France’s public hospitals have remained under financial strain despite a narrowing of their deficit in 2025, according to new figures published on July 28 by DREES, the statistical service of France’s health and social affairs ministries.
The sector’s overall deficit narrowed from €2.9 billion in 2024 to €2.3 billion in 2025, but the shortfall is still the third largest since the series began in 2005.
DREES has cautioned that the figures are first estimates drawn from accounts that were not final at the end of June 2026 and that they will be revised in 2027.
The report comes amid concerns over France’s public finances.
Eurostat data for the first quarter of 2026 showed France once again recording the highest level of public expenditure in the European Union, at 57.3 per cent of gross domestic product (GDP), compared with an EU average of 49.8 per cent. Finland was second on 56.8 per cent.
French public debt reached 117.6 per cent of GDP, or €3,536 billion, the third highest in the bloc after Greece on 143.5 per cent and Italy on 138.9 per cent.
The DREES figures highlight the challenges facing one of Europe’s largest public healthcare systems.
The statistical service has warned that the improvement masks a further weakening of hospital balance sheets.
Hospital debt fell to 27.1 per cent of revenues, or €30 billion, from 27.9 per cent in 2024. Permanent capital, which covers equity and long-term borrowing, fell faster, dropping 1.7 per cent after a 2 per cent decline in 2024.
The sector’s financial independence ratio, which measures debt against permanent capital, therefore rose to 46.8 per cent from 45.7 per cent in 2024 and 45 per cent in 2023. French public health law treats a ratio above 50 per cent as one of three markers of over-indebtedness.
The slight improvement was driven mostly by slower spending growth and rising revenues as hospital activity recovered.
Revenues increased by 3.6 per cent while expenditure rose at a more moderate pace than in previous years, at 2.9 per cent after 3.9 per cent in 2024 and 6.6 per cent in 2023. That helped reduce the deficit to 2.1 per cent of total hospital revenues, down from 2.7 per cent in 2024.
Total spending reached €113.2 billion, against €110 billion a year earlier.
Staff costs, the largest single item, rose 3 per cent after 4.1 per cent in 2024, a slowdown DREES attributed in part to the absence of the across-the-board pay rises granted the previous year.
Activity continued to grow. Short-stay admissions rose 4 per cent and home hospitalisation stays 11.2 per cent, while accident and emergency departments recorded 21.5 million visits, up 0.8 per cent.
Hospital staff numbers across the public and private sectors rose 1 per cent.
Much of the financial support provided under the 2020 reforms following the pandemic has already been absorbed.
The Ségur de la santé accords, signed in July 2020, committed €19 billion over 10 years, of which €9 billion was earmarked for new investment and €6.5 billion for reducing hospital debt.
By the end of 2025, €4 billion of that €6.5 billion had been paid out by Cades, the fund that absorbs French social security debt, according to the Cour des comptes, the national audit body.
Financial costs also remain permanently negative because of interest payments on existing debt, at €900 million, unchanged from 2024, while the sector continues to depend heavily on public funding to maintain operations.
Investment has fallen back. It stood at 4.8 per cent of revenues, or about €5.4 billion, down from 5.1 per cent in 2024 and a peak of 5.4 per cent in 2023.
In May 2026, health minister Stéphanie Rist announced €6 billion of additional State investment for the period 2026-2035, taking over from the Ségur programme.
Rist said the money would support regional projects and that it would be conditional on efficiency measures.
Hospital financing has become a recurring political issue in France, with unions and hospital directors regularly warning that repeated emergency funding packages have failed to address the sector’s underlying structural imbalance.
