will the government really release 32 billion euros, as Gabriel Attal promised?

Billions of euros to preserve “a national treasure”. Four days after his appointment as Prime Minister, Gabriel Attal went to the Dijon university hospital on Saturday January 13, accompanied by Catherine Vautrin, the new Minister of Health. During this visit, the new tenant of Matignon promised “32 billion additional euros” for the health system, undermined by years of budgetary restrictions and the health crisis. This amount will concern both the hospital and community medicine, those close to him told franceinfo.

What does this announcement mean? Will the health sector benefit from these additional 32 billion euros? Not really. First of all, it should be noted that this amount, which may seem very significant, will not only concern the year 2024, but “the next five years”, specified the head of government, or ultimately 6.4 billion euros per year. A “drop of water in the ocean”estimates economist Jean-Paul Domin, specialist in the health sector.

“To modernize the hospital system, it would take, according to some estimates, more than 180 billion euros over ten years, or around 18 billion per year.”

Jean-Paul Domin, economist

at franceinfo

Then, Matignon clarified that in reality, it was a question of “the increase in the budget for the health sector which was adopted in the last Social Security financing law” (PLFSS) in December 2023, after further recourse to 49.3 by Elisabeth Borne. In other words, this means that the figure does not correspond to a new announcement, but to a reminder of the evolution of health expenditure, called the national health insurance expenditure objective (Ondam), including hospital and city medicine.

An insufficient increase

Enough to annoy health professionals, who denounce a misleading ad. “This gives a very bad impression to caregivers”thus criticizes Arnaud Chiche, founder of the Santé en danger collective, contacted by franceinfo. “We say to ourselves that it’s either a publicity stunt or a lack of knowledge of his files.” Same story with the Force Ouvrière union, which is calling on ministerial services on budgetary mechanisms “obscure” that the government intends to implement. “What we want is social dialogue, details of investments, a clear roadmap”agrees Jean-François Cibien, president of the inter-union Action Practitioners Hospital.

In addition to the publicity effect, professionals regret the lack of resources allocated to the health system. Because if the national health insurance spending objective has indeed been revised upwards in recent years, since it will represent 8.7% of GDP in 2024 compared to 8.2% before the health crisis, according to the site Vie-publique.fr, this increase remains insufficient to cover the entire increase in health system expenses. In the Social Security budget adopted in December, the government is based on an increase in Ondam to a level of 3.2% in 2024, while it should reach 4.6%, according to the specialized site APM-News . Which means that the evolution of real health expenditure should exceed that estimated in the text of the law.

Inflation rises further

“It’s not because there is an increase in the health budget that we will be able to buy more things.”, analyzes economist Nicolas Da Silva, also a specialist in the health sector. Because this increase does not include inflation or the care needs of patients which are increasing due to the aging of the population. This is why the union of anesthetists SNPHAR-E regrets in a press release that it is “already admitted that this planned increase in the health budget will be insufficient”.

“We would therefore have to raise the budget faster than this simple natural increase in prices, in order to cover all these costs.”

Nicolas Da Silva, economist

at franceinfo

Thus, the announcement of the release of 32 billion euros represents an increase of “only” 13% of the budget over five years. “But we are not sure that this corresponds to inflation over this period, advances the economist. Over two years alone, the European statistical agency Eurostat estimates the price increase at 10%.” “For the hospital, the challenge is to finance investment, salary increases and inflation at the right level”commented Arnaud Robinet, the president of the French Hospital Federation, on the social network.

“The health system especially needs reform”, claims Mathias Wargon, head of emergency at Delafontaine hospital in Saint-Denis (Seine-Saint-Denis), on franceinfo. But this in-depth overhaul, requested several times, notably in 2019 and following the health crisis, is long overdue. Failing this, Arnaud Robinet pleads in favor of a “five-year programming law” developed with “all stakeholders in the world of health”citing as an example “National Defense where we give ourselves objectives, we give ourselves the means”. According to him, “the situation is extremely serious. It is even urgent”.