Public hospitals are not so bad, that is the situation of their banks might damage. That, in broad strokes, the picture painted in its annual rating … by Dexia Credit Local, former first sector bank being dismantled.
The deficit in French hospitals reached 220 million euros in 2010. That sounds a lot but the amount represents only 0.3% of their budgets. Excluding appendices generally accounts surplus – long stay, retirement homes, nursing schools, real estate … – care, "heart-to" hospitals, loses 470 million (0.8% of budget). A stable amount of improvement after two years. 2011 should be in the same waters: a somewhat wider scope, including both private non-profit institutions, the government announced an initial estimate of 504 million deficit, against 508 million in 2010.
These figures make it unlikely that the return to balance this year, wanted by Nicolas Sarkozy. However, they reflect "the efforts by hospitals to control their staff costs," says Claire Bouinot, Dexia Credit Local. Because their revenues have increased by only 2% in 2010, the lowest increase for over ten years. Moreover, 300 hospitals "only" are in deficit (-600 million euros), others are in balance or in surplus (380 million).
The year 2010 also marks a break: after a decade of growth, investment by hospitals fell almost 5%, to $ 6.5 billion. They are expected to decline again in 2011 and slightly more strongly in 2012 payday loan. The 2007 Hospital Plan which, in "looping" financial arrangements with state subsidies, led to the partial solution to the obsolescence of French institutions, has expired. It "does not appear in the same volumes relayed by the Hospital Plan 2012", Claire Bouinot analysis.
But above all, co-financing of investments by banks, which was almost closed eyes until 2008, has become extremely difficult. Not that the banks fear increased risk: 24.1 billion, the debt reached "6.2 years of cash flow, a normal level," says Andrew Baker, director of studies of Dexia Credit Local.
But Dexia, precisely, which gave almost half of the loans to hospitals, this activity has slowed since 2008 and early 2012 has completely frozen, waiting to know his fate. And "among our competitors in the public sector, foreign banks have disappeared, savings bank, Credit Mutuel, Crédit Agricole and Societe Generale reduce the wing," says Andre Boulanger. Standards requiring them to strengthen their balance sheets and low earnings generated by public clients explain this decline.
Nothing serious immediate for most hospitals, which merely postpone investments. But much more worrying a small minority of them, including fifty hospitals "in a particularly difficult situation, where the operation consumes cash instead of generating," pointed to by Claire Bouinot.