POLL. In Grenoble, the contested practices of the head of the mutual clinic.

It was last November: an incident”among others”. That night Dr. M., a famous surgeon from the mutual clinic in Grenoble, was on duty. A woman arrives at the emergency room, she has had a heart attack. “It was three o’clocksays richard [prénom d’emprunt]another doctor at the hospital. My colleague was unable to reach the on-call nurse and radio operator who would assist him in the operating room on his business phone. The next day we realized that our general management had cut the SFR lines of all the people on duty at the clinic. Because he thought it was too expensive and he wanted to negotiate the rates. [avec l’opérateur]says Richard.

Fortunately, “The surgeon managed to reach another nurse on his personal cell phone. He was not on call, but agreed to come in the middle of the night.”. This episode has left its mark on the mutualist clinic in Grenoble. Several other employees spoke to us about it and told us about their “incomprehension”.

The head of the Grenoble mutual clinic (or GHM, for Groupe Hospitalier Mutualiste, often called “la Mut”) is called Bernard Bensaid. He is an all-round businessman. At the head of his group of 12,000 employees, which he renamed Avec (formerly Doctegestio), he bought companies in crisis in various fields: tourist residences, nursing homes and, more recently, clinics. This diversification apparently has losses, the net result of the Avec group is in the red: minus 20 million euros in 2021.

It was in October 2020 when Bernard Bensaid bought “la Mut” from the two mutuals that had managed it until now*. Since then, deplore the employees, “It is dangerously cutting costs. We spent fifteen days in an operating room recovery room without an electrocardiogram”Richard says again. “All because I wanted to negotiate a 10% discount on the repair of the device.” This episode was also told to us by another doctor at the clinic.

Richard also claims that a cutting-edge department at the clinic won a research grant of several tens of thousands of euros at the end of 2020. But according to him, the general manager would have needed several reminders to pay them the money for this grant… Eight months later. “For doctors who have taken the Hippocratic Oath, it is very unpleasant and goes against our values. Research money should not be used to compensate for the deficit of a structure or a group, the doctor continues. In the midst of Covid, this man also kidnapped the money from the coercive fines of a certain number of doctors. Letters of claim were necessary to recover that money. And it is public money since it is issued by the Regional Health Agency (ARS).“Other doctors at the clinic told us a similar story. We publish below an excerpt from the letter sent last year to the ARS of Auvergne-Rhône-Alpes by those whose sanctions have not been paid.

Excerpt from a letter sent by doctors from the Grenoble clinic to the ARS, in 2021 (CHRISTOPHE AGOSTINIS / MAXPPP)

An employee describes for her part “maintenance operations” who wouldn’t have “nowhere more or less very late”. He talks about investments, even minor ones, “at the stop”. So an order picker would have waited “several months to have an office” to prepare your orders.

The sum of all these incidents, as well as other more technical contentious issues (regarding the fees of doctors in particular), led the medical commission of the establishment to request on May 9, 2022 the dismissal of Bernard Bensaid from the government of the clinic. This request is not trivial. The medical committee certainly only has an advisory role, but it brings together all the doctors and midwives in the clinic.

Excerpts from the report of the establishment medical commission (CME) of the Grenoble clinic of May 9, 2022. (GERALDINE HALLOT / CELLULE INVESTIGATION DE RADIO FRANCE)

Of the phone lines cut, the devices lost and the coercive fines confiscated, the head of the clinic Bernard Bensaid told Radio France’s investigative unit that “the ARS, which supervises the GHM, has not reported anything negative in the operation of the establishment (…) I will not allow everyone’s work to be dirty with malicious rumors from a very small handful of employees in need of conflict (…) )”. For its part, the Auvergne-Rhône-Alpes Regional Health Agency replied that it was not “not competent for matters related to the internal management of an establishment”.

Bernard Bensaid also assured us, regarding the exclusion request made by the establishment’s medical committee: “It has always been agreed that the deputy managing director that I appointed would be reinforced by a managing director. The job profile should be defined in the coming days”without specifying if he intended to remain the general manager.

But beyond this question of governance, the financial management of the clinic also raises questions. The Force Ouvrière (FO) and General Confederation of Labor (CGT) unions filed a complaint against X with the Grenoble public prosecutor to “illegal interest taking”. Specifically, a service contract signed in 2020 between Bernard Bensaid, the head of the Avec group and… Bernard Bensaid, the head of the clinic (as it should be remembered, he occupies both positions).

In this agreement that we obtained, it is written that the clinic must donate 1% of its turnover each year, or approximately 1.7 million euros, to the Avec group. In exchange, Avec is supposed to send employees from the central office to assist the clinic with human resources, communication or IT services.

Extracts from the agreement signed in October 2020 between the clinic and the Avec group (ex-Doctegestio) (GERALDINE HALLOT / CELLULE INVESTIGATION DE RADIO FRANCE)

Internally, this convention makes people cringe. A clinic employee we met explains: “1.7 million euros per year is the equivalent of sixty full-time positions from the Avec group that would come to work at the clinic. But there are not sixty full-time members of the Avec group who come to us. There are only two or three!” The employee continues: “There is a strong suspicion that money is going back to the Avec group for services that don’t exist.” But here again we are told that this is public money, since the mutualist clinic in Grenoble is financed more than 80% by health insurance, while the Avec group, which controls it, is totally private.

The agreement dated October 9, 2020 was reinforced by another contract signed in January 2022. This second document specifies that the clinic must pay one euro per day and per employee to the Avec group to be able to use the digital applications.

Extracts from the agreement signed in January 2022 specifying the price of digital applications within the Grenoble GHM.  (GERALDINE HALLOT / FRANCE RADIO INVESTIGATION UNIT)

These are several tools that allow, for example, to submit a cancellation, communicate internally or have access to Google services (Google Workplace). “One euro a day and per person for a Google Drive is expensive”joked a doctor. Last year, the economic and social committee (CSE) of the mutual clinic had appointed an expert who quantified the cost of these services at a much lower price. “Several subscriptions are possible, ranging from four euros to 15 euros per user per month, depending on the degree of security and data storage capacity”specifies the report dated 2021 to which we have had access.

Asked about these agreements, Bernard Bensaid defends the usefulness and reality of the services billed to the clinic. “It is by using, in particular, common IT resources that our group manages to turn around establishments in great difficulty, such as the Grenoble clinic in 2020”he wrote.

Be that as it may, this issue is causing a stir at the political level. Christophe Ferrari, the president of Grenoble-Alpes Métropole (the urban community of Grenoble) says that he fears that “Bernard Bensaid comes to the clinic looking for enough to finance his expanding group, he was even going to say his empire”. Last year, the president of the agglomeration joined an appeal filed by the unions to cancel the sale of the clinic to Bernard Bensaid (see footnote). Christophe Ferrari is now in contact with other heads of local authorities who are in conflict with the head of the Avec group in Savoy and to Metz notably.

*The FO, UNSA and CGT unions, as well as associations of inhabitants, the city of Grenoble and Grenoble-Alpes Métropole had taken the judge in court to obtain annulment of the sale of the clinic. They were dismissed at first instance (November 10, 2021) and on appeal (June 7, 2022). The judge returned the case on the merits. The hearing will take place in several months.

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