Jean Castex, March 9, 2021 at the National Assembly.

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MARTIN BUREAU / AFP

  • If healthcare workers have been asking for additional resources for years, the Covid-19 crisis has revealed the urgency of the situation.

  • The government claims to meet these needs thanks to an investment plan of 19 billion euros over 10 years, unveiled this week by Jean Castex.

  • According to the Prime Minister, this sum represents double that invested by previous plans in favor of the hospital. 

“We have already learned structural lessons” from the coronavirus crisis.

During the questioning session to the government in the National Assembly, Tuesday, March 9, Jean Castex praised the merits of an investment plan of 19 billion over 10 years for public hospitals that he had announced a little earlier , during a trip in the Nièvre.

19 billion euros invested in our hospitals.


These numbers may not speak to you.


But to fully understand the dimension, here is an order of magnitude: it is 50% more than the “hospital 2007” plan and the “hospital 2012” plan combined.


It's new and historic!

pic.twitter.com/MQYKhSzxu2

- Jean Castex (@JeanCASTEX) March 9, 2021

The opportunity for the Prime Minister to exclaim: “Unprecedented means have been made available to upgrade the professions of the hospital with the Ségur de la santé.

[…] 19 billion!

[…] For those who experienced the Hospital 2007 and Hospital 2012 plans, which were good plans, it is 50% more than these two combined plans!

"

And Jean Castex to detail, in the course of his speech, the distribution of the various envelopes of the plan:


"9 billion for the offer of care to improve the teams", "a billion and a half for the nursing homes who need it so much, 2 billion for digital ”, or the takeover by the government of“ 6.5 billion in debt of health establishments.

"

Stating in passing that "Europe will contribute 6 billion euros to the financing of the plan".

At first glance, these 19 billion euros planned for the next few years far exceed the investments of previous governments cited by Jean Castex, which the government figures, on its website, at 6 billion euros for the 2007 Hospital plan and at 2.5 billion euros for that of 2012.

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However, these two plans, launched respectively in 2003 and 2007 by the then ministers of health, Jean-François Mattei and then Xavier Bertrand, each provided for much more substantial investments for health, as several archives show.

Contacted by

20 Minutes

, the Ministry of Health had not responded to our requests at the time of publication of this article. 

Let's start by examining the 2007 Hospital plan. “A sum of 6 billion euros over five years has been released nationally to carry out [the plan], to which are added 4.2 billion euros in investments. own of the ARH [regional hospitalization agencies, ancestors of regional health agencies] and establishments.

In total, 10.2 billion euros will be devoted to the success of the five-year renovation plan for our hospital stock ”, detailed a document from the Ministry of Health dated January 2004.

The following plan aimed for an "investment effort" of "10 billion euros over five years", as noted by the ministry in February 2010, while specifying the distribution of this sum: "The plan will mobilize, on during the period 2007–2012, 10 billion euros of investments of which 5 billion will be assisted by the State in direct aid from health insurance.

"

Two plans worth close to € 20 billion cumulatively

Amounts consistent with those mentioned in a circular of June 2007 inviting the prefects and directors of health establishments to “prepare a first phase of projects corresponding to half of the envelope of the 2012 Hospital plan (five billion euros of operations, financed at 50% by direct aid from the health insurance [...]) ”.

Taking into account all the investments provided for by the Hospital plans of 2007 and 2012, we therefore arrive at a total of around 20 billion euros… ie more than the 19 billion praised by Jean Castex.

This envelope mentioned by the Prime Minister is also the addition of the 6 billion investment he had announced in July 2020 and the 13 billion already promised in 2019 by the plan "Investing in the hospital" of his predecessor Edouard Philippe .

Opt for the government's calculation method, consisting in retaining from these plans only the sums invested directly by the State - thus excluding the 4.2 billion euros of ARH in the 2007 plan and 2.5 billion euros 'euros of direct aid from Health Insurance for that of 2012 - would mean for its part to revise the budget of 19 billion downwards.

By removing the aid of 6 billion euros provided by Europe, the investment of the government of Jean Castex thus reached "only" 13 billion euros, that is to say less than 50% more than the plans 2007 and 2012 in cumulative (8.5 billion euros).

"A huge gap" compared to the reality of caregivers

Beyond the figures, this plan, like the previous ones, does not meet the needs of health personnel, according to Thierry Amouroux, spokesperson for the National Union of Nursing Professionals (SNPI), interviewed by

20 Minutes

 : an investment budget, which provides for material improvements and the construction of new hospitals, while we expect an improvement in the operating budget.

We have been surviving with the Covid-19 epidemic for a year so renovating the walls is not our priority at all, while we are still struggling today to have gloves, it is a huge gap compared to our reality, always made of the elimination of beds and posts.

"

“When we hear about 'investment', 'restructuring', 'modernization', what we see systematically, through these groupings of hospitals that have become too old to build a brand new hospital, is the elimination of beds.

Restructuring in Essonne, with the closure of 3 hospitals and the opening of a new one, resulted in the elimination of 400 beds.

And it is the same at the AP-HP with the closure of Bichat and Beaujon for the opening of a new hospital in Seine-Saint-Denis, which is accompanied by the elimination of 300 beds ”, continues Thierry Amouroux, while the Inter-hospitals collective denounced, in a column published in

Le Monde

in the fall, the “new savings imposed on the public hospital”.

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