The hospital is like a bottomless pit. No sooner had the Prime Minister announced new state aid of 1.1 billion euros to increase the salaries of caregivers working at night and on Sundays than hospitals warned of the deterioration of their financial situation.
“The deficit of public hospitals should reach 1 billion in 2022, i.e. almost doubling compared to the pre-Covid crisis situation, which was 500 to 600 million”, deplores Cécile Chevance, finance manager of the Federation of hospitals. of France (FHF). And for 2023, the situation is likely to be even worse due to a significant impact of inflation.
“Non-staff spending is increasing by around 15% and hospitals are suffering a carryover effect from the rise in energy prices after they had managed to secure advance purchases of electricity in 2022”, continues Cecile Chevance. Added to this are personnel costs related to purchasing power measures. If, on the expenditure side, the balance becomes heavier, on the revenue side, the activity does not make it possible to balance. It remains lower than it was before the crisis due to pressure on staff and bed closures.
The FHF is therefore asking for increased public funding in the next budget of the “Safety”, which will be examined next fall. While the government seeks to tighten the budgetary screws by all means to meet the commitments made with regard to Europe, public hospitals are asking for a catch-up of 3 billion euros for 2023 and an additional increase of 4 .9 billion euros for 2024.
The deterioration in the financial situation of hospitals is all the more worrying as it weighs on their ability to invest, even though a massive plan to boost investment is being implemented.
Hospitals must in fact carry out numerous large-scale projects at the same time: they must renovate their aging buildings, modernize their technical platforms, generalize the use of the DMP (shared medical file), converge the different IT systems between establishments, acquire new technologies (robotics, artificial intelligence, etc.). Without forgetting to deploy cybersecurity tools, after the attacks to which some have been victims.
This recovery plan is also itself strongly impacted by the evolution of construction and materials prices and by the rise in interest rates. Without state aid, the FHF fears “a new period of underinvestment even as public hospitals have tackled the Covid crisis with an investment rate at the lowest for twenty years”.
On the other hand, on the human resources front, the situation is improving. “We are seeing slight positive signs in terms of recruitment” in hospitals and nursing homes, after efforts to upgrade the purchasing power of healthcare staff, says Arnaud Robinet, president of the FHF and mayor (Horizons) of Reims.
However, “we must not let up our efforts”: “We are in the middle of the ford and much remains to be done,” he warns. In June 2023, 4.98% of nursing positions were vacant in establishments dependent on the FHF, compared to 5.7% in April 2022. This rate, however, remains very high in nursing homes (12.22%). “This improvement should make it possible to better organize care” and to have “the right teams in the right place”, but it would be “premature” to talk about possible reopenings of beds, because “there are still tensions and occasional closures” due to lack of caregivers, concludes Zaynab Riet, the general delegate of the FHF.
