2023-11-04 05:24:22
The Echo Survey
Every year, L’Echo delves into the accounts of Brussels and Walloon hospital institutions. And tells you everything about the health of your hospital. Follow the leader.
This is a habit that dates back to 2018: inspecting, each year, the financial data, from the annual accounts and management reports, of the 37 Brussels and Walloon hospitals – some of which have several locations, brought together under the same dome. While taking, in passing, a look at the Flemish situation. We focus on general hospitals, leaving aside psychiatric or specialized institutions. The objective? Monitor the financial health of an essential sector yet in perpetual crisis, in order to monitor its evolution.
As you don’t change a winning team, we’re back on track, with the 2022 season in our sights. The first year since 2020 to no longer really be marked by the coronavirus, even if the latter is still coupled with a financial unknown, which should be lifted in 2024.
That being said, a year without a pandemic is not necessarily easy. It was written in the stars: the energy crisis and galloping inflation have seriously damaged hospital finances. The future does not necessarily look more rosy, while the question of pensions for statutory agents is becoming more and more threatening. Come, we’ll explain all this to you.
Discover the main lessons below.
On the Loup…
The highest profit margins over 5 years 1. Mouscron hospital center 3.30% 2. Grand Hôpital de Charleroi 2.07% 3. Notre-Dame de Grâce Clinique 1.94% 4. CHR Verviers 1.70% 5. Tivoli University Hospital 1.68%
Lowest profit margins over 5 years 1. Jules Bordet Institute -10.28% 2. Reine Fabiola Hospital -7.05% 3. Brugmann University Hospital -3.47% 4. Sankt-Nikolaus Hospital -3.43% 5. CHR de la Citadelle -3.16%
The highest debt ratios 1. CHU Brugmann 64.16% 2. CHR Huy 61.45% 3. CHU Tivoli 60.15% 4. CHU Ambroise Paré 56.95% 5. Institut Jules Bordet 55.89%
TEACHING 1
2022, worst vintage of the decade
For months, this has been the fear: that the pandemic will wipe out already shaky hospital finances for good. Thanks to the support of the authorities, this was not the case; however, the calculation of what Belgian hospitals will have to reimburse the State will be drawn up in 2024. It is almost ironic: this is the year during which covid almost relaxed its grip on healthcare institutions that their accounts drank the cup.
Turnover is not in question. Continuing its quiet increase (+6.67% over one year), this stands at 10.87 billion euros. No, it’s the current result which literally plunges, ending in the crimson, to the tune of 203.45 million (-10.518%). Enough to sign the worst exercise, as far back as our data goes (2012). Not only is the profit margin of Brussels and Walloon hospitals in deficit in 2022 (-1.87%), but it is also negative over the last five years (-0.57%).
In total, 67.57% of institutions made a loss last year – a proportion which rises to 90.91% in Brussels! Over the last five years, “deficit” has been the key word for just under six hospitals out of ten (56.76%). A slightly more marked finding in Brussels (63.64%) than in Wallonia (53.85%). Ultimate proof that 2022 was a disastrous year: even Flemish hospitals, usually with a slight bonus, posted a negative result, to the tune of 30.34 million. A first since at least 2012.
TEACHING 2
Inflation and energy crisis have been there
Your wallet still remembers it. War in Ukraine obliges, 2022 is the year when the energy bill skyrocketed. There is no reason why this phenomenon should have spared hospitals. Who also fear that, if the fever has subsided a bit, energy prices will never return to the level they were in 2021. The sector has taken its accounts in 2023: on an annual basis, the painful is increased by 367 million euros compared to 2021. Suffice to say that the 80 million released by the Federal government for the first half of 2023, and not renewed since then, will hardly be enough to wipe the slate clean.
One crisis fueling another, inflation also reared its ugly head in 2022, driving all costs upwards and triggering the famous Belgian indexation mechanism. Would hospitals be at the mercy of salary increases? Partially, because their revenues follow, but lag behind. Especially on the side of fees, which were increased by 2% in 2022, while inflation tickled the 10% mark. Of course, the January 2023 indexation already looked better (around 8%), but it was only catching up, without filling the hole – what was “lost” in 2022 is lost for good . Nor anticipate the increases occurring in 2023.
TEACHING 3
The next crisis already has a name: pensions
This is a file that is nothing new. But which, as time passes, becomes more and more complicated, to the point of donning the role of star in the department of concerns expressed by management reports or the prose of reviewers relating to the 2022 vintage. what does it return? From the pension of appointed agents, within public hospitals therefore, but also from the private sector, if there has been a merger with a public institution in the past or if staff from CPAS are made available.
The basic problem, which arises in the same way for all local authorities (municipalities and provinces in the lead), is simple – if we ignore the details which are overlooked. In this statutory system which is separate and does not concern contractual staff, the contributions of active people, who are becoming fewer and fewer in number, are no longer sufficient to finance those of retired people.
For the hospitals concerned, the gap to fill is estimated at 203 million for 2024 and is likely to widen further. Since it concerns all local administrations, hospital federations are calling for a global solution to be found. In other words, that its resolution does not weigh on the health care budget, already under pressure.
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