Marseille hospitals severely pinned down by IGAS

Decidedly, the AP-HM is going through dark hours. A year after the publication of a damning report on the situation of public hospitals in Marseille, the IGAS (General Inspectorate of Social Affairs) is back, with a report no less tender.
The authors of this new report, commissioned in April 2015 by Marisol Touraine, take stock of the evolution of the financial situation of the Assistance Publique – Hôpitaux de Marseille, third CHU in France. “The 2013 and 2014 financial years saw the financial situation of the AP-HM already deteriorated, deteriorate further”, they observe.

Several factors seem to explain this situation. Two vast projects have been launched several years ago and represent a financial pit. The first, the logistics platform (PFL) of the AP-HM, began in 2010. It brings together on a single site the majority of the logistics functions of the AP-HM. The second, the Medico-Technical Building of La Timone, spread over 50,000 m², already hosts several services.

These two projects have largely contributed to widening the structural deficit of the AP-HM, which should amount to 57 million euros for 2014, according to estimates by IGAS inspectors. If these forecasts prove to be correct, the deficit will have doubled between 2012 and 2013.

Stagnant activity, increasing numbers

And construction sites are not the only cause. Among the other factors that undermine the accounts of the AP-HM, the IGAS cites the stagnation of activity and the increase in membership. Indeed, “the costs [générés par les chantiers] should have been offset by job cuts planned in the original financing plan, say the authors of the report. However, these deletions did not take place up to what was planned, and creations even took place in the care services when the PFL was put into operation ”.

In addition, recurring absenteeism, raised in the previous report, led the AP-HM to set up replacement pools. These job creations were to be offset by the reduction in overtime and temporary expenditure.

“Apart from the fact that the simultaneity of the reductions in these charges and the setting up of the pools has not been observed, the advisability of proceeding in this way may be questioned”.

An institution “unable to invest”

Indeed, according to the inspectors, “this aspect of human resources management should have been integrated into an overall reflection: search for a return to a level of absenteeism in the average for CHUs, organization of working hours. in care units (closing units on weekends for example) ”.

The stagnation of the activity, it causes “an insufficient level of receipts”. “The situation of the AP-HM is in this respect atypical compared to the other university hospitals whose average increase in activity between 2013 and 2014 amounted to 2.6%. It appears essential that the AP-HM define a proactive and structured policy for consolidating market shares: better organization of care pathways, quality of reception of patients and their relatives, quality of communication with treating physicians, etc.

In the end, IGAS describes an institution in crisis, “incapable of launching new large-scale investments (maternity, fire safety standards)”. The conclusions of this report are supposed to serve as a basis for the development of the mission letter of the new director general, who took office in April 2015 after the resignation in the form of dismissal of her predecessor, Jean-Jacques Romatet. .