La Story (Les Echos) Analysis: French Hospitals Struggling with Heatwaves, Debt, and Payment Delays

▶ Original episode: https://shows.acast.com/la-story/episodes/canicule-dette-delai-de-paiement-lhopital-en-surchauffe

July 20, 2026

Overview

This article provides an analysis of an episode of the daily podcast La Story, produced by the French business newspaper Les Echos. This episode covers the multifaceted crisis facing the French hospital system: the strain on medical facilities due to intermittent heatwaves (canicule), the deepening fiscal deficit, and payment delays to suppliers.

Pierrick Fay hosts the program, with Solène Poulenac, who covers the medical sector for Les Echos, providing the analysis. France has experienced heatwaves for over a month and a half, leading to an increase in emergency room admissions, while many hospitals are suffering from high temperatures in patient rooms and corridors, creating harsh conditions for both patients and medical staff.

As an emergency response, the government is investing 100 million euros (approximately 18.57 billion yen, calculated at 1 euro = 185.70 yen) to deploy 30,000 portable air conditioners, but this is merely a stopgap measure. More fundamentally, hospital fiscal deficits have accumulated, with problems erupting in the form of unpaid taxes and social security contributions, as well as payment delays to business partners.

The background includes structural factors such as insufficient compensation for salary increases implemented as part of COVID-19 countermeasures, rising costs due to inflation, and delays in resuming activities. With the government nearing the end of its term, drastic measures are difficult, highlighting the inability to address the "taboo" of restructuring the hospital system.

Hospitals Facing the Heatwave

In the summer of 2026, France experienced intermittent heatwaves, with temperatures reaching 39 degrees Celsius in Tulle on July 20. Serious cases have been reported at the local hospital's emergency room, including a 91-year-old man who was admitted unable to speak due to hyperthermia.

According to Poulenac, because heatwaves lead to an increase in emergency room admissions, hospitals have entered a state of alert known as the "Orsan 3 Plan," which involves postponing elective surgeries to ensure capacity for incoming patients. This alert status remains in effect.

While intensive care units have not yet reached saturation, many wards are near capacity. A more pressing issue is that patient rooms are exposed to high temperatures, and medical staff are working in the same intense heat as many other French citizens. Patients are being admitted one after another in these conditions. Excess deaths due to the heatwave have been confirmed, but the exact death toll is not yet known.

Emergency Response Regarding Portable Air Conditioners

In response to this situation, the government has indicated its intention to invest emergency funds. The plan involves purchasing 30,000 portable air conditioners with a budget of 100 million euros (approximately 18.57 billion yen).

Minister of Health Stéphanie Rist explained on July 10 that 7,500 air conditioners had already been delivered to medical and welfare facilities and nursing homes for the elderly, and stated that 15,000 units were scheduled to be delivered by July 15, with the full 30,000 units expected by early August at the latest.

However, these are merely temporary cooling measures and are only an emergency step to get through this summer. It is important to note that this is not an investment to equip all facilities with air conditioning over the coming years.

Heatwave countermeasures have also become a political issue. On July 16, regional councilor Laurent Wauquiez delivered three portable air conditioners to a hospital in Vienne and promised that the region would eventually purchase 1,500 units. He stated that 1.5 million euros (approximately 278.55 million yen, calculated at 1 euro = 185.70 yen) would be invested to deploy the first 150 units, aiming to secure strategic stock. Hospital operators are also proceeding with purchases without waiting for the government's plan, with the Assistance Publique – Hôpitaux de Paris (AP-HP) ordering 1,800 units during the initial phase of the heatwave.

Long-term Adaptation Requires Massive Investment

For hospitals to adapt to climate change in the long term, massive investment is required, as requested by the French Hospital Federation. At a press conference, the federation called for the creation of a "Green Fund" worth 5 billion euros (approximately 928.5 billion yen, calculated at 1 euro = 185.70 yen) over five years for building renovations.

According to the federation's secretary-general, many hospitals were designed based on the climate of the 1980s, and adaptation is an urgent necessity. The government has also indicated a policy of allocating budget specifically for this issue. The government explained that it has invested over 10 billion euros (approximately 1.857 trillion yen, calculated at 1 euro = 185.70 yen) in hospitals since the pandemic, and that 40% of hospitals have been "cooled" since 2003.

However, the hospital building stock is vast, and official reports have pointed to a certain level of aging. Even in recently renovated or newly constructed buildings, extreme heat like this was not necessarily anticipated. The lack of a comprehensive diagnosis regarding the state of hospital real estate assets also makes responding to the situation difficult.

In the long term, the French Hospital Federation is calling for 7 to 9 billion euros (approximately 1.2999 trillion to 1.6713 trillion yen, based on an exchange rate of 1 euro = 185.70 yen) annually for asset maintenance, equipment modernization, and the sustainable adaptation of hospitals and nursing homes to climate change.

