Question 16626 — dependency

Summary

Mr. Aurélien Saintoul draws the attention of the Minister of Health, Families, Autonomy and People with Disabilities to the results of the solidarity day established after the 2003 heatwave and to the use of resources allocated to the protection of vulnerable people in the face of extreme climatic episodes. The heatwave of 2003 was a national trauma which demonstrated how the inadequacies of the prevention system increased the vulnerability of some fellow citizens to extreme climatic episodes. In response, the State established a day of solidarity based on a day of unpaid work for employees and a contribution from employers, in order to finance the management of loss of autonomy through the National Solidarity Fund for Autonomy (CNSA). Twenty years later, while France has just experiencing a particularly intense and early heatwave, the first available data attest to significant excess mortality among vulnerable people. Establishments welcoming these populations, such as hospitals and nursing homes, remain insufficiently prepared. This observation questions the effectiveness of the measures put in place since 2004. The objectives which governed their creation are today far from being achieved. Successive reports from the Court of Auditors have regularly called for strengthening the management and evaluation of policies financed by the CNSA. In its report published on December 19, 2025, it notes in particular that the fund finances “a pile of poorly evaluated and insufficiently controlled systems” and calls for “a consolidated vision of what the CNSA finances”. Solidarity cannot be reduced to a levy on the work of employees if it does not translate concretely into means commensurate with foreseeable climate risks. The MP questions the relevance of this model. He asks what assessment the Government draws from more than twenty years of financing autonomy through the solidarity day, if an evaluation has been carried out of the effective contribution of these revenues to the prevention of the health consequences of the episodes heatwaves, in particular with regard to the adaptation of medico-social establishments, support for home help, the identification of vulnerable people and the strengthening of prevention mechanisms, and finally, if the Government considers that the consequences of climate change should be financed as a priority by capital income, by means of a shareholder solidarity day rather than by a contribution weighing on employees.

Machine translation from French. The official text remains authoritative.

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