Hospitals inspired to tighten the belt | EUROtoday

On Jun 2, 2025

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Lhe accounts of public hospitals are in crimson. In his newest report on medical health insurance, of May 25, 2025, the Court of Auditors Alert on “a trajectory of the social accounts out of control”. The monetary magistrates are involved “a significant worsening of the deficit of public hospitals, gone from 1.9 billion euros in 2023, in an estimated amount between 2.8 and 3 billion euros in 2024 despite a resumption of their activity”.

The public authorities have nevertheless massively supported them, particularly for the reason that COVID disaster, by strongly rising the endowments, which reached 105 billion euros in 2024, in order that they will recruit extra docs and nurses. But that isn’t sufficient to stability their accounts. Hospitals are due to this fact inspired to tighten the belt. While budgetary discussions start, to organize for well being financing legal guidelines for 2026, beginning with tough negotiations on the administration of taxi transport by taxi, listed below are the financial savings areas that might be potential within the hospital, with out harming its high quality.

This isn’t in step with the requests of the President of the Federation of Hospitals of France, Arnaud Robinet, who asks the federal government, quite the opposite, a rise in bills assured by “a multi-annual programming law, on the model of what is done for the defense”, he declared throughout Santexpo, the nice annual assembly of hospital staff, on May 20 in Paris, by criticizing “those for whom the hospital is an easy target”. Does it goal for the chief? Does he really feel a potential austerity treatment for white blouses?

The Minister of Labor and Health Catherine Vautrin replied on the identical day, with out taking gloves, “the deficit of the social security branch is strongly widening. It is up to the French to decide what money they want to devote to health? Everything has a cost ”.

Too many stent poses in certain hospitals

First track, avoid unnecessary hospitalizations. Based on work carried out by the High Authority for Health, on the relevance of care, the Court of Auditors estimates that “265,000 medical hospitalizations might be probably averted, or 2.5 % of stays. This is the case within the subject of the administration of continual ailments, and specifically for the administration of coronary heart failure ”.

The Court criticizes hospital docs in the identical report for not respecting the “relevance of care” sufficient and of constructing all of ava. This is especially talking, she notes, within the subject of extreme set up of coronary stents. Indeed, as a survey of the IRDES (Institute of Research and Documentation in Health Economy) demonstrates, “the launch rate of coronary stents varies from one to four, between certain departments and certain hospitals”.

We put 4 occasions extra within the Meuse than in Vendée, with out actual clarification, in any other case … a typically frantic need to make figures. “Health insurance must more sanction surgeons who pose too many stents, apart from the uses of good practice. This will relieve the budgets of hospitals, “said Professor André Grimaldi, an emeritus diabetologist at CHU Pitié-Salpétrière.

Finally reorganize the hospital card

The nerve of war, to make real savings in the hospital, is to close small structures if they do not have the level of quality sufficient to take care of patients. The Court of Auditors The Written Black Writing: “The public authorities should carry out service groups within territory hospital groups, in particular in surgery, with the aim of a graduated offer of care”.

However, closing small hospitals is a very difficult exercise in France. “When a closure is envisaged, you often have elected officials, who block the reorganization processes, even though it is very advanced, saying to act in the interest of citizens. I noticed it several times during my career, ”mentioned Dr. Stanislas Johanet, a hospital reorganization council, ex-anesthesiologist-hospital resident.

4 % of well being institutions should not licensed by the High Authority for Health, nevertheless, they nonetheless work. This is the case of the Remiremont hospital, within the Vosges, which stays open “despite six suspicious deaths in the last two years due to dysfunctions in the organization of medical care”, in line with the Regional Health Agency. On the spot on website, on December 5, 2023, the Minister of Health on the time, Aurélien Rousseau, was cautious to not take energetic measures, however had affirmed “his support for the teams”.

Will the scarlet accounts of well being, this yr greater than others, result in closings of small constructions? A regulation handed within the Assembly on May 16 doesn’t appear to go on this route, as a result of it establishes “a moratorium on the closure of maternities, except in the event of endangering patient safety”. Proposal to which the Minister of Health Range, Yannick Neuder, relected, “recovering from the wisdom of the Assembly”. “This moratorium is an absurd decision, the very example of political immobility,” mentioned Stanislas Johanet.

Favor high quality primarily based on the transparency of data

What may be the opposite levers, which to play on? Nicolas Revel, Director General of Public Assistance-Hôpitaux de Paris, highlights that of “improving quality”, in a discussion board revealed on May 25 by Terra Nova. He believes that “advanced evaluation measure, and transparency in terms of clinical practices and transparency of establishments, must be” superior. Nicolas Revel notes that “the only effective way to develop professional practices is to be able to measure them and compare them between equivalent structures”. The goal of measuring the standard of hospitals, and making this info public to most of the people, is exactly that of the listing of hospitals in Pointwhich examines the efficiency and outcomes of 1,400 hospitals and clinics via 85 disciplines, to ascertain 136 rankings.
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The kangaroo of the day

Answer

An actual nice reform of the hospital can’t be made, with no questioning of cost to the act. “Currently, the hospitalizations avoided paradoxically constitute a shortfall for health establishments,” says Nicolas Revel. Because a hospitalized affected person constitutes an “activity” for the hospital, it’s due to this fact paid as such by medical health insurance, whereas quite the opposite a preventive and virtuous angle, doesn’t convey him something. A complete absurdity, which Emmanuel Macron had nevertheless affirmed, on January 20, 2023, wanting to change by declaring “in the hospital and in the city, it is less necessary to pay the act, and more in the pass, on public health objectives”. Two years later … Nothing has moved.

https://www.lepoint.fr/sante/actes-inutiles-fermetures-les-hopitaux-incites-a-se-serrer-la-ceinture-02-06-2025-2591084_40.php