Question 8565 — social and medico-social institutions

Summary

Ms. Mathilde Feld alerts the Minister to the Minister of Labor, Health, Solidarity and Families, responsible for health and access to care, about the deterioration in reception conditions for dependent elderly people linked to the measures taken by the Government since 2020 and who have not been the subject of financial compensation. In a context of demographic aging, where the share of people over 60 expected to reach 36% of the total population in 2070 compared to 28% currently, the reception of dependent elderly people in dignified conditions is a major challenge. However, the current fabric of medico-social establishments welcoming this population is weakened by the measures taken by the Government. Indeed, the measures taken in the aftermath of the covid crisis, which were absolutely necessary (Ségur bonus, increase in the index and social contributions, revaluation of categories C and B and the night bonus), were not compensated by the ARS and the departmental council, whose budgets were cut by the Government. This obviously led to the deterioration of the budgetary situation of these establishments. This mechanism is found in the twelfth district of Gironde, at the public medico-social center of Monségur, a recognized reception center for its quality, bringing together a public accommodation establishment for dependent elderly people (EHPAD), a nursing home and a home nursing care service. Starting from a stable financial situation in 2020, the application of post-covid measures without an increase in funding has strained its budgetary situation and created a deficit. The structure is now threatened by the plans to return to balance desired by the regional health agency and the regional chamber of accounts. In fact, the regional chamber of accounts is proposing the blocking of careers, the cessation of recruitment of permanent staff and the replacement of nursing assistants with non-qualified temporary workers for the sake of savings. This is indeed an austerity plan rolled out at the local level which would lead to both an unacceptable deterioration in the working conditions of employees but also the conditions for welcoming the public within the establishment. The situation of the Monségur PPMS is far from being a unique case. At the national level, the Senate noted in its information report on the situation of EHPADs that the share of deficit structures increased from 27% to 66% between 2020 and 2023, thus proving that this is a situation created from scratch by the policies put in place at the national level and attacking directly to the quality of reception of vulnerable populations. She therefore asks him what measures he intends to take to enable the financing of post-covid measures by medical-social establishments without endangering their financial stability, while continuing to ensure dignified working conditions and quality reception of dependent elderly people.

Machine translation from French. The official text remains authoritative.

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