The director of the loss-making Freiburg hospital sounded the alarm: “The healthcare system is in danger of hitting a wall.”

class = “sc-cffd1e67-0 fmXrkB”>

“A loss of four million francs in 2022; this is our best result since 2015,” says Marc Devaud (60), head of the Cantonal Hospital of Freiburg, from the very beginning. The conversation with Blick revolves around financial problems and health policy restrictions facing hospitals.

Devaud welcomes Blick together with Chairman of the Board of Directors Annamaria Müller (58). Romani- and German-speaking Swiss are senior managers of the HFR hospital group, which covers several parts of the hospital, and represent another challenge the group has to deal with in the bilingual canton.

But let’s get back to the losses first. Things look much less rosy for 2023. The budget deficit is 28 million francs, and there is a risk of deficit for 2024. A perfect financial storm has brewed over HFR: “We are in a much worse situation compared to other hospitals,” says President Müller.

The canton has a say

The hospital is trying to do this right. The group is concentrating its acute inpatient services and interventions at the cantonal hospital in Freiburg, reducing this offer at the Meyriez-Murten, Riaz and Tafers locations and converting them into health centres.

Emergency stations outside the main location have already been closed and replaced by emergency services (permanent). An emergency center in a medium-sized canton housing around 300,000 residents – this should actually be enough.

But the hospital group is getting nowhere. Without even a single patient receiving additional treatment, costs increase. An example: Staff are subject to cantonal salary regulations and benefit from a generous cost-of-living adjustment.

“Last year alone we had to spend an additional 13 million francs,” says Devaud. “We try to work as efficiently as possible, but this becomes difficult due to externally imposed regulations.”

Since HFR is a publicly traded company, the hospital does not have an independent compensation policy. “When we wanted to change this in 2018 to have more entrepreneurial freedom, the staff went on strike,” explains Devaud.

Additional costs due to IT

Besides rising wages, there is also inflation and the IT issue. “The cantonal IT department no longer wants to be responsible for us,” explains the hospital director. “It was too complicated for them to work with the hospital.”

Problem: In a hospital, as in most companies, software cannot be updated overnight. The operation takes 24 hours, patients also need to be cared for and emergencies need to be treated at night.

Result: HFR now needs to look for a dedicated service provider. “It will cost us six million francs this year and next year,” Devaud calculates. “This is a big investment for us.”

Fears in the population

The director’s conclusion is sobering: “Every time we think we’ve got our heads above water, a new challenge presents itself.” Result: The gap in the hospital bill is getting bigger and the debt to the canton, which pays the gap every year, continues to increase.

“We are in a difficult situation,” says Devaud. “We try to work as efficiently as possible, but at the same time our hands are tied by many requirements.”

President Müller adds: “How can we work more entrepreneurially if every change raises the fear of a wave of privatizations or layoffs?” In the canton of Fribourg you have to take into account many more things than in other cantons.

This becomes clear in emergency planning. HFR had to quickly abandon its plan to reopen the emergency station in Tafers after Corona; because only the main center treated emergencies, and not just for economic reasons: “Despite a long search, we could not find personnel for this,” says Müller.

No chief physician wants to work in a small place with few emergencies. “And you can’t manage an emergency around the clock with just junior doctors.” But some part of the population does not care about this. A popular initiative aims to force the reopening of all emergency locations.

Director’s warning

Hospital management now needs to explain to the public why it is more efficient to operate the emergency organization only at the main location. At the same time, on the same voting weekend next year, additional money of up to 185 million is requested from the public to guarantee the necessary investments for ongoing operations and to advance the planning of a modern hospital center at the main location. A task close to the square of the circle.

“The population is finding it increasingly difficult to understand our healthcare system,” says Director Devaud. “The entire healthcare system is in danger of hitting a wall,” he warns. This means that the worst situation can only be prevented if the entire system finally takes action.

Source :Blick