After taking an interest in the Ajaccio hospital center a little over a year ago, the Regional Chamber of Accounts of Corsica (CRC) published this Thursday a report relating to the Bastia hospital center and its governance, its activity and healthcare provision, as well as its human resources management, its reliability of accounts and its financial analysis for the 2018 and following financial years. If the organization notes that the establishment ” serves a growing population, characterized by aging and high levels of insecurity ” and faces ” to specific constraints linked to insularity, tourist seasonality and unsuitable building resources “, while recording ” a dynamic activity which, as of 2022, has returned to its pre-health crisis level”he points out results which “nevertheless mask disparities and some of its performances are insufficient”. “The CHU must, therefore, further streamline the patient journey, seek to reduce its length of stay and optimize the occupancy of certain services. It must, in addition, develop outpatient activity in order to improve patient care “, raises the CRC, noting moreover that the CH staff are experiencing ” since 2018 significant growth (+16%) to reach 2063 full-time equivalent paid jobs in 2023, including 213 medical personnel ».
However, the CRC observes that the lack of attractiveness of the medical professions correlated with insularity, has ” leads the CH to resort mainly to non-permanent jobs (56%”. Temporary employment expenses have thus increased from 2,160 euros per year in 2018 to 283,322 euros per year in 2023. In addition, the chamber emphasizes that ” in order to make salaries more attractive” The CH was forced “to pay many doctors for additional working time that was not being done “. Irregularities which the CRC recommends putting an end to, while also inviting the CH to ” react to the growing absenteeism of non-medical healthcare staff and to regularize the working hours of hospital workers.” “These actions are all the more necessary as the situation of the establishment has seriously deteriorated. The CH has, of course, had its accounts certified, but the chamber has identified several actions necessary to make them more reliable. “, warns the organization.
A deficit multiplied by four since 2018
According to the CRC, the annual deficit of the Bastia hospital has in fact been multiplied ” by four over the period to reach 21.2M in 2022, or even 38.8M after reprocessing of cash aid granted by the Regional Health Agency”. “The cumulative deficits peak at 110.5M in 2022 and even approach 200M€ if we add tax and social debts and those of suppliers”, adds the report, noting that these debts
exhibit the hospital ” to supply disruptions and abnormally high risks of litigation.”
Finally, the Chamber notes that CH is “ unable to generate its own resources for investment, even though it has a major reconstruction/restructuring project ” and that if he has ” “Once the causes of its deficit have been clearly identified, it must immediately finalise a realistic recovery plan which has been lacking for years, by objectifying the constrained deficit linked to the exercise of specific activities which the hospital is required to carry out as part of the continuity of care.”
In the face of all these observations, the CRC formulates de facto five recommendations: ” define and implement an action plan to develop outpatient surgery » ; « formalize, from 2024, protocols with a view to improving the internal and external patient journey » ; « use the contractual practitioner contract only to deal with “particular recruitment difficulties” and not for very short-term replacements” ; « carry out a diagnosis and implement an action plan aimed at reducing absenteeism » ; et « reorganize the internal functioning of the emergency reception service and the organization of on-call care, in order to provide and stabilize the medical resources necessary for the proper functioning of the service.
