The 32 French university hospital centers (CHU) have reached a cumulative deficit of 1.2 billion euros at the end of 2023, or three times more than in 2022, alerted, this Monday, January 29, the representative bodies of directors, deans and doctors , calling for “emergency measures”.
These latest figures show to what extent “the deterioration was deep and rapid”, after the deficit of 402 million euros at the end of 2022, write in a press release the presidents of the conferences of general directors of CHU, deans of medical faculties and presidents of establishment medical commissions. “The self-financing capacity of CHUs, and therefore investment, has fallen by 86%,” they continue. These difficulties are “perhaps the most serious since the creation of university hospitals in 1958”.
The deterioration “is linked to several external factors”, including an explosion in expenditure due to inflation (with a balance of 585 million euros for CHUs in 2023), a lack of funding for Ségur measures. health and a drop in revenue due to bed closures after the Covid-19 epidemic, explain the presidents. These figures “weigh heavily on the hopes of improvement”, recently observed in terms of the attractiveness of careers and the loyalty of caregivers, they believe. The CHUs felt “a slight improvement in terms of absenteeism”, despite a “still high turnover among nurses. “Even if we have been able to reopen beds in recent months, several sectors are in great difficulty, such as geriatrics, pediatrics or psychiatry”, details Professor Rémi Salomon, who represents the doctors, in the press release. Furthermore, the CHUs are “responsible for a triple mission” of care, training and research, requiring “healthy and solid”, the presidents still observe.
“There is still time to avoid the worst”
The current situation will, according to them, lead to “an extension of payment terms for suppliers and a profound weakening of Ségur investment operations, at a time when recourse to borrowing is more difficult and more costly”. “In the short term, there is still time to avoid the worst,” they argue. They call on the public authorities to “compensate for the high inflation” of 2023 and to “return to public hospitals” the part of the Ondam (national objective for health insurance expenditure) reserved for hospitals but which has not been actually consumed. An amount they estimate at 800 million euros. Finally, they call for a “long-term financing strategy”.
In a letter addressed to Prime Minister Gabriel Attal, numerous mayors of large cities including Anne Hidalgo (Paris), Grégory Doucet (Lyon), Pierre Hurmic (Bordeaux) and Martine Aubry (Lille), who are also presidents of the supervisory boards of CHU of their municipalities, ask for a “meeting” on Monday to be able to “present proposals” to the government. Public hospitals, all establishments combined – from university hospitals to small local hospitals – are asking the government for 1.8 billion euros in additional funding for 2023, including 1.1 billion for inflation, according to figures released Monday by the French Hospital Federation (FHF).