Life Sciences Horizons Brochure 2025 - Flipbook - Page 56
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2025 Horizons Life Sciences and Health Care
Private health care investments in France: First responses to growing financialization
Private health care in France has been attracting
increasing investment from private stakeholders,
including health centers and private health care
establishments. Among these, some are structured
as companies formed by self-employed practitioners
(sociétés d’exercice libéral, or “SEL companies”),
whose legal framework was recently amended
and took effect on 01 September 2024.
While this reform did not drastically change existing regulations,
it clarified key aspects, particularly regarding capital ownership
and governance. It also reaffirmed the current model, which
allows third-party investors to hold minority stakes, provided that
practicing health care professionals retain over 50% of the capital.
At the same time, several national boards representing health care
professionals have raised concerns about third-party investments,
particularly from financial investors, warning that they could
compromise practitioners' professional independence. In
response, the French Senate’s Social Affairs Committee published
a report on 25 September 2024, analyzing the impact of private
investors on the health care sector. The report highlights
increasing market concentration, particularly in for-profit
hospitals (dominated by four major investment funds), medical
analysis laboratories (controlled by six major groups), and
medical imaging groups.
The report identifies several factors driving the financialization
of health care, including legal provisions allowing non-health
care professionals to invest in SEL companies and the need for
cost-sharing to maintain high-quality care. However, it warns that
the consequences of this financialization are poorly understood
and controlled, raising concerns about monopolies that could
reduce competition and limit health care options. It also questions
whether regulatory bodies, such as Regional Health Agencies
(ARS) and health insurance providers, can effectively oversee
these financialized health care services while maintaining
accessibility and quality. Additionally, it points out that
health care services are increasingly seen as a “profitable
and secure” investment.
To address these issues, the report proposes 18 recommendations,
including stricter oversight of health centers, better regulation of
health care service authorizations by ARS to ensure balanced
territorial coverage, and the creation of a “financialization
observatory.” It also suggests protecting the independence of
health care professionals by tightening rules on capital ownership
and voting rights in SEL companies and introducing a minimum
investment period for SEL capital.
The committee emphasizes that these recommendations are not
meant to exclude investors, but rather to ensure that financial
involvement prioritizes public health over profit. It also calls
for a clear and consistent doctrine governing SEL operations to
maintain professional control. In response, some national health
care boards have begun drafting their own guidelines, though
certain decisions have already been legally challenged. Court
rulings expected in the coming months will help shape a more
balanced regulatory framework. In the meantime, private
investors should implement the initial guidance elaborated
by national boards and ensure compliance with current market
practice with the objective to maintain a balance between
profitability and professional independence and improvement
of care quality.
Mikael Salmela
Partner
Paris
Joséphine Pour
Senior Associate
Paris
Louis-Nicolas Ricard
Senior Knowledge Lawyer
Paris
