Calendar time again

Image by pedrosimoes7 via Flickr

About this time of year, if you live in rural France, you lay in stocks of aperitif biscuits and booze and keep a store of twenty euro notes at hand.
It is calendar time, when every organisation from the football club to the fire brigade presents you with their offering, varying from what resembles a group of wild-eyed psycho killers...the football club...to heroic figures dealing in masterful fashion with the Towering Inferno...the fire brigade.
It is tactful to press some of the folding stuff into the hands of their representatives as they take their leave as one devoutly wishes to be spared a visit from the psycho killers and not to be ignored in one's hour of need by the fire brigade.

I was thinking of this when the fishmonger handed me a calendar of stupendous proportions to add to those from the agricultural co-operative, the local supermarket, the garage and the Red Cross, who handle all the ambulance work in Costa Rica...and a great deal more besides..

The first time my husband was taken ill in France, many years ago, the doctor called up an ambulance but as it was lunchtime on a Sunday, it took two hours before it arrived and there was no provision for  a stretcher.
The driver drove and his assistant held on to my husband, by now entering a coma, while they drove for one hour to the local hospital.

I was not allowed to accompany them, and had to follow behind.

At the local hospital, I did manage to see the emergency room doctor and explain the situation.

The hospital did not have the appropriate facilities to treat him.

Another ambulance was summoned.....but there was a delay as the ambulances available did not have oxygen on board....so another hour was lost.

Once again, I could not travel in the ambulance.

Finally he reached a major hospital which could treat him but, in large part down to the delays in waiting for ambulances to arrive, he had suffered major damage and had to spend over a month in hospital.

I was not impressed.

Another moan about public services?
Not at all.
These were the private ambulance services which at that time had a complete monopoly on the  transport of patients, except in the case of road accidents.

They usually double as taxi companies....and each company holds the monopoly on service for its area, so if you think 'Taxis Merdiques' offers a rotten service..... too bad. 'Taxis Merdiques' is what you're stuck with.

Sit in any French hospital waiting room and you will see as many white coated ambulance/taxi drivers as patients, as in many cases the cost of transport to hospital by ambulance/taxi can be claimed back under the health insurance scheme, so one day you are sitting alongside Madame d'Enculade and her taxi driver in the orthopaedic department and the next day she is cutting you out of a parking space at Leclerc...driving herself.

The ambulance theme continued when I returned from shopping to find an e mail from Guy with all the local gossip.

Apparently, the ambulance companies regional confederation had held its annual meeting at which the owners of these companies let rip in no uncertain manner.

They claimed that the fire brigade, in order to cover up for lack of activity in fighting fires and rescuing people generally, were poaching on the preserves of the ambulance companies by taking people to hospital!

Shock horror! What is the world coming to when a monopoly is not respected!

The whole thing is a nonsense.

For a start, most of the fire brigade personnel in rural parts are volunteers, who give up a great deal of their time to train and practice for the task of helping people in danger.
There is no way that these men and women want to take time off from running their businesses in order to poach clients from Taxis Merdiques.

And as far as I can see, there is the usual rate of arson, gas explosions and accidents, so hardly a lack of activity for the fire brigade to need to cover up.

The fire brigade are, not surprisingly, livid.

Their point of view is that if they are called by the SAMU...the medical co ordinating body...to transfer someone to hospital, it is because there is no one else available to do it....Taxis Merdiques being otherwise engaged in running children to and from school under their contract with surrounding communes.
In those circumstances, the fire brigade is carrying out its legal duty to come to the assistance of the population and far from trying to take custom away, the fire brigade, snowed under as it is, would be only too delighted if Taxis Merdiques could get their act together and carry out the business in which they hold a monopoly.

So what is all this about?

I think it may all stem from the increasing problem of health cover in rural areas.
Doctors don't want to live out in the sticks any more and as their numbers decrease those that are left either don't have the time or don't have the inclination to make house calls.

The rural population is elderly...though it seems that young people are starting to return to rural areas as the nature of work changes.....and reluctant to go to the doctor's surgery, having been brought up in the age where the doctor came to them.

A doctor on a house call would automatically call Taxis Merdiques to take his patient to hospital but nowadays the patient - doctorless - is likely to call the SAMU who, if they decide that hospitalisation is called for will not wait around if all Taxis Merdiques' drivers are otherwise engaged but will summon up the fire brigade.
They have targets to meet and ensuring the profitability of Taxis Merdiques is not one of them.

You can see why the ambulance companies are uptight, though.
The ambulances cost money.
The staff need a high standard of training.
Given French employment law, they try to keep staff to a minimum, so urgent calls can conflict with their contract jobs.
And everyone carted away by the fire brigade is a payment missed.

It is the usual way things happen in France....one system super-imposed on another with no thought for the contradictions.

And, as usual in France, no one dares root and branch reform because of the many vested interests involved. Just look at the pensions fiasco if you need proof of that.

All I can suggest is that when the fire brigade come calling with their Christmas calendars the ambulance companies make a very generous donation......they might need a fireman some day.