the regulations offer great freedom to private groups

Brigitte Bourguignon (blue jacket), Minister Delegate for Autonomy, leaving the Elysée, March 30, 2022.

“Our lives, their lives are worth more than all the profits!” » : Would Emmanuel Macron ever have plagiarized the campaign slogan of Philippe Poutou, candidate of the New Anti-Capitalist Party in the presidential election, if the Orpea scandal had not broken out? By pronouncing this sentence during his campaign rally in Nanterre on April 2, the candidate president played on the sensitive chord by being indignant against those who consider “old age like a money pump”, according to the formula used by Brigitte Bourguignon, at the beginning of February, after reading Victor Castanet’s book, The Gravediggers (Fayard, 400 p., 22.90 euros), on the practices of the private commercial group. The Minister Delegate for Autonomy then reacted by launching a campaign to check Orpea establishments entrusted to the regional health agencies (ARS). It also announced a series of measures to improve the effectiveness of controls and the implementation of rules of transparency and independent evaluation of the quality of nursing homes.

But these first remedies administered cannot exempt the government from examining the legal rules which have enabled Orpea to generate the financial profits it is accused of having made at the expense of the well-being of residents. Rules that no one openly questioned so far.

Read also: Article reserved for our subscribers Orpea: the administrative report made public confirms a cost optimization system at all levels

Tuesday, March 29, in the Senate, Mme Bourguignon targeted the law on the adaptation of society to aging (ASV) of December 28, 2015. Before the senatorial commission of inquiry devoted to the control of nursing homes, the minister deplored that this text, voted under the five-year term of François Hollande , has opened “two possibilities, which I would like to denounce today, favoring private groups even more”she lamented. “It is, first of all, the possibility of not paying back financial surpluses every year [aux agences régionales de santé ou au département], which led Orpea to the maneuvers now criticized. » It is then, she said, “the possibility for commercial Ehpad groups not to produce all their accounts”. Clearly, to present them in a simplified form without the ARS having “more knowledge of the budget devoted to accommodation”, in other words to the commercial accounts of establishments, which has become, she says, “a black box” for guardianships.

Public credit surpluses

The ASV law also gave rise to the so-called reform “tariff convergence”she continued, “which has greatly benefited commercial nursing homes, the public giving to the private! » The law has in fact programmed the payment of additional credits from Social Security and the departments to the commercial sector from 2017, to finance the hiring of caregivers and thus reach the same number of positions as that of the public sector, historically better staffed.

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