Emprunts toxiques dans les hôpitaux publics

Les effets désastreux à long terme de la crise financière, puis économique de 2008 n’en finissent pas de se faire ressentir. Un exemple récent en témoigne : le député-maire de la commune de Saint-Maur-des-Fossés (Val de Marne) , Monsieur Henri PLAGNOL, a annoncé qu’il entendait soumettre à la délibération de son conseil municipal l’autorisation de porter plainte contre plusieurs établissements bancaires, sans que l’on sache au demeurant s’il s’agirait d’actionner la voie pénale ou la voie civile.

Les exemples les plus spectaculaires concernent les collectivités territoriales. Mais qu’en est-il des hôpitaux ?

L’encours de la dette de certains centres hospitaliers peut comprendre une part plus ou moins importante d’emprunts à taux dits « structurés ». La Cour des comptes a consacré de précieuses analyses à cette situation dans ses rapports publics annuels 2009 et 2010.

Aussi, en complément d’une charte de bonne conduite en date du 7 décembre 2009, a été prise une circulaire interministérielle n°IOCB1015077C du 25 juin 2010 consacrée aux produits financiers offers aux collectivités territoriales et à leurs établissements publics, elle-même précisée par l’instruction n°10-019-M0 du 3 août 2010 de la Direction générale des finances publiques.

L’intérêt d’un produit structuré réside dans le fait d’obtenir un taux d’intérêt moins élevé que le taux du marché proposé. Ce taux bonifié demeure stable tant que les conditions de marchés contractuellement définies au départ sont remplies. Il peut toutefois évoluer en défaveur d’une des parties au contrat si les conditions du marché ne sont plus identiques, ni propices au maintien de la formule définie initialement (taux de change entre deux monnaies qui évoluent, indice monétaire qui augmente, etc.).

Au départ, il s’agit pour les collectivités territoriales et les établissements hospitaliers d’un outil intéressant pour réaliser une gestion active de leur dette, jusqu’au jour où les conditions initiales ne sont plus réunies.

Le travail des Chambres régionales des comptes va notamment consister à mesurer la part d’emprunts structurés dans l’encours global de la dette. La moyenne nationale considérée comme un maximum a été fixée à 20% ((B. Fleury, Le contrôle des produits structurés par les chambres régionales des comptes : entre rappels à l’ordre et pédagogie, JCP A n°13, 28 mars 2011, 2106.)). Les rapports d’observations définitives tirent donc la sonnette d’alarme au-delà de ce seuil, et généralement quand il dépasse 50% de l’encours, ce qui est le cas par exemple du centre hospitalier Pôle Santé Sarthe et Loir, dont l’encours de la dette comprend 68,7% d’emprunts structurés, ce qui fait peser sur l’établissement des risques significatifs et durables, « éloignés de sa vocation et peu compatibles avec l’origine de ses financements. » ((CRC Pays de la Loire, 31 août 2010, p.2.))

Les magistrats financiers invitent généralement les organismes placés dans une telle situation à engager un processus d’apurement, d’assainissement par voie de renégociation, ce que les banques n’accepte pas facilement.

Pour aller plus loin, vous pouvez vous reporter au site de la revue Finances Hospitalières.

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