François Fillon: 2.4 billion euros will be set aside for health projects

Politique publique | 31 May 2011
During a speech at the Research Institute against Digestive Cancer (IRCAD) in Strasbourg on Monday 30 May, Prime Minister François Fillon announced that 2.4 billion euros will be ring-fenced specifically for health projects, and e-health projects in particular, via the Investment for the Future programme.
On the subject of health, the Prime Minister said: “Our focus is on modernization and innovation.
We are taking the same approach with our Investment for the Future programme, under which around 2.4 billion euros will be ring-fenced specifically for health projects.” This investment will enable progress to be made in a variety of sectors, including e-health.

“What we are seeing here is the significance of the €35 billion Investment for the Future programme undertaken by the president and the government,” he added, highlighting the success of the minimally invasive surgery project led by Professor Marescaux.

“Our health policy is not a burden,” the Prime Minister continued. “On the contrary: it is a resource for innovation, growth, labour market activity and, consequently, jobs.”

Earlier in the day, François Fillon had opened a new building in the Sélestat local hospital, a hospital that has “opted for innovation by joining the vanguard […] of the electronic health record project.”

Full speech

Strasbourg, Monday 30 May 2011

Ladies and gentlemen,

I have not come here to Alsace this afternoon to conduct any minimally invasive surgery, even though I took to it rather well earlier!

I’ve actually come to share a strong conviction with you – and I’m happy to be doing it in the company of Xavier Bertrand and Nora Berra. I’m convinced that our health policy is not a burden. On the contrary: it is a resource for innovation, growth, labour market activity and, consequently, jobs.

And what I’ve seen today, Professor, proves this, because your project, which is at the highest level of international excellence, will attract (and is in fact already attracting) healthcare professionals from around the world, to undergo training in these new technologies.

Your project is based on an alliance between private and public research. As you know, France’s previous private/public research model had certain weaknesses compared to other major developed countries.
All of the local biotechnology stakeholders are involved in this project, working together –
Alsace Biovalley, for example.

It is a project that has strong support among the local Alsatian communities.

It is a project that will have a substantial impact on your region, and its influential effect is something that Philippe Richert values extremely highly.

And more widely, it is a project that will have a positive effect all over France.

The first thing I’d like to highlight is what we can see here – what you’ve just shown us and the interventions we saw earlier – first and foremost, this underlines the significance of the €35 billion Investment for the Future programme undertaken by the president and the government.

Initially, this programme was met with some scepticism.

Of course now, the criticisms surrounding its announcement have been forgotten and everyone is pleased to see that the French government has taken the decision to boost the economy through investment, innovation and support for research.

But I’m sure you won’t be surprised that I would like to say something about the lessons we can learn from these situations.

The way we reacted to the financial crisis, and especially the way we saved our financial system, was harshly criticised.

Now the results are plain to see. The decisions we took were the right ones. France is practically the only country in Europe lending money to its banks at a rate of 8%, which will bring in 2.5 billion euros, while in most other European countries the banks are being bailed out by the taxpayer.

We have chosen to support investment during this crisis, even though many people were demanding we support consumption.

The countries that have supported consumption – I’m thinking of our British friends here – now have weaker growth than us. They are much more indebted than us and, in a way, they have not prepared themselves for the future, because the money they have spent in support of consumption has not been matched in support of investment.

I strongly believe that the Investment in the Future programme illustrates perfectly our effective, sensible reaction to this economic and financial crisis.

No doubt you’ll think I’m being self-congratulatory here, but since I so rarely read anything good about the government in the press, I thought I might as well take this opportunity!

Week after week we see successful projects emerging from this investment programme, and I’d like to highlight something else – the choice we made to use international panels of judges, to apply extremely rigorous selection criteria for projects, based on the views of international, scientific judges. In other words, eliminating any political intervention: taking ourselves out of the equation entirely. Given the situation we are in, with public money so stretched, and global competition so fierce, I believe we made the right choice. And I’d even go so far as to say that this process is something of a cultural revolution in our country.

In the past, we handed out public money to those who demanded it most loudly; we handed out public money after putting in place certain criteria – “redeveloping the country”, it used to be called.

When it comes to research, when it comes to universities, we no longer have the right to do that.

We no longer have the right to do that, firstly, because there is less money to go round; but above all because competition is so stiff that it is vital that public money goes to the best teams – those who are able to stay on top of the pack internationally.

And I can assure you that this is something we will continue to do.

It is no use writing to me to plead the case for projects worthy of inclusion in the Investment for the Future plan, because it is judges who decide now.

And I scrupulously ensure that these decisions are taken by scientists, taken by panels of judges, taken by the people who are best placed to tell us which are the most promising projects.

Therefore, the selection process was extremely demanding, and many high-level projects didn’t make it, but the work was done nevertheless. I want you to know that the work that was done was not in vain, because this process has raised the bar for our entire system.

