Doctors, red tape get heat wave blame

PARIS -- A scathing French government report Monday blamed hospital understaffing during summer holidays, chronic bureaucratic snags and a dearth of elderly care for the 11,400-plus death toll in this summer's brutal heat wave.

Also Monday, the Dutch Central Bureau for Statistics estimated 1,000 to 1,400 people died in the Netherlands from the heat that gripped Europe this summer -- higher than an earlier projection of 500 to 1,000.

The French report, ordered by the Health Ministry, pointed to disarray and lack of communication between weather officials, emergency services and hospitals, and said that a "massive" exodus of doctors on August vacation left many elderly to fend for themselves.

"Hospitals found themselves in growing difficulties to provide personnel in a sufficient number," said the 47-page report, with some 100 additional pages of graphs and charts. The study also said France's 35-hour workweek had cut into hospital staffing.

Michel Combier, president of the National General Practitioners Union, said it was unfair to blame doctors and other health-care workers for going on vacation at the same time as everyone else.

"The problem wasn't that everyone was on vacation, but that the alert system was too weak to allow for hospitals to get everyone back working," Combier told The Associated Press. "And the catastrophe, of course, was totally unpredictable and out of the ordinary."

The government has put the provisional death toll at 11,435 from the heat wave, which brought choking temperatures of up to 104 in the first two weeks of August in a country where air conditioning is rare. The heat baked many parts of Europe, killing livestock and fanning forest fires.

The high death toll -- no other European country even came close -- has triggered an emotional debate in France over shortcomings in its highly regarded health system. The government is considering eliminating a national holiday to raise revenue for elderly care.

The French joie de vivre has also come under scrutiny, since some of the elderly victims died alone in their homes while families were away on lengthy August holidays. Authorities reportedly had difficulties making contact with survivors who were away at the beach or vacationing in the mountains.

The report listed several major factors in the high death toll.

Among them was a lack of coordination between meteorological agencies and health-care institutions. The report said better methods should be developed to communicate early warnings of potentially dangerous weather conditions to health authorities.

The study also took hospitals and clinics to task for being able only to respond to demands rather than take initiative in a crisis.

Little information sharing

Bureaucratic divisions also played a part, meaning there was little sharing of information between ministries and emergency services. France's system of tallying death tolls was blamed for being too slow to alert authorities to a crisis.

The report also said many general doctors -- who provide a large part of the care for France's elderly -- were away on vacation, and more hospital beds than expected were taken out of service for the summer.

The number of patients in France's city hospitals was already "intolerable" by Aug. 10, and peaked two days later, with hospitalization rates five times what they were last year at that time, the report said.

"Despite all their efforts, personnel were unable to stop the almost total flooding of emergency services and the intolerable crowding of hospital corridors," the authors wrote.

In addition, it is becoming increasingly difficult to recruit doctors for hospitals, the study said.

The report called for an alert system to identify and check up on vulnerable elderly people, emergency coordination between weather agencies and the health system and a reform of emergency services to gear them more toward the aged, among other steps.

Patrick Pelloux, president of the Emergency Hospital Doctors Association of France, said a significant increase in funding would be needed to strengthen services for the elderly.

"It's necessary to give considerable means at the level of emergency services so they can work in close coordination with general doctors," Pelloux told France-Info radio.