2023-07-05 09:02:31
Too many people die badly in France. More than 60% of deaths each year are linked to an incurable disease involving physical pain or mental suffering, which could be relieved by medical support designed to soothe these symptoms. “The estimated needs for palliative care would only be covered up to 50%”estimates the Court of Auditors in a report presented, Wednesday, July 5, to the National Assembly.
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The president of the social affairs commission, Fadila Khattabi, MP (Renaissance) for Côte-d’Or, had seized the financial magistrates in September 2022 so that they draw up an inventory of the supply of palliative care. The report once again highlights the obstacles to access to this end-of-life medicine, while Emmanuel Macron has pledged to legislate by paving the way for active assistance in dying.
With caution, for lack of reliable indicators, the court made estimates. From his calculations, it therefore follows that only half of the 383,328 patients, who, according to his projections, should die of a serious illness in 2023, will have had access to palliative care.
Territorial disparities
France has however progressed since the previous report of the Court of Auditors on this subject, in 2015. In the hospital, where 53% of people die each year, the park which receives patients suffering from incurable pathologies has increased by 24% since 2013. Thus, 7,529 beds are distributed in palliative care units (USP), or listed “identified palliative care beds” in services where deaths are frequent.
However, about twenty departments do not have a USP. The court expects the ministry to keep its commitment to remedy these territorial disparities. Rather than a “hospital-centered approach” palliative care, the financial magistrates advocate the priority deployment of a “access to town”, “lacunary” at home and “very insufficient” in an accommodation establishment for dependent elderly people (Ehpad). A position underpinned by budgetary considerations. “Public spending on palliative care, which is 1.453 billion euros in 2021, an increase of 24.6% since 2017”East “mainly attributable to hospital stays”.
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But this call for a change in strategy responds primarily to a concern for public health. The hospital receives palliative care for the vast majority of patients at the very end of life. But, with “increased life expectancy for cancer patients”notes the Court, “the notion of a curative, then palliative, phase of a disease gives way to the benefit of coordinated and appropriate care throughout the disease”.
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