INVESTIGATION. In Grenoble, the contested practices of the boss of the mutualist clinic

It was last November: an incident “among others”. That night, Doctor M., a famous surgeon from the Grenoble mutual clinic, was on call. A woman arrives at the emergency room, she has had a heart attack. “It was three in the morningsays Richard [prénom d’emprunt]another doctor at the hospital. My colleague was unable to reach the nurse and the radio operator who were on call and who were to assist him in the operating room on their professional telephone. We realized the next day that our general management had terminated the SFR lines of all the people on call at the clinic. Because she found it too expensive and wanted to negotiate the rates [avec l’opérateur]“, says Richard.

Fortunately, “The surgeon managed to reach another nurse on her personal cell phone. She was not on call, but she agreed to come in the middle of the night”. This episode has left its mark on the mutualist clinic in Grenoble. Several other employees spoke to us about it and told us about their “incomprehension”.

The boss of the Grenoble mutual clinic (or GHM, for Groupe Hospitalier Mutualiste, often called “la Mut”) is called Bernard Bensaid. He’s a jack-of-all-trades businessman. At the head of his group of 12,000 employees, which he renamed Avec (formerly Doctegestio), he bought companies in difficulty in several areas: tourist residences, retirement homes and, more recently, clinics. This diversification is apparently at a loss, the net result of the Avec group is in the red: minus 20 million euros in 2021.

It was in October 2020 that Bernard Bensaid bought “la Mut” from the two mutuals that had managed it until now*. Since then, deplore the employees, “it is dangerously squeezing costs. In an operating theater recovery room, we stayed for a fortnight without an electrocardiogram”says Richard again. “All because he wanted to negotiate 10% off the repair of the device.” This episode was also told to us by another doctor at the clinic.

Richard also affirms that a cutting-edge department at the clinic won a research grant of several tens of thousands of euros at the end of 2020. But according to him, it would have taken several reminders for the general manager to pay them the money for this scholarship… Eight months later. “For doctors who have taken the Hippocratic oath it is very unpleasant and it is against our values. Research money should not be used to make up for the deficit of a structure or a group, continues the doctor. In the middle of Covid, this gentleman also sequestered the money for penalty payments for a certain number of doctors. It took dunning letters to get that money back. And it is public money since it is issued by the Regional Health Agency (ARS).“Other doctors at the clinic told us a similar story. We publish below an extract from the letter sent last year to the ARS of Auvergne-Rhône-Alpes by those whose penalties have not been paid.

An employee describes for her part “maintenance operations” who would not have “no place or so with a lot of delay”. She talks about investments, even minor ones, “stopped”. So an order picker would have waited “several months to have an office” to prepare their orders.

All these incidents put together, as well as other more technical contentious issues (around the fees of practitioners in particular), prompted the establishment’s medical commission to request on May 9, 2022, the dismissal of Bernard Bensaid of the governance of the clinic. This request is not trivial. The medical committee certainly only has an advisory role, but it brings together all the clinic’s doctors and midwives.

Regarding the terminated telephone lines, missing devices and confiscated penalty payments, the head of the clinic Bernard Bensaid told the Radio France investigation unit that “the ARS, which exercises supervision over the GHM, has not reported anything negative in the operation of the establishment (…) I will not allow everyone’s work to be soiled by malicious rumors peddled by a very small handful of employees in need of conflict (…)”. For its part, the Auvergne-Rhône-Alpes Regional Health Agency replied that it was not “not competent for matters relating to the internal management of an establishment”.

Bernard Bensaid also assured us, regarding the request for exclusion made by the medical committee of the establishment: “It has always been agreed that the deputy managing director I appointed would be reinforced by an administrative director. The job profile must be defined in the coming days”without specifying whether he intended to remain general manager himself.

But beyond this question of governance, the financial management of the clinic also raises questions. The Force Ouvrière (FO) and General Confederation of Labor (CGT) unions filed a complaint against X with the Grenoble prosecutor for “illegal taking of interest”. In particular, a service agreement signed in 2020 between Bernard Bensaid, the boss of the Avec group and … Bernard Bensaid, the boss of the clinic (since it should be remembered, he occupies both positions).

In this agreement that we obtained, it is written that the clinic must donate 1% of its turnover each year, or approximately 1.7 million euros, to the Avec group. In return, Avec is supposed to second employees from the head office to provide the clinic with assistance in human resources, communication or IT services.

Internally, this convention makes people cringe. An employee of the clinic we met explains: “1.7 million euros per year is the equivalent of sixty full-time positions in the Avec group who would come to work at the clinic. But there aren’t sixty full-time members of the Avec group who come to us. They are barely two or three!” The employee continues: “There is a big suspicion that money is going back to the Avec group for services that do not exist.” But here again, we are told that this is public money, since the mutualist clinic in Grenoble is financed at more than 80% by health insurance, while the group Avec, which controls it, is entirely private. .

The agreement dated October 9, 2020 was reinforced by another contract signed in January 2022. In this second document, it is specified that the clinic must pay one euro per day and per employee to the Avec group in order to be able to use digital applications.

These are various tools that allow, for example, to submit leave, to communicate internally or to have access to Google services (Google Workplace). “One euro per day and per person for a Google Drive is expensive”, quipped a doctor. Last year, the social and economic committee (CSE) of the mutual clinic had appointed an expert who quantified the cost of these services at a much lower price. “Several subscriptions are possible ranging from four euros to 15 euros per user and per month, depending on the degree of security and data storage capacity”specifies the report dated 2021 to which we had access.

Asked about these conventions, Bernard Bensaid defends the usefulness and reality of the services billed to the clinic. “It is by using common IT resources in particular that our group succeeds in turning around establishments in great difficulty, such as the Grenoble clinic in 2020”he wrote.

Be that as it may, this affair is causing a stir at the political level. Christophe Ferrari, the president of Grenoble-Alpes Métropole (the Grenoble urban community) says he fears that “Bernard Bensaid comes to the clinic to find enough to finance his sprawling group, I was even going to say his empire”. Last year, the president of the agglomeration had joined an appeal filed by the unions to have the sale of the clinic to Bernard Bensaid canceled (see note at the bottom of the page). Christophe Ferrari is now in contact with other heads of local authorities who are in conflict with the boss of the Avec group in Savoie and Metz in particular.

*The unions FO, UNSA and CGT, as well as associations of inhabitants, the city of Grenoble and Grenoble-Alpes Métropole had seized the judge in chambers to obtain the cancellation of the sale of the clinic. They were dismissed at first instance (November 10, 2021) and on appeal (June 7, 2022). The judge returned the case on the merits. The hearing will take place in several months.