The body and health have become lucrative sources of profit for operators in the sector, such as the Vivalto group. Like its competitors, it is restructuring its services not to meet the real needs of the population, but solely to increase its profit margins. At the Côte d'Opale clinic, employees have long been at odds with the group's management. Recently, management decided to close the maternity ward and lay off thirty-five people. We spoke with one of the key figures in this struggle.
Can you tell us about the announcement of the layoff plan?
A year ago, we were abruptly informed of the closure of the maternity ward during a works council meeting
[1], while being presented with the "strategic directions." "Actually, we were expecting it, we were talking about it amongst ourselves, in connection with the declining birth rate...
At the time, management assured us that the department wouldn't close; on the contrary, they claimed to be starting renovations to develop a women's surgery wing while preserving a maternity wing. They even went so far as to ask us to be involved in choosing the furniture, the color of the new premises, etc. Despite everything, we still held onto a certain hope...
How many people did this plan affect?
Management intended to lay off thirty-five people, twenty-four of whom were affected by the redundancy plan[2], as well as four salaried pediatricians, nurses, a client manager, and hospital service workers... Among the group of pediatricians affected by the redundancy plan, one chose to retire."
As a union representative, I participate in Vivalto group meetings, and in that context, I experienced the closure of the maternity wards in Cholet, Béthune, and Saint-Germain-en-Laye. It went very badly, with the same brutality. In Cholet, the situation was slightly different; there was no surgical department, no pediatrician, and very few births were taking place there. But at the Côte d'Opale clinic, the number of births was stable, and there were no financial losses, as confirmed by the expert report.
As always, it's just a question of profit?
Obviously... Management wasted no time; they immediately began work to develop more profitable services. It will be general medicine, so a lot of geriatrics, rehabilitation and long-term care, and outpatient services.
Are these investments being made with the group's own funds?
When the Vivalto group became the operator of the Côte d'Opale, it only owned the buildings for a few years before selling them to invest abroad. In this case, the landlord paid EUR12 million to begin the renovations, and Vivalto is paying the remainder. However, since the sale of the buildings, the rent has increased fivefold, straining the establishment's cash flow.
In which countries does the group invest?
This buy-and-sell strategy has allowed the group to expand and invest in Spain, Portugal, Poland, and some Eastern European countries such as the Czech Republic and Slovakia. Morocco is also being considered for future investments. In some of these countries, the group operates as a public service concessionaire. It uses existing infrastructure, provides its staff, and reaps the profits without incurring management costs, taxes, etc. It's a particular form of subcontracting...
So, since your department closed, the public hospital is taking over the patients from the clinic?
Families who used to give birth at the clinic now go to the hospital, but it's under the supervision of the Regional Health Agency (ARS) and can no longer hire staff. Their maternity ward has to work more, but with the same resources; it must be tough for them...
From there, what happened in practice?
Everything happened very quickly. It hit you like a ton of bricks, and you don't have time to think. The redundancy plan was implemented, and for us, it was a first. Starting in March 2025, we'll have three months of meetings, an exhausting marathon... With the help of a lawyer, the goal will be to try to leave in the "best possible conditions."
The first layoffs will happen in October, but some of the staff won't be affected by the redundancy plan. These were six nurses, a customer service representative, and two healthcare assistants whom management hoped to redeploy to other departments. Ironically, none of them accepted the management's offer. They left with roughly comparable terms in terms of seniority, but they did not receive redeployment leave.
How did the other departments react to the announcement of the closure?
Unanimously, it was a terrible reaction. Doctors who had never participated in any action before went on strike-a first! The maternity ward had always existed, but management was inflexible; even the patients didn't understand...
Management's brutality went so far as to force employees to come to work and monitor their punctuality, even though the day after the layoff plan was announced, the premises had been looted by managers! The labor inspectorate intervened and ordered colleagues to stay home.
It's important to understand that management wants to cut staff as much as possible because, according to the collective agreement, if the workforce falls below 300 employees, we lose the same rights within the Works Council, we lose the Health, Safety and Working Conditions Committee[3], etc. This is why, in 2020, we launched a strike against the outsourcing of hospital service staff, and we won. Previously, we hadn't been able to stop management when they decided to outsource the kitchen...
Then came the strike...
With the CGT union, we always organize rolling, open-ended strikes. This time it lasted three weeks, but we have to admit we didn't get much. The starting point was a EUR7,000 raise for everyone, and it was a struggle to get it. We quickly realized the director had no real power; he had no decision-making authority. We got people moving; the group's HR director came down, made promises she obviously didn't keep.