Accumulating Fiscal Deficits and Unpaid Taxes and Social Security Contributions

This need for investment arises in the context of a significant deterioration in the financial condition of hospitals in recent years. Deficits widened after the pandemic, and most recently, the total cumulative deficit across all facilities reached 2.7 billion euros (approximately 501.39 billion yen, based on an exchange rate of 1 euro = 185.70 yen). Although this is a slight improvement from the 2.9 billion euros (approximately 538.53 billion yen, based on an exchange rate of 1 euro = 185.70 yen) of the previous year, the situation remains dire. Even a government-commissioned study has described the severity of the financial situation as "unprecedented."

In addition to the accumulation of deficits, hospital debt is also ballooning. In particular, unpaid taxes and social security contributions exceed 2 billion euros (approximately 371.4 billion yen, based on an exchange rate of 1 euro = 185.70 yen). Hospitals are obligated to pay taxes on salaries and insurance premiums for staff pensions, but these are not being paid on time, piling up as debt to pension funds. Along with payment delays to suppliers, these are nothing more than symptoms of the extreme financial strain on hospitals. Hospitals lack sufficient funds, and payments are frequently delayed.

Why Post-Pandemic Support Measures Are Not Effective

After the pandemic, the government invested large sums of money to support the hospital sector, starting with a 1.9 billion euro (approximately 352.83 billion yen, based on an exchange rate of 1 euro = 185.70 yen) plan known as the "Ségur de la Santé" (health sector labor negotiations). In particular, improvements were made to the salaries of hospital staff.

However, according to Mr. Purnac, although hospitals raised staff salaries as requested, the increased burden was not fully compensated by the state. Salary increases were implemented in stages, and the process of reflecting decisions made in Paris at the local and operational levels was not easy.

In addition, strong inflation occurred after the pandemic, causing hospital expenses to surge while the resumption of activities was delayed. Staff absenteeism and the postponement of surgeries overlapped, leaving hospitals busy dealing with delayed medical care. Hospitals describe this situation as a "scissor effect." The result of several years of surging expenses and sluggish revenue growth is the current massive cumulative deficit.

Disparities Between Hospitals and Government Response

However, not all facilities are in the same situation. Reports from the General Inspectorate of Finance and the General Inspectorate of Social Affairs point out that the financial situation is highly uneven. In addition to the structural problem of insufficient compensation for salary increases, there are also differences in management skill.

The background also includes the existence of stagnant departments in rural areas, such as maternity wards shrinking due to declining birth rates or operating rooms with low utilization. When there are multiple hospitals in close proximity in the same region and the population is declining, the very organization of the hospital system is called into question.

As of early 2026, 60% of the outstanding debt for taxes and social security contributions was concentrated in just 20 facilities. It is said that difficult situations can be seen in overseas departments and several hospitals in the Normandy region.

The government's response is in an extremely difficult situation. Having lost its majority, it cannot launch major policies, and the topic of hospitals is extremely sensitive politically. Although instructions have been issued to work with hospitals through Regional Health Agencies to consider reconstruction plans, the reality is that since the term is ending, no fundamental response can be expected. The Inspectorates of Finance and Social Affairs point out that the hospital system needs to be rethought over several years, but reorganization, including the closure of departments, has become a current "taboo."

Payment Delays Hurting Supplier Companies

It is not just the state that suffers from payment delays. Companies that provide goods and services to hospitals are also facing significant delays. An ambulance service provider interviewed by Mr. Purnac spoke of the reality that small and medium-sized enterprises are being hit hard by payment delays. He said that while the situation improves temporarily when they protest, it worsens again after a few months. This is because the hospital's cash flow problem is structural.

Companies have been sounding the alarm for months, and several industry groups have sent letters to the Prime Minister's office. According to the companies' letters, payment delays can reach 200 to 300 days. The legal deadline for hospital payments is 50 days, but according to the research firm Altares, as of May, there were delays exceeding the legal deadline by 25 days. While private companies tend to shorten payment periods, the situation in hospitals is worsening. This problem is occurring in an environment where companies are anxious due to tensions in the Middle East, soaring crude oil prices, and an increase in bankruptcies.

In early June, Senator Olivier Hainaut, representing the north, complained that many hospital contractors in fields such as cleaning, security, and collective catering were on the verge of bankruptcy, pointing out that public hospital debt to suppliers had reached 7.5 billion euros (approximately 1.3927 trillion yen, based on an exchange rate of 1 euro = 185.70 yen).

Amir Reza Tofighi, president of the organization representing small and medium-sized enterprises (formerly CPME, now the "Entrepreneurs' Federation"), is appealing that unpaid companies are on the verge of bankruptcy. There is a growing sense of unfairness that while private companies are sanctioned if they delay payments, the state is not punished if it does not pay. With the General Directorate for Competition Policy, Consumer Affairs and Fraud Control (DGCCRF) strengthening monitoring of companies that do not meet payment deadlines since the beginning of the year, companies are demanding that the state fulfill its responsibility to lead by example.

#France #Economy #LesEchos #FrenchEconomy #Heatwave #ClimateChange #Healthcare #Hospital #FiscalDeficit #PaymentDelay #SME #SocialSecurity #Euro #PublicFinance