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A few weeks ago, Philippe Luccioni-Michaux succeeded Laurent Legendart as director of the Regional Health Agency of Guadeloupe, Saint Martin, and Saint Barthélemy. He took office amid a public health situation marked by challenges that vary from one territory to another. That is why the new director began by making a “tour” of the three islands. “You have to travel a lot to understand the issues, which are different,” confirms Philippe Luccioni-Michaux, currently visiting Saint Barthélemy. “I don’t have a detailed roadmap yet, since I’m still in the meeting phase.” That hasn’t stopped him from already identifying priorities.
In Guadeloupe, the ARS director identifies mental health—"which has multiple causes"—as "a major issue." It’s a topic he believes must be addressed "holistically." He adds: "Water is also a very serious issue. I want to continue increasing health inspections. More than 2,000 samples have been taken." ” In Saint Barth, it goes without saying that the issues of concern are different.
Hospital Land: “A Smart Compromise”
“What stands out from my discussions is the hospital’s reconstruction,” says Philippe Luccioni-Michaux. “The land issue was resolved through a smart compromise that shows all stakeholders were able to come to an agreement. The hospital retains its land, while the Collectivité retains that of the nursing home and the parking lot. The hospital’s reconstruction must also be an opportunity to re-examine the care pathway and our specialties, and to ask ourselves what the region needs. I strongly hope that we can sit down together to make a diagnosis: to identify the challenges and how to resolve them. We need to establish a local health contract between the State and the Collectivité.”
When it comes to healthcare, two topics regularly come up in conversations in Saint-Barthélemy: mobility and the decline in the number of private practitioners. Regarding mobility, the ARS director believes there are two aspects. He explains: “Mobility refers to leaving the territory but also to moving within the territory. There are no private ambulances. I would like to take this opportunity to commend the commitment of the STIS (Territorial Fire and Rescue Service), which, under an agreement, fills these gaps. This is essential for the population.” Furthermore, Philippe Luccioni-Michaux points out that “Saint Barthélemy cannot have a technical infrastructure so developed that it would address every issue.” For the ARS director, a second facility in Saint Martin, a third in Guadeloupe, and a fourth in Martinique remain essential. “The issue of transportation is a matter of concern for which I have no answer at this stage,” he admits. “But we must address it.”
A Joint Effort Between the State and the Local Government
Regarding the decline in the number of medical practices—which has fallen from eight to four, though a general practitioner has recently joined the Maison de la Santé—the director seeks to reassure. “Five general practitioners for every 10,000 residents (Saint-Barth seems closer to exceeding 12,000, according to the latest census data, ed.), we’re still in a reasonable situation,” he assures. The island is not a medical desert. But if we do nothing, there will be four, then three… The Collectivité, the State, the hospital, and healthcare professionals need to sit down together to discuss how to make the island more attractive. There are several levers we can pull: grants, housing assistance, relocation support… The living environment is attractive, but living here comes at a cost. With the ARS, we can make a difference. To do so, we need input from the Collectivité to build an environment together. Health care today is a shared responsibility, like security or education; it’s a joint effort between the State and the Collectivité. Otherwise, we won’t get very far. ” Philippe Luccioni-Michaux also believes that relocation assistance “makes sense given the initial costs.” He states: “It’s not because they’re private practitioners that I find assistance objectionable.”
In the midst of Disability Awareness Week, Philippe Luccioni-Michaux notes that the ARS supports people with disabilities—particularly children—at multiple levels. “First, through an early detection platform that operates across the entire region,” he emphasizes. “But here again, we’re working in a very collaborative manner.”
For the new director of the ARS, the message is therefore clear. Every advance in healthcare will be achieved through cooperation. An approach rooted in dialogue that will require all stakeholders to listen and respond.
