• Heavily indebted, the two establishments accumulated a tax debt of 41.5 million euros in 2020, despite significant financial aid.

  • “The competitive positioning of the two establishments does not allow them to generate sufficient activity to ensure their sustainable operation”, for the regional chamber of accounts.

    But the proposed merger of the two establishments is "undervalued" according to the regional chamber of accounts.

  • A vision that the mayor of Millau and president of the supervisory board of the hospital center does not share: “We have never been so close to a project which perpetuates the health offer while rationalizing its cost”.

The Regional Chamber of Accounts has delivered a severe report on the management of the hospitals of Millau and Saint-Affrique, two establishments in southern Aveyron about thirty kilometers apart.

“The failure of a first merger led to the empowerment of the two establishments which continue to offer a mirror care offer, without pooling or gradation in care, details the jurisdiction.

In particular, there remain two maternities, two surgery departments and two continuing care units which compete with each other without either of the two establishments managing to generate sufficient activity to balance its financial situation and make the necessary investments to accommodate in more suitable conditions, patients and caregivers”.



Heavily indebted, the two establishments accumulated a tax debt of 41.5 million euros in 2020, despite significant financial aid: 20 million for the Saint-Affrique hospital center since 2012, 13.9 million for Millau since 2015. With the same consequences: placement under provisional administration between 2019 and 2020. “The financial situation of the two establishments raises the question of their sustainability within the framework of a mode of financing proportional to their activity.

Indeed, the competitive positioning of the two establishments does not allow them to generate sufficient activity to ensure their long-term operation.

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Skepticism about the proposed merger

The merger project is greeted with the same skepticism: "Its cost, estimated at 55.8 million euros, is underestimated: beyond the construction of a new hospital and the rehabilitation of the two old sites, the tax and social security debts of the two establishments, which amount in 2020 to nearly 41.5 million euros, will have to be cleared.

The envelope necessary for the creation of the median hospital would thus amount to at least 97.3 million euros, to which the price of the land on which the building will be located as well as the necessary equipment would have to be added.

A figure nuanced by Emmanuelle Gazel, mayor (PS) of Millau and president of the supervisory board of the Millau hospital center.

“We obtained 80 million euros from the State for the construction of the new hospital”.

The court also points to an inconsistency: “Part of the savings generated by this project is based on the assumption of a reduction in staff, thanks to the pooling of staff made possible by the merger of the services of the two hospitals.

However, such a social plan is not envisaged by the authorizing officer, who has undertaken not to dismiss agents.

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"This project sustains the offer and rationalizes the costs", for the mayor of Millau

Sylvie Marty, director of the Millau Hospital Center and acting director of that of Saint-Affrique, specifies that “the joint hospital project has since evolved”.

She also believes that “the age pyramid of non-medical staff, older than at the national level, should be favorable to this project”.

"Given the delay of approximately 6 years before the opening of the new hospital, a certain number of positions may be eliminated, without resorting to dismissal", emphasizes Emmanuelle Gazel.

The future establishment is, in his view, essential for maintaining the supply of care for an aging population: "We have never been so close to a project which perpetuates the supply of health care while rationalizing its cost ".


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