One year after the Orpea scandal, multiple and fragile measures


Jean-Christophe Combe, the Minister for Solidarity, Autonomy and People with Disabilities, visits an Ehpad in Agen, January 20, 2023.

On the top floor of the Ministry of Health, around thirty journalists are gathered around a large oval table, Tuesday January 24, at the invitation of Jean-Christophe Combe. ” You’re in luck ! Because I didn’t have Victor Castanet’s book. I don’t know what’s in it.” slips the Minister of Solidarity, Autonomy and People with Disabilities. Released a year ago, the book The Gravediggers fate, Wednesday, in pocket format (J’ai Lu, 512 pages, 9.50 euros). The new edition is accompanied by ten new chapters. Would new revelations about the fallen giant of retirement homes shake up the ecosystem again and fuel the mistrust of the French towards retirement homes? Since the health crisis, occupancy rates have fallen and are struggling to rise. An aftershock of the earthquake caused by the book’s revelations is to be expected. Was Mr. Castanet’s book reviving the debate on the impossible reconciliation between the search for profits and the quality of care for residents?

Read also: Article reserved for our subscribers Orpea scandal: in his reissue of “Fossoyeurs”, Victor Castanet reveals the pressures and manipulations suffered during his investigation

“Post-Orpea Minister”, as he defines himself, Mr. Combe preferred to take the lead in an attempt to defuse the media shocks. This led him to draw up, on Tuesday, an initial inventory of the measures taken over the past year to clean up practices in the sector. In March 2022, the government undertook to mobilize the regional health agencies (ARS) to check the 7,500 nursing homes by 2024. To date, they have carried out 1,400 checks since the spring, including 59% on site. They gave rise to nearly 1,800 recommendations, prescriptions or injunctions and to eleven referrals to the public prosecutor, in particular for mistreatment, endangering others, bad circuit of the drug.

49% of these checks concern lucrative nursing homes. Failures observed by the ARS “do not depend on the status of the establishmentsaid the Minister. There are no more in the lucrative sector than in the public or the associative sector. Regarding the quality of support, we see that there are difficulties everywhere”. A finding which justifies that the government has taken measures over the past year that target all nursing homes.

States General

Among the Orpea post-scandal measures, the High Authority for Health published, in March 2022, a “reference” as it exists for hospitals which serves as a basis for future evaluations of nursing homes. The National Solidarity Fund for Autonomy has created five quality criteria which will be allocated to nursing homes and made public (number of single rooms, presence of a coordinating doctor, etc.). Five other criteria should be created such as the number of caregivers per resident but need to be validated by legislation. The idea of ​​establishing a “minimum ratio of caregivers per resident” is provided for in the bill “aging well” tabled by the majority in the Assembly, in December 2022. “But the problem is more to bring in professionals than to free up financial means”, points out Mr. Combe.

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