For the health sector, €2.4 billion has been allocated to health-related projects, plus another €1 billion or so for projects involving health in one way or another.

Behind these figures there are activities, and concrete progress, that we don’t talk about enough.

For example, this investment will enable France to catch up with other countries in terms of establishing large cohorts of patients for epidemiological research.

More specifically, for cancer, three of the ten cohort projects approved will be observing cancer patients in order to improve their treatment, halt the progression of the disease, and improve remission.

The “health and biotechnologies” programme, with an investment of €1.5 billion, will fund the creation of clinical investigation centres, or the production of vectors for gene therapy.

Teaching hospitals, which have been awarded a total of €850 million, will be studying subjects as diverse as rhythmology, cardiac modelling, nutrition, neurosciences and infectiology.

These hospitals will be world-class centres of excellence, just like yours. And they will be at the heart of a renewal of the teaching hospital model used in this country since the decisions taken by Michel Debré in 1958.

Just now we were in Sélestat, and I want to mention it again by way of example.

This is a local hospital engaged in a federative process with neighbouring hospitals in Obernai and Sainte-Marie-aux-Mines.

This is a local hospital opening a new building to improve working conditions for the medical teams, to improve conditions for patients, and to improve the delivery of care.

This is a local hospital that has opted for innovation by joining the vanguard of the national relaunch of the electronic health record project, which is one of the projects being conducted by Xavier Bertrand and Nora Berra.

The result should be better monitoring of patients, a more efficient organization of healthcare, and greater coordination between community medicine and hospitals.

The future also lies in e-health. From the most advanced, high-tech medicine to community medicine.

It is an area where in the past we may have lagged, but we’re now catching up.

The law of July 2009 established a legal framework for e-health. The Shared Healthcare Information Systems Agency has just allocated €18 million. The foundations have been laid and we are now going to intensify our efforts.

In the next few days we will be presenting our strategy for the development of e-health, to improve the coordination of national and local initiatives emanating from the stakeholders – in the community and in hospitals – as well as elected representatives.

The e-health component of the Investment for the Future programme is well underway. The first call for tenders was launched in January, with €10 million made available for projects relating to health and autonomy in patients’ homes via digital technology. And a second call for tenders worth €30 million will be launched imminently.

Last March, we allocated €1.4 billion to the National Fund for the Digital Society.

Through this fund, the state will be able to invest in companies of all sizes, and make the most of the potential for growth and innovation in this sector. We are already seeing the emergence of projects on the medical imaging treatment chain, on clinical diagnostic tools and on virtual simulation tools.

The introduction of new technologies to the health and medico-social sectors has a cross-disciplinary aspect which I think is very important to emphasize, because we can no longer restrict ourselves to the compartmentalized approach that has prevailed for too long; it has revealed its limits, and unfortunately has had some extremely negative effects on the quality of care provided to the most vulnerable people in society.

The establishment of the regional health agencies was a major milestone in breaking up the institutional model of the past. But now we have to go further, into the substance of healthcare – patient treatment.

This is the president and government’ main concern, which is why we have undertaken the mammoth task of reforming the healthcare system and dependency within it – a large-scale project led by Roselyne Bachelot.

I’m convinced that if we are to respond effectively to the challenge of the ageing population, it is absolutely vital that we use the resources offered by technology, for the benefit of both the most advanced high-tech medical treatment and local care provision.

In essence, we are looking at a new economic and social sector.

We are looking at a new, more autonomous society.

The challenge of the ageing population should not be perceived merely as a constraint. It is a challenge that harbours potential for growth and jobs, which we absolutely must not let slip.

Our fellow citizens attach great importance to the quality of their healthcare system. On the whole, they have a high level of trust in our healthcare professionals.

Some major public health projects have been launched by the president: the Alzheimer’s plan, the cancer plan, and the national palliative care development plan.

We are endeavouring to respond appropriately to the new risks and new vulnerabilities we face.

But we have to be aware of the challenges. The finances of the national health insurance fund and our level of public debt are forcing us to adapt and work harder.

Of course we could just ignore what’s going on, put the problem off for another day...

As others have done before us!

We could always resort to the most common solution – tax rises...

But we refuse to do that, because we won’t find sustainable solutions to guarantee the continuity of our healthcare system, or guarantee our system of social solidarity, by strangling our economy.

Our focus is on modernization and innovation.

On quality, security and efficiency in the healthcare system.

And it is by focusing on these things that we will find the financial and economic resources
we need.

This is the purpose of the law on hospital reform and on patients, healthcare and the regions, which is now a reality. We can see it here in action, in Alsace. The new hospital governance bodies are in place. The regional conference on health and autonomy has been established. The regional associations of healthcare professionals have been elected. The multidisciplinary health centre projects have begun. The regional health project and the local contracts are in preparation.
The process of reinforcing inter-institutional cooperation is underway: just look at the regional community hospital projects in Mulhouse, southern Haut-Rhin and northern Bas-Rhin.

