Editorial of the “World”. The publication of the survey Fayards (Fayard, 400 pages, 22.90 euros), in which Journalist Victor Castanet denounces significant dysfunctions in the Orpea Group-Dependent Seniors (EHPAD) facilities provoked a Vivid emotion. Is right. The charges are serious and the facts particularly sordid.
The book describes an implacable system in which hygiene care, medical care, or even meals of the residents would be “rationed” to inflate the profitability of ORPEA, a leading company of its sector and listed on the sector. Paris stock exchange. The failures revealed by the journalist are limited to a “concern for organization”, as the leadership advance, or are they an integral part of an economic model dedicated to the detriment of well-being, of health, even the lives of residents, as the book gives him to think? It is still too early to decide.
At this point, you have to be wary of generalities: many EHPAD, despite insufficient means, continue to fulfill a difficult but indispensable mission to society. Still, the number of families who have been faced with retirement home abuse should alert us on system malfunctions.
Parliamentary procrastination
One of them is the role played by the private sector. In the absence of sufficient public funding, the activity had to open up to a number of companies. They have certainly led to developing host capabilities to support the aging of the population, but many investments have been made in a purely financial logic. Today in full expansion, the profit private sector proposes on average higher rates by 40% than the public, with 10% to 15% less staff. However, it is obvious that the well-being of residents is proportional to the density of the framework.
Then each establishment, regardless of its status, affects the same amount of public funding by the regional health agencies (ARS) and the departments, the accommodation being the responsibility of the residents. It is on this position that the private sector ensures its profitability, without proposing for all the best benefits. The economic model remains focused on real estate, less about the needs of the elderly. Public funding theoretically have a counterparty: regular control of institutions by ARS. In practice, according to the book, these controls are too lax and random to prevent abuse.
For years, addiction has been waiting for its financing law. Despite some progress like salary upgrading, job creation and new investments, the current power did not derogate from this legislative procrastination. Yet the demographic projections show that the need for opening places in EHPAD will accelerate.
Two choices are possible. Either collective management that will reduce the financial burden for families while guaranteeing better benefits – the political limit of this solution is that it involves an increase in social levies – or continue to delegate the mission to a Lucrative private sector, more expensive than the public but unable to guarantee better benefits, all funded largely by public funds that remain poorly controlled. It is not too late for the issue of old age to invite in the presidential campaign.