english.prescrire.org > Positions > Access to healthcare > A hospital is more than just a business

Theme: Access to healthcare

Providing quality healthcare for all is one of the most pressing challenges facing every nation on earth today. The need to reconcile quality of care with availability concerns citizens, policy makers, regulators and healthcare professionals alike.

A hospital is more than just a business

Hospitals play a fundamental role in society, providing care for even the most disadvantaged. Recent years have seen French hospitals move away from the aim of trying to balance their books to that of making a profit. But hospitals should be there not just to dispense technical care but to take care of people.



Recent years have seen French hospitals move away from the aim of trying to balance their books to that of making a profit. Furthermore, a new funding formula has been introduced, the "T2A" ("tarification à l'activité"), which ties funding directly to delivery of medical acts. France's National Consultative Council on Ethics has opposed this shift, for ethical, economic and social welfare reasons.

Hospitals play a fundamental role in society, as a fully accessible public service providing care for even the most disadvantaged. They have a multiple remit, both current and evolving, which is not just to provide technical "care" but also to "take care of" people. But the T2A tends to downplay taking care of patients in favour of delivering technical care. Thus devalued, care-taking activities tend to dwindle, through lack of time and resources. This results in inadequate care that bears no relation to patients' real needs.

Talking to patients is part of providing medical care. Managing a hospital as if it were a business just like any other, and cutting personnel costs to pay for expensive technical "innovations", comes at the expense of both health and human wellbeing.

©Prescrire 2008

Source: "Hôpitaux : pas de gestion sans éthique" Rev Prescrire 2008 ; 28 (292): 133.