Blaye Hospital Center: fragile finances and call for greater energy efficiency
Until 2022, the hospital had managed to maintain positive available savings, despite a tense environment. But in 2023, the situation deteriorated sharply. Net self-financing capacity fell to -€1.8 million, and forecasts for 2024 confirm the continuation of this trend, with an estimated deficit of -€2.7 million. The establishment had to mobilize €3.8 million of its working capital in 2023, and expects another €1.2 million in withdrawals this year. Operating expenses, meanwhile, jumped by €5.2 million in four years, driven largely by personnel costs, up 22% between 2019 and 2023. This trend is explained in particular by the revaluations linked to the Ségur de la Santé (health insurance scheme), the increased use of temporary staff and precarious contracts, but also by persistent absenteeism. Added to this in 2023 was a sharp rise in energy costs, with bills tripling to one million euros. This surge is linked to the renegotiation of the electricity and gas markets, amid soaring prices.
In light of these findings, the Regional Audit Office points to a lack of foresight regarding the energy transition. While the hospital displays intentions in its 2023-2027 eco-responsible project, it has not set any quantified targets for reducing greenhouse gas emissions, contrary to legal requirements. The carbon footprint assessment carried out in 2022 reveals a 5% increase in emissions between 2016 and 2021. The hospital has therefore not yet initiated a genuine energy efficiency policy.
Forced energy sobrietyThe transition plan, although presented, remains largely theoretical. It mentions future actions, such as thermal insulation of buildings, renovation of woodwork, and conducting an energy audit. Only a few one-off projects have been undertaken, such as pipe insulation. The chamber recommends defining a clear trajectory for reducing the carbon footprint and updating the energy performance diagnosis, the last version of which dates back to 2010.
Other levers have been identified. The report suggests better adapting meal tray orders to the actual number of patients present, combating food waste, and recycling biowaste. Measures already initiated in nursing homes could be extended to the entire facility. Finally, the chamber notes that several recommendations made during the previous audit have not been implemented, particularly regarding the monitoring of medical time or compliance with regulatory rates for on-call care. Blaye Hospital also continues to face strained medical demographics. Despite cooperation with hospitals in Libourne and Bordeaux, staffing levels remain too low, particularly in anesthesia and gynecology. The maternity ward, already forced to close occasionally, could be transformed into a perinatal center.
