The words appear in large print on the cover of Release : “The purge that threatens the hospital”. The daily today unveils a 69-page note addressed to the Regional Health Agencies (ARS). Entitled “Regional deployment kit of the ONDAM plan (1) for the ARS”, this document gives instructions, in particular, to achieve savings of 10 billion euros by 2017, including 3 billion on the hospital.
And the newspaper’s editorialist, David Carzon, does not cut corners: “This kit is first and foremost an accounting, technocratic instrument that acts blindly based on performance indicators and economic objectives, such as if each health expenditure operated in a compartmentalised way”. The burden is all the heavier since Marisol Touraine must present her health bill on Monday at a press conference.
However, both in form and substance, this text reflects a contradiction between words and deeds. “A double language”, denounces Gérard Vincent, general delegate of the Hospital Federation of France, questioned by the journalist Eric Favereau. While the ARS were set up to adapt the supply of care to regional specificities, here is a national manual for savings torn this desire for decentralization to pieces. “With this plan, we are witnessing the creeping nationalization of the hospital system”, adds the representative of public hospitalization.
The diet of 3 billion euros planned for hospitals is not “intended to reduce the hospital workforce”, assured, at the end of the week, Marisol Touraine. “The government does not want to assume”, retorts the newspaper. The figure of 22,000 jobs cut in three years has been mentioned and the “kit” reports a saving of 850 million in payroll savings for 2015-2017.
Hospitals that are too numerous and cost too much, few are those, among the specialists, who question this observation and the need to restore order. But, as Philippe Batifoulier, a teacher at Paris-Ouest Nanterre, points out in the daily newspaper, health is the major absence from this document addressed to the ARS. “We have in front of us the document of a commercial enterprise that needs to save money,” he explains. Taking the example of outpatient surgery – which allows the patient to return home after an intervention – and which the public authorities want to encourage, this expert drives the point home: “We have the impression that the patient is a kind of hot potato , which must be discarded. »
(1) National health insurance expenditure target