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Of all the issues weighing on the desk of the President of the Collectivité territoriale, improving healthcare provision on the island is undoubtedly one of the heaviest. Particularly the part concerning the hospital. On the heights of Gustavia, the aging structure still bears, eight years on, the scars of the passage of Hurricane Irma in September 2017. Thanks to the work undertaken since the beginning of the mandate in March 2022 by first vice-president Marie-Hélène Bernier, notable progress has nevertheless been made. For example, the end of the joint hospital management with Saint-Martin has enabled a director to be appointed to head the healthcare establishment. The arrival of Eric Djamakorzian gave a boost to the hospital's reconstruction project. A new milestone was reached on Friday October 3, when a general committee meeting was held at the Hôtel de la Collectivité.
At this meeting, held behind closed doors between the territorial councillors and those involved in the island's healthcare sector, a majority of the elected representatives present endorsed one principle: that of committing the Collectivité's finances to the tune of 28.8 million euros to the project to rebuild the Irénée de Bruyn hospital in Gustavia, on the site of the current facility. This sum will be supplemented by the 4.7 million euros allocated to Saint-Barthélemy as part of the Ségur de la santé program (190.000 euros were used to renovate the hospital's fire and security system). This will bring the estimated budget for the reconstruction project to just over 33.3 million euros.
Pending approval by the territorial council
"The General Commission of the Territorial Council has approved the principle of paying a capital grant of 28.8 million euros to see the hospital through to completion.euros to ensure a brand-new, fully operational hospital to serve the population", confirmed President Xavier Lédée online at the end of the meeting. He added: "Obviously, this is not a blank cheque, and there will be a number of milestones over the coming months. In view of the urgency of rebuilding this hospital, and the prevarication on this subject since 2017, I wanted, in partnership with the hospital's director, Mr. Eric Djamakorzian, whom I would like to thank, that this item be debated at the next territorial council meeting, in order to put this project on track for work to start at the end of 2026 and delivery in 2030. "In fact, "validation of the project to rebuild the Irénée de Bruyn hospital and payment of a capital grant" is on the agenda for the territorial council meeting scheduled for October 23, at 5 p.m.
A four-stage financial plan
Two scenarios were presented to the general commission on October 3. The first involves reconstruction combined with restructuring of the existing facilities. This option is estimated to cost around €32.6 million. The second involves a complete reconstruction of the facility, rethinking its layout. Estimated cost: over 34.6 million euros. In both cases, several options were proposed to the elected representatives: the installation of a vertiport, a helipad, the construction of housing, the integration of a Maison des assistantes maternelles and the Maison de la santé into the structure. The estimated budgets include all these options. At the general committee meeting, it was the scenario of a complete reconstruction, with three of the five options proposed by the hospital's management (a helipad, housing and the construction of a health center) that was chosen.listation, housing and integration of the health center currently based at Saint-Jean).
If the Collectivité follows this scenario, the financial plan will be divided into four tranches: 5% in 2026, 35% in 2027, 40% in 2028 and 20% in 2029. However, this exciting project will not be possible until a major question has been answered: who owns the land on which the current hospital is built?
Land: a thorn in the side
Indeed, this issue remains unresolved. In August 2022, the President of the Guadeloupe Department, Guy Losbar, undertook to formalize the retrocession of the plots to the Collectivité. However, in the meantime, the hospital's management has also taken a position, indicating that the hospital will be the owner of the land. The issue is therefore far more complex than it first appeared.
The mediation process initiated between the hospital and the Département de Guadeloupe has been extended by three months. Marie-Hélène Bernier, chairwoman of the hospital's supervisory board, reports that the mediation "would go more in the direction of the hospital owning the land, but also the Ehpad grounds, the housing and the imaging center". If this is the case, it means that the Collectivité territoriale is preparing to invest in an ambitious construction project on land that does not belong to the Collectivité. It's taking a big risk," says the Collectivité's first vice-president. They tell me it's not important because it's a public hospital. But if the land actually belongs to the hospital, the Collectivité will have to enter into a new mediation with the hospital. We're in total limbo."
Hospital director Eric Djamakorzian has already indicated that he feels it is essential that the question of land ownership be settled before any ground is broken. For the time being, the uncertainty remains and could, in fact, already jeopardize the projected schedule.
A criticized reconstruction project
The decision of the five elected members of the presidential group (Unis pour Saint-Barthélemy) and the five from the Saint-Barth d'Abord group (not forgetting Francius Matignon, now a free electron) to opt for the reconstruction project was a major step forward.sormais électron libre) to opt for rebuilding the hospital on the historic Gustavia site is not to everyone's taste. Starting with the eight elected members of the Action-Équilibre party, who are questioning why the possibility of building a new facility on Saint-Jean was ruled out by the President of the Collectivité. "The general commission meeting on Friday October 3 revealed the accumulation of constraints on the hospital reconstruction project in Gustavia," writes the group in a publication. Indeed, while we were eagerly awaiting this presentation to ensure the relevance of the project, it has to be said that the discussions revealed all the problems that would have to be resolved to bring it to a successful conclusion. Without even mentioning the problems of land ownership or the exact size of the site, the technical, organizational, nuisance and financial constraints involved are enormous. "And the training course goes on to ask: "At the general committee meeting of April 8, 2025, at the request of Bettina Cointre, it was agreed that a general study should also be launched on the Saint Jean site, which offers a number of advantages. This was not done. Why was this not done? As a result, only one solution is now being presented to the elected representatives, and it is clearly unsuitable. It would seem, therefore, that certain elected members of the Territorial Council are content with what they are offered. Unless the health of the population has become hostage to political arrangements and outside influences. "
For the elected members of Action-Équilibre, the President's political survival is now intimately linked to his good relations with Saint-Barth d'Abord. A group that supports the Gustavia reconstruction project. Not to mention the fact that the idea of building a new hospital on Saint-Jean came from... Marie-Hélène Bernier. All the more reason for the President not to pursue this second possibility.
A medical hub in Gustavia
The plan to rebuild a new hospital on the Gustavia site would be accompanied by the attachment of the Maison de la Santé, currently located in Les Sables, to Saint-Jean. The aim of this move, for both the hospital and the local authorities, would be to create a "medical hub" designed to "improve patient care". This, combined with the scale of the overall project, will mean complying with parking standards. On a site that is, by definition, not expandable.
