The Death of the Hospital? Publication date : May 25, 2022
Bernard Granger is a professor of psychiatry at Paris Cité University and head of the psychiatry and addictology unit at Cochin Hospital. An ardent defender of public hospitals, Granger sits on the Medical Administration Panel and Public Aid Monitoring Commission for the Paris hospital system. He co-authored the highly successful Les Borderlines, published in 2012.
- France’s public hospital system is in crisis. The quality of care is poor, and staff are at the end of their tether. Bernard Granger’s first-hand observations reveal how a wave of bureaucratization in the 1980s destroyed health system management. Constant reporting and pervasive administrative monitoring take up the lion’s share of budgets and staff time. Planning, reports and paperwork have taken precedence over patients’ needs. Staff are overworked and exhausted. The health system has lost its sense of purpose and is becoming abusive.
- In today’s world, red tape commonly obstructs governance, not only in public services but in the private sector. Granger denounces an obstructionist mindset that is depriving those in charge of the means to do their work. This wastes time, (public) money and the energy of a talented workforce. Max Weber and, more recently, Michel Crozier, Luc Boltanski and Alain Suppiot have all described the dangers of this kind of managerial disfunction.
- Granger calls for a reckoning and a return to governance that takes into account the unique nature of hospital medicine. Healing is savoir-faire, a craft – a very human endeavor that must not be constrained by endless administrative processes. Public hospitals are losing their healers. It is past time that they were allowed to do their work in better conditions.