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Doctor’s sacking is setback for French public health, supporters say

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c711 (Published 09 February 2010) Cite this as: BMJ 2010;340:c711
  1. Paul Benkimoun
  1. 1Paris

    A high profile expert on public health, Alain Braillon, has lost his position at the University Hospital of Amiens, Picardy, in a move that public health doctors fear may become more frequent because of a new hospital payment system.

    Public hospitals in France now have to comply with what is called “T2A,” which stands for “tariff by activity,” under which hospitals are funded per activity carried out. Health experts point out that time consuming public health interventions are therefore less rewarding for hospitals, particularly in the short term.

    François Bourdillon, chairman of the French Public Health Society (Société Française de Santé Publique), said, “This is the first case of the sacking of a public health expert that I have heard of. Public health activities in university hospitals are vulnerable because of the logic of ‘tariff by activity.’ Such activities do not make money flow in, and they weigh on the hospital finances as a whole. Hospital directors and chairmen of hospital boards ask us: what is the added value of your position? If the medical community …

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