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Fiscal years 2017 to 2021
January 2023
Executive Summary
An incomplete overhaul of the statutes, and strategic thinking on the use
of funds and reserves to be accelerated
The French Federation of Cardiology (FFC) brings together 27 regional cardiology
associations that provide patient support and carry out preventive actions on the ground,
supported by 260
clubs cœur et santé
[Heart and Health Clubs] covering the whole country.
The Court
s audit concerns the period covering the terms of office of two presidents of
the federation, during which several modernisation projects were launched: the creation of a
development plan for the first time, the creation of research and regional mobilisation services,
the setting up of specialised committees, Don en confiance [Donate with Confidence] labelling,
and the plan to reform the statutes. Nevertheless, several issues brought tensions within the
Board to the surface. These internal conflicts led to a significant delay in defining the new
development plan and delayed the reform of the statutes.
Although reform is necessary, it is also blocked by the federation
s reluctance to change
its governance by putting more focus on associative democracy, as requested by the Ministry
of the Interior. This raises the question about the organisation of the FFC’s governance, which
contains seeds of dysfunction, notably by granting double votes to certain members of the
Behind the internal conflicts and the question of governance, it is also, in reality, the
s strategy and prioritisation of its actions that is at stake. Is it moving towards
objectives of a learned society intended to raise funds primarily for research, and which is then
intended to maintain a governance restricted to cardiology professors? Or is it a federation that
promotes prevention above all, and intends to lead local non-profit organisations that rely on
volunteers, which would then require, for the sake of consistency, that these be given greater
access to its decision-making bodies? Between these two polar models, it is up to the
federation to clarify in its strategic plan, currently under construction, the weight it intends to
give in the medium term to its various programmes (regardless of fluctuations linked to the
recent pandemic), so as to provide donors with a clear message on the actions it intends to
promote. It must therefore endeavour to clearly prioritise its actions within an action plan with
quantitative and qualitative objectives and a precise timetable. It should set a multiyear budget
for each of these actions. Appropriate governance will be self-evident, and sources of conflict
will be contained accordingly.
In addition, the federation has begun to take greater account of ethical issues in its
operations, although a number of institutional reforms have not yet been implemented.
Finally, despite the recommendations made in several audits
, the federation
s current
management still lacks a risk management system. The audits conducted during the Court
investigation highlighted numerous anomalies which demonstrate a lack of internal control.
s cash position, which was already high before the health crisis, has increased
sharply over the past two financial years (€24 million in 2020
-2021) due to the combined effect
of a sharp drop in expenditure on social programmes and an increase in funds raised. This
high level of cash makes it necessary to reflect on the FFC
s investment policy and, above all,
to commit to spending on social programmes, which is what donors expect. While a certain
level of prudent reserves is obviously acceptable, given the uncertainties that characterise
See audit reports by two firms in 2015 and 2020 and Don en confiance reports, a private labelling body, between
2019 and 2022.
legacies, which constitute an important source of financing for the federation, this must be set
at the most appropriate level following an objective analysis. Defining the new development
plan and implementing it within a strategy for the use of these funds donated by the public is
therefore not only urgent in order to clarify the federation
s position in terms of principles, but
also to accelerate the effective use of the funds raised.
An annual use-of-funds statement whose cost allocation rules slightly
overestimate the magnitude of social programmes
Only the appendices to the use-of-funds statements for the period under review,
approved each year at the same time as the accounts, contain information concerning the
expenses to be allocated exclusively or partially to social programmes, fundraising costs and
operating costs.
These appendices should therefore have served as a frame of reference for the FFC,
particularly for allocating expenditure to the use-of-funds statements, which was not the case.
The adjustments made by the Court show a decrease in expenditure attributable to social
With regard to the use of funds, compliance with the objectives set out in donation
appeals and therefore with donors’ wishes was not perfect due to technical difficulties. This is,
in particular, at least the case for the annual campaign focused on supporting research. Finally,
the Court
s audit revealed inconsistencies between the accounts and the financial information
published for several financial years. This is all the more problematic as some of these
inconsistencies have been pointed out in previous reports, some of which are old, reflecting
the federation
s difficulty in questioning its operating methods.
For these various reasons, the financial information provided to donors does not give
them a sufficiently accurate picture of how the funds are used.
Dynamic fundraising, but insufficient implementation of GDPR obligations
The donations received (excluding legacies and gifts) have been increasing since the
2019 financial year reaching €6.5 milli
on at the end of June 2021, at the expense of a
15% increase in fundraising costs over the period under review. The service provider rigorously
manages the processing of donations and the issue of tax receipts, and access to the donor
database shows a satisfactory level of security.
However, compliance with the General Data Protection Regulation (GDPR) is still lacking
when it comes to obtaining consent or the data retention period.
Social programmes strongly affected by the health crisis and unequal
development of actions
The cardiovascular disease prevention programme, where spending fell by 45%
between 2016 and 2021, has been heavily affected by the health crisis. The programme for
funding cardiology research has been professionalised during the period, while benefiting from
an increased budget until 2019-2020: research projects are now all selected following calls for
proposals by the scientific committee. However, many research projects fell behind schedule
during the health crisis, calling for increased monitoring of their implementation.
The FFC has launched several initiatives to improve the coordination of regional
associations. The network indicators showed a steady increase in network activity over the
early part of the audit period, although the health crisis subsequently affected them.
The momentum of the FFC
s social programmes therefore appears to be mixed. All were
affected by the health crisis. Expenditure on social programmes thus fell by €3.7 million (
between 2018 and 2021.
By clarifying its strategy and mobilising its cash flow, the FFC must endeavour to regain
positive momentum for the social programmes that it intends to prioritise.
Audit recommendations
The Court is making the following audit recommendations:
Improve the management of the FFC
As part of the development plan to be adopted at the 2023 general meeting: rank the
strategic priorities, plan the associated activities and the corresponding budgets, and
mobilise the accumulated cash flow accordingly;
At the 2023 general meeting, finalise the reform of the statutes, clarifying the division of
responsibilities between the governing bodies and diversifying their composition to reflect
the social programmes;
Implement declarations of interest for directors, members of the Scientific Committee and
employees in charge, and formalise the withdrawals of members of the Bureau, the Board
of Directors and the Scientific Committee in the minutes;
Establish an internal control system to ensure compliance with procedures.
Ensure appropriate accounting, financial and regulatory procedures are in place
Ensure that donors
wishes are respected by identifying earmarked donations and making
their tracking in the accounts reliable;
Clarify the rules for preparing the annual use-of-funds statement, make the governing
bodies deliberate on these rules and ensure their application;
Bring procedures into line with the requirements of the General Data Protection Regulation.