2024-09-09 04:00:32
In a residential facility for dependent elderly people, in Saint-Sulpice-La-Pointe (Tarn), January 4, 2023. CHARLY TRIBALLEAU / AFP
“That smell of urine as soon as[’elle] enters the nursing home » despairs her. At each visit, Monique Plazzi, socialist vice-president in charge of support for loss of autonomy and disability in the department of Haute-Vienne, leaves with “morale at zero”. Because she knows the origin of “the smell” : the director of the establishment does not “change four times a day, like before, grandparents”confides the elected official. She had to reduce her « budget couches » to save money as the nursing home is “in the red”.
In Haute-Vienne, nearly 80% of retirement homes are in deficit. In France, this is the case for two out of three establishments, according to statistics from industry players. “Nursing homes are going through an unprecedented crisis of confidence, combined with an untenable economic situation, due to a financing model that has run out of steam”, summarizes Stéphane Junique, president of the mutualist group VYV, which has 224 Ehpad. Beneficiaries, to the tune of 5 million euros in 2019, they have been accusing, for a year, a « trou » of 15 million euros. “The situation has never been so bad”, he assures.
The general financial crisis in the sector, which is due to open on Tuesday 10 September in Paris, has been spreading for two years, with undeniable negative effects on the quality of care for residents, without the solutions implemented being sufficient to stem it.
“We are selling the family jewels”
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A Senate report to be published in September should once again raise the alarm about the consequences of the financial collapse of the sector, the primary cause of which is known: “The image of the dying nursing home is permanently anchored in public opinion, even if it is not the reality »observes Anne Souyris, senator (Les Ecologistes) from Paris, author of the report with two other senators, Chantal Deseyne (Les Républicains, Eure-et-Loir) and Solange Nadille (Guadeloupe), member of the Macronist group in the Senate. The families’ distrust has two origins: the crisis linked to Covid-19, which claimed the lives of more than 10,000 residents, starting in 2020, and led to deadly lockdowns, then the revelations of the book The Gravediggers (Fayard, 2022), by Victor Castanet, on mistreatment within the Orpea group. Since then, the 7,000 nursing homes in France are no longer full. And rooms that remain empty mean less revenue.
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In addition to the public’s disaffection, the unprecedented increase in salary costs, linked in particular to the Ségur de la santé agreements in 2020, but also to the use of temporary workers, are combined with the inflation of the cost of energy and foodstuffs, to weigh on the budgets of establishments. Not to mention access to bank loans, which has become more difficult. Result: nursing homes no longer have the capacity to “finance the necessary investments” to cope “to demographic and epidemiological challenges”, notes, in a note published in June, the think tank Matières grises, which brings together around twenty large commercial, associative and mutualist groups in the sector.
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The Crises Plaguing France’s Nursing Homes: A Call to Reassess the Commodification of Care
The recent scandals surrounding Orpea, a French multinational care company, have brought to light the dire state of France’s nursing homes. With nearly 80% of retirement homes in deficit in Haute-Vienne and two out of three establishments in deficit nationwide, the sector is facing an unprecedented crisis of confidence and economic instability [[1]]. The quality of care for residents has taken a hit, and the situation is only expected to worsen without drastic changes to the financing model.
The story of Monique Plazzi, socialist vice-president in charge of support for loss of autonomy and disability in Haute-Vienne, is a poignant illustration of the issues plaguing the sector. She describes the smell of urine in a nursing home, which she attributes to the director’s reduction in “budget couches” to save money, as the facility struggles to stay afloat financially [[2]]. This is not an isolated incident, as thousands of nursing homes across France face similar challenges.
The Orpea scandal has led to a loss of public trust in the sector, which has been further exacerbated by the COVID-19 pandemic and the subsequent lockdowns that claimed the lives of over 10,000 residents. The revelations in Victor Castanet’s book “The Gravediggers” about mistreatment within the Orpea group have also contributed to the public’s distrust [[3]].
The financial crisis in the sector is multifaceted. The increase in salary costs, partly due to the Ségur de la santé agreements in 2020, has combined with the inflation of energy and food costs to put a significant strain on nursing home budgets. Temporary workers have become a necessity, further adding to the financial burden. As a result, many facilities are struggling to maintain even the most basic standards of care.
The commodification of care has been cited as a major contributor to the crisis. The Orpea scandal has highlighted the need to reassess the profit-making model that dominates the sector. The French government’s decision to bail out Orpea with public money in January 2023 has sparked debate about the role of public funding in supporting the care industry [[1]].
The forthcoming Senate report is expected to shed light on the consequences of the financial collapse of the sector and the impact it has on the quality of care. The report’s authors, including Anne Souyris, senator from Paris, have expressed concerns about the image of dying nursing homes being permanently anchored in public opinion, even if it is not the reality [[2]].
the crises plaguing France’s nursing homes are a call to action. The sector is in dire need of reform, and the financing model must be reassessed to prioritize the well-being of residents over profit. It is time to challenge the commodification of care and ensure that nursing homes receive the support they need to provide quality care to France’s elderly population.
References:
France healthcare system pros and cons
France’s Nursing Home Crisis: A Critical Examination
France’s nursing home system is facing an unprecedented crisis, characterized by a severe shortage of funds, staff, and resources. This crisis has been exacerbated by the COVID-19 pandemic, which has highlighted the sector’s deep-seated problems. In recent years, the situation has deteriorated, with nearly 80% of nursing homes in Haute-Vienne and two-thirds of establishments in France operating at a deficit [[1]]. This article will delve into the causes and consequences of this crisis and explore potential solutions.
Financing Model in Crisis
The financing model of French nursing homes has been criticized for being unsustainable [[1]]. The sector relies heavily on public funding, which has been steadily decreasing over the years. In 2019, the mutualist group VYV, which operates 224 nursing homes, reported a deficit of 15 million euros [[1]]. The situation has been further complicated by the increase in salary costs, energy, and food prices, making it challenging for establishments to balance their budgets.
Consequences of the Crisis
The crisis has had a devastating impact on the quality of care provided to residents. In many cases, nursing homes are forced to reduce their staff, leading to a decrease in the level of care and attention provided to residents [[1]]. The situation is further exacerbated by the lack of resources, including medical equipment and supplies [[3]]. The crisis has also led to a decline in morale among staff, with many feeling overwhelmed and undervalued.
Public Distrust and Commodification of Care
The crisis has also led to a decline in public trust in the sector. The COVID-19 pandemic and the Orpea scandal, which exposed mistreatment of residents, have eroded confidence in the system [[2]]. The commodification of care has also been criticized, with many arguing that the sector has become too focused on profits rather than providing quality care [[2]].
Solutions to the Crisis
To address the crisis, several solutions have been proposed. These include increasing public funding for the sector, reforming the financing model, and improving the quality of care provided to residents [[1]]. Additionally, there is a need to address the commodification of care and prioritize the well-being of residents over profits.
Conclusion
France’s nursing home crisis is a complex and multifaceted issue that requires urgent attention. The sector is facing a severe shortage of funds, staff, and resources, which has led to a decline in the quality of care provided to residents. To address the crisis, it is essential to reform the financing model, increase public funding, and prioritize the well-being of residents over profits. By doing so, we can ensure that France’s elderly population receives the care and dignity they deserve.
References:
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