On June 23, 2022, the French Hospital Federation (FHF) discreetly acknowledged heterogeneous recruitment difficulties depending on the size of the facilities, while noting an overall increase in headcount (+3% between 2019 and 2020). The health crisis has acted as a catalyst, making the issue of attractiveness central to the most sought-after services and facilities within the healthcare system, some of which have even been forced to close: emergency services, home help, accommodation for the elderly.

Against this backdrop, recruitment agency YourVoice was keen to organize a conference on the challenges of attracting people to jobs in the healthcare and medico-social sectors, to coincide with the 16th National Forum of Associations and Foundations, held on October 20.

This debate cannot focus solely on the remuneration deficit, which is certainly real, as this would be tantamount to concealing the deep malaise of staff caused by the loss of meaning in their commitment and a genuine lack of recognition for their work. So, far from any ideological positioning, it is now necessary to observe managerial organizations within the various sectors (public, private for-profit, private not-for-profit) in order to bring out the best practices for attracting talent and meeting important needs.

Benoit Péricard, Senior Consultant at YourVoice, moderated the round table. In his introductory remarks, he asked Denis Piveteau, State Councillor and author of the February 2022 report "Experts, acteurs, ensemble pour une société qui change" (Experts, players, together for a changing society), about the lessons learned from his study, and in particular about the link between the power to act of supported people and the staff responsible for providing this support.

Denis Piveteau emphasized the importance of time: taking the time to carry out the various tasks in order to fully respond to the empowerment of the people we support.

1. Recruitment in the healthcare, medical-social and social sectors requires the development of real strategies.

Our speakers are unanimous: we need to implement new recruitment strategies. Indeed, the difficulties are not solely focused on the lack of manpower, but rather on the match between working conditions and the new expectations of candidates.
Open-ended contracts are no longer the preferred option, as candidates are now looking for greater flexibility: this involves not only the use of fixed-term or temporary contracts, but also the choice of well-defined working hours, balanced with personal time.

Faced with this new context, recruiters are obliged to resort to recruitment strategies in order to "seduce" candidates by offering career paths and flexibility in work organization. For Marie-France Begot Fontaine (DG UGECAM IDF), recruitment requires more time and inventiveness on the part of recruiters.

By way of example, Saïdi Mesbah (VYV3 HR Director) assures us that 1,000 positions remain vacant at VYV3, despite the fact that recruitment is going well; however, candidates are more likely to opt for fixed-term contracts or "à la carte jobs".

Private not-for-profit organizations are still partly shielded from this situation by their strong values and, for some, the presence of volunteers in the field.

In Europe, France is not alone in facing this situation: its German and Spanish neighbors are experiencing similar tensions, but it's worth remembering that a French nurse is paid 10% less than the OECD average, while European nurses are paid 20% more.

Thibault Ronsin (HR Director, Groupe SOS) points to two other difficulties: the skills drain and the limits of conventional frameworks.
Attractiveness contexts differ from one region to another, so that some regions have to cope with the flight of skills to regions offering better opportunities, because they are more developed economically, culturally...

The healthcare and medical-social sectors are highly regulated by various agreements and regulations, which limit the scope for innovation and initiative. And even if these frameworks were to become more flexible, the managerial culture is so hierarchical that it is not conducive to such developments. For example, the head of department (in a hospital or institution) is still not considered a manager.

So it's imperative to be aware that a vocation is no longer enough to work in these sectors, and that staff are looking for change and new ways of working. In concrete terms, what form should these adaptations take?

2. What initiatives need to be implemented?

Instead of waiting for a shortage of candidates, one approach is to be proactive in training future candidates.
The SOS Group has set up apprenticeship training centers to identify its own talents, with the aim of seeking out people who would not have come forward on their own. In this way, the Group works with priority urban districts and targets young people with no diploma, no job and no formal education.

Similarly, APF France Handicap is placing particular emphasis on apprenticeships, thanks to a €1.2 million grant from ARS Ile-de-France. Laurence Lecomte (APF France Handicap IDF Regional Director) reports on APF's commitment to apprenticeships, which enable us to welcome talented young people and introduce new practices to our facilities.

Denis Piveteau assures us "you have to take care of those who take care of you".. For him, this is one of the conditions for the long-term survival and adaptation of the care system (care and cure) to the needs of the people being cared for. Philippe Denormandie, who took part in the debate, particularly emphasized this attention to the care of caregivers, making a severe self-criticism of the sector, which, in his view, has seriously neglected this aspect.

Particular attention must be paid to facility managers. The health crisis and the shortage of personnel have also had an extremely discouraging effect on managers. To preserve their vocation and commitment, it is imperative to take care of them, as they will be the protagonists in the deployment of future projects.

For Pascal Duperray (CEO of the Fondation Saint Jean de Dieu), quality of life in the workplace is essential to ensure the quality of care provided to vulnerable people. A facility that does not care about the well-being of its employees is more likely to create poor conditions for patient care.

The speakers agreed on the need to bring out ideas from the field, in line with the specific features of each environment. It would be counter-productive to impose the same model on all structures, in the same way, while ignoring the specific situations of each territory. However, this idea runs counter to the very hierarchical, very "Jacobin" model of the sectors.

As mentioned above, we need to respond to the need for flexibility and adaptability, and establish career paths within the company to offer employees career development prospects. The challenge is to enable everyone to project themselves within the same structure, without having the feeling of "stagnating".

For Denis Piveteau, improving the attractiveness of the healthcare and medical-social professions will only be truly effective if the care provided for the people they support is part of a more global social project.

3. How will the sector hold up over the next 20 years?

Our speakers tried their hand at a forward-looking exercise, giving us the keys that will enable the healthcare and medical-social sectors to survive in the next 20 years.

Generally speaking, everyone agrees on the need to strengthen communication between different sectors (private for-profit, private not-for-profit, public) and professions, and to open up work with different public bodies: everyone needs to be able to talk to each other.

In addition, each sector will have to work on three issues in particular:
1. Enhancing the value of skills acquired through experience and not certified by a diploma;
2. Restoring confidence in these professions, to make them more attractive;
3. Improve material working conditions, in particular by deploying building renovation programs or working with public authorities to develop transport or accommodation solutions.

The task ahead is a tough but necessary one, because as Marie-France Begot Fontaine puts it, "we are condemned to succeed because we are indispensable".