Bastia and Ajaccio Hospitals Annually Lose €10 Million to Unplanned Staff Days Off

Ten million euros. That is the amount the Ajaccio and Bastia hospitals spend each year on days off that the law simply does not provide for. The finding comes from the Court of Auditors itself, backed by the work of the Corsican Regional Court of Auditors, in a chapter with a blunt title: “The Ajaccio and Bastia Hospitals: A Financial Situation Compromised by an Increase in Personnel Costs Not Linked to Activity.” This document was made public on February 8, 2017, as part of the financial jurisdiction’s annual public report.

The mechanism is contained in a handful of budget lines, but its impact is colossal. Between 2010 and 2015, absenteeism rose by 27% at Ajaccio hospital and by more than 100% at Bastia. This surge is not accidental: in both establishments, it is accompanied by a parallel leave system, created locally, without any regulatory basis.

Des jours de congés sortis de nulle part

The principle of the public hospital service is, however, straightforward: a national framework fixes the number of days of rest, identical for all workers in the country. In Corsica, the two hospitals have taken some liberties with this principle. Additional leave days are granted “outside any regulation” to hospital staff: six at Bastia (including two for local holidays) and five at Ajaccio (three for the building’s age, one for Pentecost Monday, one for a local holiday). Aging buildings, patronal holidays, regional holidays: as many motives that do not exist in any legal text applicable to all French hospitals.

The calculation of working time itself has been generously interpreted. The counting of breaks, meals, dressing and undressing as work time results in the loss of the equivalent of 32 full-time positions at Ajaccio hospital and 58 at Bastia. In concrete terms, this means that dozens of positions funded by public money do not correspond, on paper, to any real patient care activity. A bookkeeping absurdity, coupled with an organizational absurdity in departments already under strain.

Un absentéisme deux fois supérieur à la moyenne nationale

The second pillar of the problem is absenteeism. Not the occasional and legitimate absence due to illness or maternity, but structural absenteeism that has weighed on care organizations for years. National statistics for the public hospital sector show an absentee rate for non-medical staff of 7.9% in 2014 (7.71% for Bastia hospital), 8% in 2013 (8.23% for Bastia) and 7.39% in 2012 (7.60% for Bastia). These figures, already high compared with other parts of the public sector, hide a trend that is even more worrying over time.

The two hospitals have seen a significant rise in absenteeism, excluding maternity, paternity and adoption leaves, rising between 2010 and 2015 from 33,882 days to 43,229 days at Ajaccio hospital, i.e., 210 full-time equivalents, and from 20,625 days to 41,352 days for Bastia hospital, i.e., 201 full-time equivalents. More than 400 full-time positions, across the two establishments, are mobilized each year to compensate for absences. A figure that makes one’s head spin when one considers that these hospitals already struggle to recruit doctors on an island renowned for its lack of medical attractiveness.

The staff demographics partly explain this drift. The aging of teams weighs heavily, with a marked gap between age groups: employees over 55 absentee themselves significantly more often than those under 40. But age is not everything. The Corsican Regional Court of Accounts also points to organizational rigidities, failing management, and an almost total lack of control over the employees’ time counters.

Dix millions d’euros financés à crédit, par des hôpitaux déjà exsangues

Here lies the paradox that makes this matter particularly shocking. These largesses are not funded by a providential budget surplus. They are funded by medical temporary staff, overtime, and cascading replacements, even as the two facilities have run massive deficits for more than a decade. All these exemptions together account for 4 million euros per year for the Ajaccio structure, and 4.4 million at Bastia, a total that approaches 10 million euros annually once other exemptions concerning working time are included.

The circle is vicious. The higher absenteeism climbs, the more the hospital must rely on external reinforcement, often billed far more than a regular, permanent position. As off-schedule leave days accumulate, schedules tighten, and the use of medical temporary staff becomes the adjuster. A circle that the Court of Auditors, as early as 2017, urged to break by simply ending the additional leave days.

This mechanism is far from incidental given the financial trajectory of the two establishments. Bastia’s hospital center saw its annual deficit quadruple in a few years to exceed 21 million euros, a figure that climbs to nearly 39 million once health agency cash-flow aids are neutralized, according to a more recent Corsican Regional Court of Auditors report dedicated specifically to that facility. Cumulative deficits, meanwhile, approach 200 million euros. Hard, under these conditions, to continue distributing days off that the law never allowed.

Almost ten years after the first warnings from the Court of Auditors, the question remains: how long can a regional hospital system sustain itself by funding on credit advantages that do not exist anywhere else in France? The Corsican Regional Court of Auditors continues to document, hospital by hospital, what Corsican public finances pay each year without objection.

Sources : oeil.europarl.europa.eu | assemblee-nationale.fr | corsenetinfos.corsica