Before the clinic was sold to the Vivalto group, when we went on strike, we faced the boss directly. There was a lot of shouting, but the decisions were made in his office. Back then, we actually got things done. Today, it's much more complicated.
We called off the strike because we couldn't take it anymore... We shouldn't have, but when there's no one left to maintain the picket line, what can you do?
In a way, the strike was successful because there were many walkouts in all departments, which really annoyed management, but the movement wasn't as strong as in 2020. Colleagues would come to the picket line but wouldn't stay all day. The group of strikers was always the same, because there are those who claim to be in solidarity, those who are afraid... Currently, losing a day's pay is difficult for some, which is why walkouts are successful.
And at one point during the strike, there was an intrusion by politicians...
Can you explain?
I had warned that if politicians showed up on the picket line, I would withdraw. They all came, especially the newly elected National Rally MP for the district, Antoine Golliot... The first time, the strikers chased him away, but a second time a midwife contacted him even though I had warned her that if he showed up, I was leaving. He came back, and everyone started shaking his hand... From that moment on, I never set foot on the picket line again. That was the first time, and the last straw... Whether it was him or someone else, it didn't matter; they won't do anything for us anyway, and they've proven it!
And now?
Since then, management is more focused than ever on maximizing profits, so they have to fill the beds, and there's a lot of outpatient work. You can have three patients on the same bed; it's exhausting. And when you're having a quiet day, they call you because there's a staff shortage in this or that department. Many healthcare workers are longing to leave. Three years ago, fourteen employees in the operating room resigned, which put management in a difficult position. And we're still seeing departures; young people spend two or three years with us, just long enough to get their training, and then they disappear-there's a lot of turnover... Recently, Vivalto announced they want to charge their employees for parking at the clinic! That's already the case at the group's main clinic... Needless to say, here, as long as I'm here, that's out of the question!
And what about the future?
More and more, you can sense the employees are disillusioned. They either go on sick leave or they leave, but the will to fight isn't a priority. Despite everything, we often go on strike; management is used to it, but this time they were caught off guard. They were hoping to quickly close the case, as they had done in their other facilities. After that, the bosses are thinking long-term, they have a vision and know that the union elections are coming up, and they'd like a CFTC majority, but I won't see that happen. I'm keeping my union representative position during my redeployment leave, and after that, it'll be unemployment...
Boulogne-sur-Mer, March 31, 2026
The Vivalto Group's Position in the Sector
In France, the private healthcare industry is undergoing constant restructuring and increasing consolidation. In 2021, there were 468 private acute care (MCO) clinics nationwide, and the average capacity of for-profit rehabilitation (SMR) clinics is currently greater than that of the public or non-profit private sectors. These groups employ a total of 441,000 people.
Three major groups dominate the sector, each with dedicated real estate subsidiaries. Vivalto ranks third behind its two competitors, Elsan and Ramsay Santé. The Vivalto Santé Group was founded in 2009 by Daniel Caille, formerly head of Société Générale de Santé, and a group of Breton doctors. Its revenue currently stands at EUR2.2 billion across 53 facilities. Vivalto employs 21,000 people.
The sector, in unison, admits to being confident about the future because: "it is banking on the aging population and the rise in chronic diseases"... The 2004 DRG (Diagnosis Related Group) reform, which introduced fee-for-service pricing, only fueled the race for profit and fostered competition.
Notes
[1]CSE: The Social and Economic Committee (CSE) is the new employee representative body, created by the Macron ordinances. It replaced the Works Council (CE), the Staff Representatives (DP), and the Health, Safety and Working Conditions Committee (CHSCT).
[2]PSE: A PSE is a plan implemented by the company in the event of collective redundancies (more than 10 employees over 30 days). It must include: internal or external redeployment measures; training or retraining programs; personalized support (via a redeployment unit); enhanced severance pay; and a consultation procedure with employee representatives. The PSE (Employment Protection Plan) must be validated or approved by the Regional and Interdepartmental Directorate for the Economy, Employment, Labor and Solidarity.
[3]CSSCT: Health, Safety and Working Conditions Committee. Its responsibilities have been carried out since January 1, 2020, by the Social and Economic Committee (CSE).
http://oclibertaire.lautre.net/spip.php?article4701
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Source: A-infos-en@ainfos.ca
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