Abstract
Abstract The French public hospital system represents a major element in overall social security expenditure and ongoing reforms are having a significant impact on its financial equilibrium and the internal management of its activities. Nonetheless, the system has been unable to achieve the productivity objectives imposed on it. Significantly, staffing costs account for three quarters of its expenditure, yet most employees are civil servants who cannot be laid off easily. The only possibility for meaningful change in the size of its workforce may lie in the demographic revolution now affecting the French population, which will see half the present staff of public hospitals reaching retirement age within the next decade.
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