Finally, I’d like to add that the Hospital 2012 plan is producing concrete results; one example is the idea of pooling operating theatre suites, which is currently being put into practice in the teaching hospitals of Strasbourg.

From a budgetary point of view, the indicators prove that ours is a responsible position to take.

In 2010, expenditure on the health insurance fund strictly complied with the forecasts passed under the Social Security finance law.

You’re probably thinking that’s the least of our worries...

But it was the first time that this had happened since 1997!

And it is very important that the measures we take lead to the results we want to achieve; otherwise we have to find new measures, new methods, new ways of doing things.

We are going to pursue this course of action. We’ve just received the first indicators for 2011 and they confirm that we are on the right track. The objectives of the deficit conference of May 2010 should be met again this year.

But we know that we will have to go further to guarantee the sustainability of our solidarity policy over the long term.

And this is the reason why I asked the Economic, Social and Environmental Council to examine our system of social protection, and particularly the issue of the balance between basic and supplementary medical coverage.

We cannot proceed with the modernization of our healthcare system without the full support of our healthcare professionals.

We have faith in them, and we are listening to them.

The protocol of 2 February 2010 enhanced the status of the paramedical professions. We have enhanced the status of general medical consultations.

We will be going even further with the Community Medicine project. We want to restore confidence in community medical practice and we are aware that the problem of areas with low levels of healthcare provision cannot be resolved without consultation.

Through the public service employment contracts, we have already enabled 200 medical  students to receive grants in exchange for jobs in areas with low population density.

We have launched the 250 Health Centres programme in rural and deprived areas.

We will continue to reinforce these types of incentives, so that every single person in the country can receive treatment from top-class healthcare professionals without us having to resort to methods that are too coercive or too extreme.

Via the parliamentary bill on hospitals tabled by Senator Fourcade, we will be giving an added boost to community medicine and outpatient treatment in general, and this is how we will solve the problems of civil liability for the healthcare professions, which do not yet have sufficient guarantees.

Ladies and gentlemen,

For the last four years we have been trying to reform the country, and we are doing it together.

What I mean by that it is, contrary to what people often say, the French are not conservative.

More often than not they support a movement, they adapt, they invest in it.

The action we have taken comes from a conviction that, in our globalized world, a great country is a country that fights to defend its level of economic competitiveness, and one that is in control of its public finances.

We have reformed our retirement system to ensure its continuity, and we are currently considering solutions to respond to the challenge of our ageing population.

We have thrown our weight behind our higher education system, behind research and innovation – an ambition I believe has no equivalent in our recent history.

The economic crisis of 2008, mentioned just now by Mr Fradin, which has put pressure on the banking system – something we are trying to minimize as far as possible – is a very interesting example of the paradoxical situation we are in, because after the financial crisis everyone said: “Never again, the banks are badly run, they’re taking unacceptable risks and we have to put systems in place to prevent this from ever repeating itself.”

So we put systems in place to prevent this from ever happening again and now people are telling us: “There are too many guarantees and you’re going to destroy lending by making it too expensive”.

Therefore, we have to find the right balance; but crucially, this also means that, before we rubbish
a system when it is in crisis, sometimes we need to think twice.

In any case, the economic crisis has not steered us off the course we are taking.

We have sought to recover from the crisis from the top down.

We have sought to recover from the crisis through investment and reform.

And our efforts are now paying off.

Growth has returned and the French economy has started to create jobs once again.

Of course we are very much aware that, once we are out of this crisis, competition between nations will be no less fierce than before – in fact it will be even fiercer than before because, as in all crises, some countries which were historically strong have been weakened, while others, which were enjoying strong growth, have benefited from the crisis and risen higher in the rankings.

The global power map has now been redrawn.

And we are seeing new countries with aspirations to dominate. In this context, can we maintain our high standard of living, and can we maintain our high level of social protection?

We know that our high standard of living and high level of social protection are not set in stone, and that it is better to step back and take stock of the upheavals rather than harbour any illusions.

But at the same time, I’d just like to say that realism and hope are not mutually exclusive, and nor are willpower and clarity.

The new world currently taking shape will offer a wealth of opportunities for creativity, reflection, research, training and expertise. And these are not concepts that are alien to us.

And if we are careful to rely on our assets, our destiny will remain in our own hands, we will preserve our social pact and stay at a level that is in keeping with our fine history.

We have the resources to be the best in many sectors. This is what we are seeing here now in Strasbourg: French medical research, supported by a strong political will, proving that excellence can be maintained and renewed.

And Mr President, I’d like you to know that this is a great symbol of hope for me, as head of the government, to have witnessed today the very best of what France has to offer the world in terms of excellence and success.