Opinion | Law introducing a minimum number of carers per hospitalized patient: a false good idea … unfunded, with no available staff, and which also reinforces the antagonism between clinics and hospitals.

Publication of law no. 2025 – 74 of January 29, 2025 concerning the introduction of a minimum number of caregivers per hospitalized patient: a false good idea … unfunded, with no available personnel, and which also reinforces the antagonism between clinics and hospitals.

by Bruno Lorit, partner in Healthcare & life sciences 

Independently of the creation of safety ratios enabling certain care activities to be subject, by decree and for a period of five years, to specific operating conditions required for the reception of patients, the law above all introduces quality ratios by stipulating, in particular, that in order to guarantee the quality of care and conditions of practice, a minimal ratio of carers per open bed or per number of passages for outpatient activities is defined for each specialty and type of hospital care activity.

This ratio, which takes account of the burden of care associated with the activity and may distinguish between needs specific to the specialization and size of the establishment, is set by a decree, issued after consultation with the Haute Autorité de Santé, for a maximum period of five years.

Conversely, and assuming that funding is implicitly provided for in or outside the law, how can the private sector accept having been excluded from a scheme to improve patient care?

To sum up, either no funding is expressly or implicitly provided for, and the obligation of quality ratios, without funding and without additional human resources, will further worsen the situation of hospitals. Or, if funding is provided, the imbalance with the private sector will once again become apparent.

In either case, hospitals and clinics will be the losers.

Finally, those who wish to take a closer look at this strange law should read the parliamentary proceedings, which explain that the exclusion of private clinics is justified by the need to take account of on-call duty and continuity of care imposed on hospitals, even though… continuity of care also applies to private clinics, as do on-call duty when they are responsible for receiving emergency patients.

But above all, the fact that the system does not apply to private clinics is justified by the fact that the latter have sufficient resources to recruit staff, as illustrated by the situation of… the American Hospital, i.e. a clinic that has not signed an agreement to provide hospital care!

A more subtle caricature of the private sector…