Clinics must participate more in the public hospital service, believes the Court of Auditors

The Court of Auditors is throwing a spanner in the works. “The public hospital service must also be provided by the private sector,” declared Pierre Moscovici, first president of the Court of Auditors, presenting three reports on the hospital on Thursday. “It is not a privatization of the hospital,” he defended himself, “but given the tense healthcare situation, there is a waste, the clinics would make it possible to meet needs.”

While public and private have long worked in silos, the health crisis has led them to cooperate more. “They must continue to overcome their historical opposition,” believes Pierre Moscovici. For this, the Court recommends a relaxation of the authorizations issued to clinics by regional health agencies (ARS). In return, the fees of the liberal professionals who work there would be regulated and “the remainder payable by the patient would be equal to zero”. In addition, practitioners should participate in ongoing care, and nursing staff should be shared between establishments to provide “nights, weekends, the month of August, public holidays and end-of-year celebrations” .

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The obligation to participate in on-call duty for doctors working in private clinics is a provision of the Valletoux bill currently being discussed in Parliament. This is a red flag for liberal practitioners, and one of the reasons for the strike called for by all the liberal doctors' unions from Friday. The financial magistrates also took the opportunity to draw up an assessment of the “Ségur de la santé”.

If the exceptional effort of financial support for health in the face of the health crisis was "justified", the "whatever it costs" lacked "management" and the allocation of sums in the emergency suffered from insufficient “control”. Thus, despite 6.5 billion euros allocated to the recovery of hospital debt, many of them are still faced with significant deficits. “The choice was to spread out the aid instead of concentrating it on the hospitals most in difficulty,” regrets Pierre Moscovici. And to point out that thirty hospitals even received debt relief assistance greater than… the amount of their debt!