Year after Orpea scandal, multiple and fragile measures

Since the revelations of the book “Les Fossoyeurs” on the practices of the giant of retirement homes, the government and the public and private actors have groped to moralize the destabilized sector of nursing homes.

By Béatrice Jérôme

On the top floor of the Ministry of Health, around thirty journalists are gathered around a large oval table, Tuesday, January 24, at the invitation of Jean-Christophe Combe. “You are lucky! Because I did not have the book of Victor Castanet. I do not know what is in it,” slips the Minister of Solidarity, Autonomy and Disableds . Released a year ago, the work Les Fossoyeurs was released on Wednesday in pocket format (I read, 512 pages, 9.50 euros). The new edition is accompanied by ten unpublished chapters. Was new revelations about the shot giant of retirement homes were going to shake the ecosystem again and fuel the distrust of the French towards retirement homes? Since the health crisis, occupancy rates have decreased and have struggled to go up. A replica of the earthquake caused by the revelations of the book is to be expected. Was Mr. Castanet’s work to relaunch the debate on the impossible conciliation between profits research and quality of care for residents?

“Post-Orpea Minister”, as he defines himself, Mr. Combe preferred to take the lead in an attempt to defuse media jerks. This led him to draw up on Tuesday a first inventory of the measures initiated for a year to clean up practices in the sector. In March 2022, the government had committed to mobilizing regional health agencies (ARS) to control the 7,500 EHPAD by 2024. To date, they have carried out since spring 1,400 checks, including 59 % on site. They gave rise to nearly 1,800 recommendations, prescriptions or injunctions and eleven referrals from the public prosecutor, in particular for mistreatment, endangering others, bad drug circuit.

49 % of these controls concern lucrative nursing homes. The shortcomings observed by the ARS “do not depend on the status of the establishment, said the minister. There is no more in the lucrative sector than in the public or the association. Regarding the quality of the support , we see that there are difficulties everywhere “. Observation which justifies that the government has taken, for a year, measures which have targeted all EHPAD.

Among the post-scandal measures Orpea, the High Authority for Health published, in March 2022, a “repository” as there are for hospitals which serves as the basis for future evaluations of nursing homes. The National Solidarity Fund for Autonomy has forged five quality criteria which will be assigned to EHPAD and public rendering (number of single rooms, presence of coordinating doctor, etc.). Five other criteria should be created such as the number of caregivers by residents but require to be validated by legislative means. The idea of ​​establishing a “minimum ratio of caregivers by resident” is provided for in the “aging well” bill tabled by the majority in the assembly, in December 2022. “But the problem is more to bring professionals What to identify financial means, “notes Mr. Combe.

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/Media reports cited above.