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If this was a public meeting designed to convince the population of the merits of the project to build a new hospital on Saint-Jean, the objective was clearly achieved. By the time they left the Gustavia harbor master's office in the early evening of Tuesday November 5, many of the participants had been won over by the idea of a new hospital on Saint-Jean.the idea of setting up a new hospital facility as close as possible to the airport and the Territorial Fire and Rescue Service fire station. Of course, as the first vice-president of the Collectivité territoriale, Marie-Hélène Bernier, has repeatedly stated Marie-Hélène Bernier, the construction of a new facility is currently only at the proposal stage. However, the favorable opinions expressed by the healthcare practitioners and architects present at the meeting were enough to convince many of the hundred or so people in the audience of the project's supposed relevance.
Land: an ongoing process
Before addressing the issues, advantages and disadvantages of renovating the Irénée de Bruyn hospital or building a new facility the construction of a new facility, Marie-Hélène Bernier provided a detailed overview of the overall healthcare situation on Saint-Barthélemy. In particular, she answered a question that the management of the Regional Health Agency (ARS) had refused to raise with JSB. In this case, the issue of the Bruyn hospital property, which belongs to the Conseil général de Guadeloupe, and for which the former acting director of the St. Barthélemy health establishments was responsible.tablissements de santé de Saint-Barthélemy et Saint-Martin, Anne Calais, initiated legal proceedings against the Département de Guadeloupe in November 2023 for "excess of power". For the record, in August 2022 and again in August 2024, General Council President Guy Losbar undertook to regularize the retrocession of the land to the Collectivité de Saint-Barthélemy. To date, this matter has still not been settled.
Change in status?
The meeting was an opportunity to reiterate some key issues. For example, the status of the hospital, which is currently evolving within a shared medical system with that of Saint-Martin, as part of a "groupement hospitalier des territoires" (GHT). In its feasibility study for the possible construction of a new healthcare facility on Saint-Jean, the AP-HP (Assistance publique - Hôpitaux de Paris) raised the possibility of moving towards the status of a private healthcare establishment of collective interest. This would enable the hospital to become autonomous, creating an autonomous medical project with a new hospital and an expanded care offering. "There's a lack of clarity about how the GHT will work," conceded Eric Djamakorzian, director of the de Bruyn hospital, who has also been acting director of the Fleming hospital in Saint-Martin since September.
A hospital that no longer meets regulatory requirements
In addition to administrative issues, the outdated and cramped conditions of the current hospital are also a source of concern. Marie-Hélène Bernier highlighted the fact that, since Hurricane Irma struck in September 2017, part of the administrative buildings at de Bruyn Hospital have been abandoned for years and eaten away by termites. She also noted the relative dilapidation of certain areas of the facility, which, for the record, was built in 1936 before being gradually modernized. Without, however, obtaining any recognition from the French health authority. Eric Djamakorzian explains: "This hospital has its charm, but no longer meets the requirements of current regulations. "What's more, while the number of emergency room visits remains stable (7,965 in 2014 and 7,781 in 2023), the number of advanced consultations has risen from 324 in 2014 to 1,242 in 2023. The increase in the population, now estimated at over 12,000, combined with the rise in the number of tourists visiting the island, means that the hospital's capacity is no longer adequate for the island's public.
To create a compliant facility, more than a simple renovation, it would be necessary to demolish the current buildings in Gustavia and rebuild on the same site. This is because, according to the expertise of several architects, the foundations of the 1,820 square metre structure would not support additional construction. Consequently, to make more space available, it would be necessary to demolish and rebuild. With all the nuisances that such a construction site could entail (truck traffic, dust, noise, etc.).
"Taking the right turn
While Marie-Hélène Bernier refers to the "emotional attachment of part of the population" to the Gustavia site, she points out the difficulties of access, as well as the constraints of surface area and infrastructure. In favor of a new hospital on Saint-Jean, she emphasizes the central location, the strategic proximity to the airport and the Stis barracks, and the improvement in healthcare provision in a new, modern facility.
Finally, the first vice-president in charge of health issues, who is also president of the supervisory board of Bruyn hospital, stressed that Saint-Martin hospital has a deficit of eight million euros. If we don't take the right turn, Saint-Barth will face the same problems as Saint-Martin," she said. But in Saint-Barth, we have the means. "And Director Djamakorzian backs up these remarks by declaring: "We need a clear direction and position over the next few months. "So, while there's no urgency, time seems to be running out. The nuance is tenuous, but perceptible.
Medical evacuations: an essential component
Given the absence of certain hospital services in Saint-Barth, medical evacuations to Saint-Martin, Guadeloupe or Martinique are as frequent as they are essential. At Tuesday evening's public meeting, only Saint-Barth Executive was represented. It was this company that responded to the invitation to tender launched by the hospital's management. Although a number of details have yet to be worked out, as confirmed by the publication of a new contract notice in issue 1588 of the JSB. In any case, the company has indicated that it will have operated 587 "evasan" by 2023. Marie-Hélène Bernier pointed out that the cost of air travel has risen from 1,693 euros in 2019 to 2,572 in 2021, and will now be close to 4,000 euros in 2024. The airline operator explains this trend by the permanent availability of aircraft, which have to react very quickly to transport sick and injured people.s to transport the sick and injured, as well as constraints linked to the different regulations governing the region's airports. He also points out that, despite repeated requests to the French government, emergency evacuations, such as those for medical procedures, are not covered by social security. It is therefore the hospital, with the help of the Collectivité, which covers the cost of evacuation. "The main difficulty in Saint-Barth is the budget for a 24-hour service," confirms Vincent Beauvarlet, President of Saint-Barth Executive.
