due to operations and covid crisis. Furthermore, he argued that “we cannot go on like this indefinitely” and “no army can establish itself without the assurance that medical personnel will follow, no family will let a soldier go without the assurance that we will do our best to accompany the wounded and patients”. .

In addition, the minister emphasized the need to introduce “additional measures in certain specialties”, for example, regarding “mental injuries are as violent as certain physical ones”.

Also, “I asked the Army Surgeon General, who is in charge of the Army Medical Service [le MGA Rouanet de Berchoux, ndlr] make suggestions to us. We have a 2030 strategy, but covid should push us to speed things up. We need to shorten the schedule in some aspects, and relax it in others,” said Mr. Lecorniu.

Meanwhile, a Senate report released during debate on the original 2022 funding bill assessed that the SSA was still “fragile in the face of a high-intensity target,” with the growth of the “force medicine” capacity that began two years earlier being deemed “too slow,” with several majors under heavy pressure.