Avenue de Ségur holds no secrets for him. In The Ministry of Broken Arms* published in early February, Marc Payet, journalist for The Parisian for twenty years, leans on what really happened behind the scenes of power during the Covid-19 crisis. Behind the slightly trashy title hides a fine investigation into the responsibilities, the failures, but also the immense commitment of the civil servants at the front for two years.
While we can hope to get the head out of the Covid-19 tunnel and the Court of Justice of the Republic has indicted Agnès Buzyn for her management of the crisis and investigation of Olivier Véran and Edouard Philippe, this essay reveals the heaviness of the administration, the bickering between ministers, Emmanuel Macron’s rants… and a failing ministry. Salt and pepper hair, sparkling eyes and precise analyses, 20 minutes met this Thursday Marc Payet, follower of war metaphors, in the premises of Albin Michaela few steps from the Montparnasse cemetery.
What makes the specificity of the Ministry of Health, which you describe as a “broken arm” ministry during this health crisis?
I wanted to take an interest in the executive during the crisis, in the Ministry of Health. Because many good stories have been published about caregivers, but little about the “black box”. I came to this title a bit of a shock, The Ministry of Broken Arms, to be taken on several levels: at the beginning, they were not good. But there are also broken faces: many people who work in this ministry are burnt out. This ministry, it’s like soldiers after a war, comes out in tatters. It should be remembered that civil servants also saved lives. I take my hat off to them.
You explain that the tainted blood affair hovers like a shadow over this ministry…
It is a department that is no doubt more exposed to the risk of criminal prosecution than others. It sometimes paralyzes its action a little. Historically, you have in the 1980s the tainted blood drama, then the Mediator affair. All this creates an atmosphere of paranoia, of fear of justice. There is an investigation of the Court of Justice of the Republic in progress on the management of the crisis, that complicates things. Indeed, it is not easy for Olivier Véran to carry out a public action knowing that the investigators can land in his office at any time.
One of the mysteries of this beginning of the health crisis, in March 2020, was the absence of masks. What mistakes led to this big failure?
An anecdote helps to understand the situation. In March 2020, the mayor of Rennes, Nathalie Appéré (PS), discovers that she has a stock of 500,000 masks in Rennes. She calls the Regional Health Agency (ARS) and asks: “Can I distribute them to nursing homes and city officials? “. And there, she falls out of the cupboard, she is told that they should not be distributed, because that would create inequality! It’s Ubu King. We are really in an administration that applies the instructions in an absurd way.
Now, why didn’t we have masks? We had a large stock of masks before, the Stahl report in 2019 said: we need a stock of one billion masks. But Jérôme Salomon, Director General of Health (DGS), after discussions with François Bourdillon, then Director of Public Health France, decided to keep a stock of only 100 million masks. And Solomon is pushing for the report not to be made public. Did Agnès Buzyn know? She assured him not. The Minister of Health, at the very least, was not aware of what was going on in her ministry…
The crisis has been punctuated by many grotesque situations… Which one shocked you the most?
François Bourdillon told me that the French reserve of masks was stored at Paris-Vatry airport. We had reduced the positions so much that there were only two full-time people to take care of them. You want to go to war, it’s your strategic stock and you have two troopers!
What do you think explains this big mess?
In its organization, the Ministry of Health is a little too fragmented in several structures: we have many agencies, therefore no unity of command. On the other hand, there were rivalries. The ministries which make war, normally it is the Interior and Defence. There, there was a fight between ARS and prefects. And then the system technically crashes. The messaging systems of the chiefs are saturated. A civil servant told me an anecdote that I did not write down: the urgent messages from the ministry to the ARS are called “Mars”. He told me “it was Mars Attack! We couldn’t take any more of the Mars, which contradicted each other…”
Philippe Juvin explains in your essay: “in this first wave, ultimately what we missed the most was the truth”. Two years later, has the government really made its mea culpa?
On the matter of masks, he could have been more transparent. Afterwards, Philippe Juvin is elected LR, adviser to Valérie Pécresse. Despite everything, and this is the meaning of my book, the government should have said more about the extent of this war. Has the government managed the health crisis well? This is an issue of this election campaign. The Elysée says it has admitted and learned from its mistakes. There has been progress, the vaccination campaign is a great success, but there are still things to be settled, particularly on the relationship between the Ministry of Education and the Ministry of Health. Under cover of a large unity of facade, the book reveals important standoffs. Blanquer did not really want doctors to dictate their laws at school. We can wonder since January 2022 if there is no relapse…
There has been a lot of talk in recent months about the lack of caregivers, but you insist that it is all health that suffers from underinvestment…
According to William Dab, former director general of health, there were 420 people working at DGS in 2005, there are now 270 and only about twenty at the executive level. The RGPP, with the non-replacement of one out of two civil servants since 2007 has done a lot of harm. Marisol Touraine, François Hollande’s Minister of Health, also continued to reduce resources. We disarmed the Ministry of Health, which had incomprehensible organizational charts and a very complicated way of working.
What senior sources, who like the Ministry of Health, say is that we put a lot of money into health in France. And so much the better. But we are entitled to expect excellent results. Where does the money go? On another subject, that of nursing homes, The Fossoyeurs, shows that the inspections of the ARS did not find much. The common point is a certain failure of public authority controls.
Do you think that a redefinition of the role of the health agencies, a reorganization of the ministry or the ARS is necessary and planned?
It is fundamental. Emmanuel Macron had launched a mission on the subject. He had suggested avenues for modification, but for the moment the administrative millefeuille has not been reformed. One has the impression that they responded by shaking hands with the consultants. The McKinsey firm has had many contracts. It’s cautery on a wooden leg! I think that we should rather give more resources to public health, if we want to be more effective for a future health war. We must understand that the Ministry of Health is as important as the Ministry of Defence.
* The ministry of broken arms, Albin Michel, February 2022, €18.90.