Question 5435 — social security

Summary

Mr. Laurent Alexandre draws the attention of the Minister to the Minister of Labor, Health, Solidarity and Families, responsible for health and access to care, to the future of the National Autonomous Fund for Social Security in Mines (CANSSM)-Filieris due to the absence, to date, of contractualization between the mining regime and the State. Created in 1946 to ensure the management of the special social security regime in mines, CANSSM manages a vast network of health professionals, accessible to all, employing 4,600 employees in 70 different professions, committed to developing local health mainly in former mining territories, particularly affected by medical desertification and difficulties in accessing care. In Occitanie, there are 730 employees distributed between 14 health centers, care services nurses and home help, 1 EHPAD and 2 medical and rehabilitation establishments. Filieris is therefore a key player in the public health service which mobilizes a wide variety of stakeholders to ensure effective access to local care in local areas. Over the years, CANSSM-Filieris has undergone numerous reconfigurations of its healthcare offering. The latest objectives and management agreement (COG) between the State and the CANSSM, set itself the precise goal of initiating “a process of evolution of the organization of Filieris and of completing its development no later than the date of its expiration”. This COG was completed at the end of 2024. Today, CANSSM-Filieris, its collaborators and its patients are however kept in serious uncertainty due to the lack of commitment from the Ministry of Health on a 2025-2028 COG. This one is nevertheless necessary to guarantee Filieris the budgetary means of operation and multi-year investments allowing it to guarantee the sustainability, the development of its missions, the essential recruitment of health personnel and professionals in response to the needs of the populations. The CANSSM-Filieris union federations are proactive and proactive in order to achieve a public service mission as part of a cooperation agreement between the CNAM and the CANSSM aimed at consolidating its healthcare offering, particularly in terms of prevention, home care for the elderly and care for chronically ill people. To date, nothing seems committed and CANSSM-Filieris sees its development hampered by this lack of visibility while the recruitment of health professionals is expected by the population of the living areas. concerned. Consequently, he asks the Government's intentions on the future of mining social security, in particular concerning the development of the COG 2025-2028 between the State and the CANSSM.

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