The French National Audit Office (Cour des Comptes) has just published its report on competition and complementarity between public and private healthcare establishments. The spirit of the report is clear: a new dynamic must be set in motion, and new balances must emerge between the sectors if we are to meet the challenges of healthcare.
“We’ve been waiting for it“, exclaims Lamine Gharbi, President of FHP (French Federation of Private Hospitals). “First and foremost, the Report makes a major recommendation, one that has been at the heart of our advocacy for years: the renovation of the Public Hospital Service (SPH) resulting from the so-called “Touraine” law (former Minister of Health in 2015), a law that we fought hard against because it profoundly excluded private players. The Cour des Comptes is calling for “more flexible criteria” for participation in the Public Hospital Service, to allow private players to participate within a framework of shared responsibilities. This is a breach in the dogma, and this recommendation must now be translated into action.
The report also notes that the public sector has too much of a monopoly on emergency and intensive care services, and that this needs to be offset by cooperation. We already care for three million people in our 122 private emergency departments, but we are relentless in our demands for the necessary authorisations to provide ever better care for the public, in addition to the public hospital.
The role of private clinics and hospitals is also highlighted. Contrary to certain preconceived ideas, private sector activity is equivalent to that of the public sector during the summer months, and even higher at the end of the year. So everyone does their bit, and the Report rightly stresses the importance of “concerted and cooperative organisation” during these sensitive periods. It also mentions that “in some less-favoured areas, private establishments welcome more beneficiaries of solidarity-based supplementary health insurance than public establishments”.
In terms of resources, this time financial, the Cour des Comptes deplores the lack of clarity of certain allocations, “with their uncertain and evolving scope”, as well as “the inadequacy of their justification”. We have long been calling for greater proportionality between the weight of health care provision and the funding allocated.
Everything in this Report converges on one need: to move from a culture of supply to a culture of response to patients’ needs, with more evaluation of the service provided, which presupposes that players of all statuses can share public service missions.
This is at the heart of the message from the private hospital sector, and we hope that it will be fully heard.
Editorial published on the FHP website
