Like a new cobblestone in the pond. The release this Wednesday of the book “The Gravediggers” by independent journalist Victor Castanet reveals after three years of investigation, behind the scenes of certain establishments of the Orpea group: deficiencies of certain health and food products, lack of care administered to certain residents… His work adds to the list of reports from associations and television reports already produced in recent years in certain French nursing homes (accommodation establishments for dependent elderly people).
As soon as good sheets appear in The world, the reaction of the Ministry of Health was not long in coming. “In order for light to be shed on the serious facts mentioned in Victor Castanet’s book, I am summoning the CEO of Orpea as soon as possible, at the request of Olivier Véran. I have a moved thought for the residents of Ehpad, their families and the professionals, ”assured through
from a tweet Brigitte Bourguignon, Minister Delegate in charge of Autonomy.
Director General Orpea will soon be received by the Minister
Investigation flash was also requested from ARS Ile-de-France. Contacted by 20 minutes, the ministry confirmed that the minister was totally “revolted against these treatments which are degrading and unworthy, if they were proven”. The Board of Directors of Orpea has since announced that it has taken the decision to call on two independent firms to assess all “reported allegations”. Jean-Christophe Romersi, the group’s managing director, will be received on Tuesday February 1 by Brigitte Bourguignon.
Following these revelations, 20 minutes takes stock with Joachim Tavares, former director of Ehpad and founder of Papyhappy (company specializing in finding housing for seniors) and Pascal Champvert, president of the association of directors serving the elderly (AD-PA). What are the different levers available today to counter abuse in certain nursing homes?
An abusive system?
For Joachim Tavares, founder of pappyhappy, these revelations raise “the problem of the global system of care for the elderly”. However, it should not be generalized to all establishments, believes the former director of Ehpad. “I don’t think we’re taking the problem in the right direction. It’s easy to hit big groups like Korian or Orpea, but it’s the profession and the sector of activity that needs help to improve. »
An observation partly shared by Pascal Champvert, who sees in it a certain number of “individual abuses”. Nevertheless, for the president of the AD-PA, “some of the things that are revealed relate to systemic abuse. That is to say that it is the whole system that is mistreating”.
“The State and the departments are judges and parties”
Valérie Précresse said on Wednesday that she wanted to “radically” review the Ehpad model and pleaded for the creation of a “compulsory reference system” for all establishments. Presidential candidate LR wants daily living conditions to be “strictly controlled”, from the quality of food and care to the size of the rooms, including “the time devoted individually to each resident by caregivers “.
Taking better account of these reports could appear to be a simple and lasting solution. According to the director of the AD-PA, a strengthening of controls would not make sense without an increase in human and financial resources on the part of the State and only if they are carried out by independent authorities. “In this case, they will be able to check what the State and the departments are doing. Which is not the case today, since they are judges and parties. »
An independent authority to ensure controls?
Because the financing of nursing homes, whether public or private, is divided into three areas: care, dependency and accommodation. It relies in part on public funds. The care and dependency allocations are financed respectively at 100% and 70% by public administrations. However, in several cases mentioned in The Gravediggers, “part of the public money which was to be allocated for the benefit of the elderly was not”, said Victor Castanet on France Inter on Tuesday. The journalist also points to the responsibilities of the regional health agencies (ARS) “which, in many respects, have failed in their primary missions: to ensure the proper use of public money and, above all, to protect our seniors”.
Laurent Garcia, nurse and former Orpea executive, is the main whistleblower whose remarks are taken up in The Gravediggers. Asked by
France Info, he considers that it is necessary “that there be an independent administrative authority which can control all private and public nursing homes”. Very committed, he campaigns for the creation of an Observatory of old age (Ogra).
Basic problem
According to information sent by the ARS to the Defender of Rights, the number of unannounced checks and inspections during the years from 2017 to 2019 varied between three and 50 per year, depending on the region. In one
recent report of the defender of rights about the “fundamental rights of the elderly in nursing homes”, five recommendations addressed abuse. One of them proposes setting up regional observatories in order to respond to reports.
Joachim Tavares also underlines a lack of action on this file. “For more than 20 years, nothing has actually been done to think about a new nursing home system and support. The human resources at present are not sufficient. »
An expected “Ephad” roadmap
Pascal Champvert notably defends the implementation of a ratio of eight professionals for ten residents. In addition to the difficulties inherent in the lack of medical and qualified personnel, “the real fundamental problem is that we are in a ageist society “, he underlines. He believes that awareness is necessary, especially on the part of the political world and hopes that Emmanuel Macron will speak out on the subject by the end of his mandate.
One report on long-term care units (USLD) and Ehpad was submitted to the Ministry for Autonomy in July 2021. Among the 25 recommendations listed, one suggests that establishments should ensure the exhaustive reporting of “events serious undesirable effects” linked to care, including in particular “situations of mistreatment”. Announced by Brigitte Bourguignon, the publication of a
“Ehpad” roadmap is expected in the coming weeks. It remains to be seen to what extent she and her teams will take up existing recommendations.