Hospital tariffs 2025: Fairness cannot be decreed, it must be proven, starting with the financing of the wage agreement expected by the sector’s 170,000 healthcare professionals
The Ministry of Health’s assertion of ‘achieved’ fairness in hospital tariffs between public and private hospitals is undoubtedly a successful communications exercise. Unfortunately, it does not stand up to the test of facts and demonstration. It is particularly in the social sphere that the gap between the announcements and the actual needs to implement an ambitious pay policy for the benefit of professionals in the private sector is widest. And clearly, it’s not enough!
NO, the tariffs announced do not reflect the difficulties faced by healthcare establishments, and flout the commitments made by the Government
On 24 March 2025, the government announced a 0.5% increase in hospital tariffs for 2025 for both the public and private sectors. In reality, this increase is a sham, as it does not create any new resources. Inflation, estimated at 1.5% in the construction of the National Health Insurance Expenditure Target (ONDAM) for hospitals, has not been taken into account, and the liability of underfunding remains very high: one billion euros of inflation without compensation over the last three years, putting private health establishments in the red to an unprecedented extent: 45% will be in deficit in 2025, compared with 29% in 2022.
The commitments made by the Government have therefore not been honoured. The application of the abolition of the coefficient designed to neutralise the impact of tax and social security cuts (CICE), although duly promised, has been unjustifiably truncated for 2025, reducing private sector resources by €43m, even though a decree dated 31 December 2024 clearly formalised this abolition.
The gulf between the commitment to support the hospital sector in all its aspects and the reality of the decisions made has one major consequence: the impossibility of implementing a pay policy worthy of the name for healthcare professionals who deserve and expect it.
NO, the Government’s social promise to private sector healthcare professionals has not been kept
The Ministry has announced a sum of €80 million to finance the pay rise agreement for professionals in the private sector, known as ‘Avenant 33’. What’s more, this amount is likely to be reconsidered in 2026, creating uncertainty in a context of political instability. In addition to the substantial contribution from healthcare institutions, which will bear 53% of the total cost, the amount required to finance the application of the agreement is €140m.
The proposed budget therefore makes it impossible to implement the wage agreement, which was signed by a majority of the sector’s 170,000 healthcare professionals and which they are eagerly awaiting. The sustainability of the private sector, which is already in deficit, is at stake.
In a sector that is exclusively regulated by the State, the FHP points out that healthcare professionals in the private sector are paid on average 16% less than their counterparts in the public sector, and even 18% less for nurses and 31% less for care assistants. There is a pressing social need for a pay policy that provides a framework for professionals in the private sector. Failing to respond to this will create the conditions for social tensions.
NO, there is no equity between the public and private sectors
The figures speak for themselves. Here are a few examples:
– The public sector benefited from a significant increase in its tariffs in 2024 (+4.4% vs. 0.4% for the private sector), in order to incorporate the salary increases granted. In the private sector, these salary increases were refused.
– 200 million has been allocated to public-sector establishments in difficulty, by redistribution following the abolition of the ‘SMA’ funding guarantee, without private-sector establishments, 45% of which are in deficit, benefiting. This funding is matched by a €400m ‘establishments in difficulty’ envelope, 91% of which is allocated to public establishments. This means that a total of €560m of support is earmarked solely for public establishments in difficulty, in addition to the increase in tariffs.- The reform of the financing of medical and rehabilitation care (SMR) has led to a differential in tariffs between the public and private sectors, which by 2024 will have risen from 40% to 85% for treatment of identical patients, leaving private SMR establishments in an inextricable equation.
NO, the current situation is untenable, offers no prospects for the sector and requires immediate adjustments.
Lamine Gharbi, President of the FHP: ‘Through this pricing campaign, the FHP was waiting for a clear sign from the Government, in line with its commitments, in particular for the implementation of the ‘Avenant 33’. Fairness, real fairness, cannot just be a communications argument; it must be translated into concrete action for hospitals, professionals and patients. I call for the political positions taken to be drastically revised in the interests of everyone, to meet the conditions for implementing the pay deal that professionals are waiting for, and which is currently at a complete impasse.”
Read the Press release in French
