They were only missing that ! Two years of Covid have exhausted the hospital and its staff, despite the billions of euros put on the table during the “Ségur de la Santé”. And now a financial storm threatens hospital accounts. Its name: inflation. It’s not just households that have been struggling with their wallets lately. Hospitals, both public and private, too.
What give insomnia to Vincent Vesselle, the director of the Saint-Côme polyclinic, in Compiègne, one of the largest structures in Picardy. Since the fall, letters from his suppliers detailing the menu of future tariff increases have been piling up on his desk. The last concerns all its purchases of operating drapes, the prices of which are expected to rise by almost 7% in 2022. One more line that turns red: “Everything is becoming more expensive, energy, medical devices, insurance… situation is becoming very worrying,” he said.
In the public, the bill is just as salty. Bruno Carrière experiences this on a daily basis. He directs the largest purchasing center for public hospitals, representing nearly 6 billion euros in expenditure each year on behalf of nearly a thousand establishments. He too aligns the figures: +15% for dressings, +5% for plastic infusion tubing, +15% for catering… But these are the energy items (electricity, gas…) and insurance who hurt the most.
Heavy-handed insurers
“Hospitals that wanted to play solo and contract directly with energy suppliers are subject to review clauses included in contracts ranging from 100% to 200% in certain cases”, chokes Bruno Carrière. A massive blow when the energy item represents between 7% and 10% of a hospital’s budget.
As for insurers, they also have a heavy hand on premiums. “They anticipate an explosion of litigation, with some Covid patients accusing the hospital of having contracted the disease when they sought treatment for another pathology”, adds Bruno Carrière. And then, the companies pass on the very strong increase in absenteeism in the provident insurance premiums, these contracts being used to cover the additional costs linked to the lack of staff.
But there is still more worrying for the future. “All the real estate and renovation investments that we had launched within the framework of Ségur are subject to cost increases fluctuating between 10% and 30%”, insists Cécile Chevance, in charge of finance at the French Hospital Federation.
An inflation check for the hospital
The problem is that unlike a normal company, public hospitals like private establishments cannot pass on these price increases to their prices, which are strictly regulated by the State. “It doesn’t loop anymore”, warns Cécile Chevance.
Certainly, the government claims to have loosened the constraint of hospitals during the last Social Security budget, voted last November. The increase in the national health insurance expenditure target (Ondam) was increased to 2.4% this year. “Part of the increase is simply eaten away by inflation,” retorts Cécile Chevance. Above all, the hospital package should theoretically only increase by 0.2% in March, as had been written into a multi-year agreement engraved in stone with Agnès Buzyn in 2019 … Prehistory.
“We are asking for a 1% increase in the hospital package and an inflation allocation of nearly 2 billion euros,” says Lamine Gharbi, spokesperson for the Federation of Private Hospitalization. In the meantime, Olivier Véran’s cabinet turned a deaf ear and did not wish to answer our questions.
In hospitals, we are again talking about savings plans. Some university hospitals, yet in balance before the Covid pandemic, would be on the verge of embolism. And 30% of clinics are already in deficit. “I have already thought of closing the maternity ward or reducing the airfoil in certain departments. As, moreover, I cannot recruit”, blows, fatalistic Vincent Vesselle. Inflation, the last twist of fate the hospital hadn’t seen coming.