The French (dis)connection

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  • 03/27/2009
The keyword: don’t ever go to hospital. Much as the French will prance about the superior quality of their health system, the facts are increasingly unfavourable in terms of public provision.

To witness, check  “The black book on hospitals” (Livre noir des hôpitaux, Calmann-Lévy 2009) which enumerates an awful range of black spots, mishaps and tragic deaths of patients who nevertheless had full faith in the French model and universal care.

That figures; what about statistics? Try this one for size: on average 40 deaths every day, in terms of “undesirable events”. Obviously this figure covers more than people dying from medical errors, negligence and other mistakes in the hospital environment. The ballpark ranges from 350,000 to 460,000 deaths annually for hospital stays, of which some 120,000 to 190,000 might have been avoided, according to the authors.

Anecdotal evidence attests that astonishing number of physicians in the (public) hospital environment are either alcoholics, drug addicts or afflicted by some mental disorder. For obvious reasons, no statistics on this scandal are readily available; but how come these people, albeit hopefully a minority, are still allowed to practice? (Just imagine having surgery by a psychotic doctor!)

The primary reason is simple: hospital doctors (or nurses) are government employees and thus enjoy life-time employment. Any private company would try (with difficulty but still) to fire such people, especially in view of their life-or-death responsibilities.

France retains the advantage of a relatively dynamic private sector; but although private clinics are a lot more efficient and benefit from a much lower budget, they are under constant political assault. The budget divide is roughly 80/20 in favour of state-run hospitals. Nevertheless, France is world champion of hospitals/clinics per head: one institution per 20,000 people compared to one for 40,000 people on average in Europe.

The private sector has an obligation to perform; this is where most of restructuring has taken place for economic reasons. The public sector has an obligation to ask for greater budgets despite decreasing results.

Cherchez l’erreur.



CMPI

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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