Ehpad: a year after the book “Undertaker”, the rules are stricter, but the difficulties remain
the important thing
Published a year ago, the book “Les Fossoyeurs” dedicated to the alleged embezzlement of the Orpea group and the living conditions of its elderly residents caused a scandal. What has changed in nursing homes over the past year?
The emotions sparked a year ago by the revelations of the book “Les Fossoyeurs” about the malpractices of the Orpea group led to increased controls, stricter budget rules and greater transparency, but did not change anything on the chronic shortage of staff in homes for the elderly, underline the actors of the sector.
First hit by the media tsunami, the Orpea group itself first reacted by denying any failure, then changed strategy: it fired its top executives and announced that it wanted to improve its practices. But the company, which is the target of several legal investigations, is struggling financially and struggling to complete a debt restructuring plan.
For the author of “Fossoyeurs” (Fayard), Victor Castanet, who is pleased to have started a “social debate”, in any case there is no longer a “system” in Orpea whose goal is to maximize profits at the expense of good residents and employees, and through embezzlement public money. Internally, social dialogue has improved significantly, said a CGT delegate, who wished to remain anonymous. “Before, the management simply did not listen to us. Now we can talk to each other, in a calm atmosphere”, although “some regional directors are still in their places, formatted in the old Orpe”, she adds. The unions of Orpe also expect a lot from the new professional elections scheduled for March 9, because the judiciary annulled the previous election, considering that it was manipulated by the former administration in favor of the “house” union – as Victor Castanet said. Initially focused on Orpe, the scandal has had consequences for the entire sector of retirement homes, whether private, association or public.
Before and after
Controls have been stepped up everywhere: while previously each facility was inspected only every 20 years, the government has ordered an inspection, within two years, of all 7,500 nursing homes in France. By December 31, there were about 1,400 of them (or in the process), half of them on site. By the end of the year, 120 inspectors must be hired in order to strengthen the staff responsible for these inspections. In addition, a regulation published in April forced institutions to be more transparent about their services and management of the amounts charged to residents.
“Not everything changed overnight because not everything deserved to change,” emphasizes Florence Arnaiz-Maumé, general delegate of Sinerpa, the union of private nursing homes. “There will be before and after “Les Fossoyeurs”, but the evolution must be done in the long term,” she assures. In order to “restore public confidence”, Synerpa presented this week a “charter” of ten commitments, which have already been signed by the main groups in the sector, including Korian, Colisée and DomusVi. It is planned to publish indicators on the quality of care for residents, but also on the quality of life at work for employees, as well as an analysis of the risk of abuse.
“Nothing has changed for the elderly”
However, “transparency does not necessarily mean quality,” notes Annabelle Vêques from the association Fnadepa, which brings together around 1,200 directors of homes for the elderly. “Not because we show the number of employees, the elderly will be better supported”, adds this official, who doubts the effectiveness of the controls announced by the Government: according to her, in most cases, the controllers will be satisfied with only accounting and administrative documents sent by e-mail by directors . “We hoped that this scandal would lead to something concrete. But on a daily basis, nothing has changed for the elderly,” complains Annabelle Vêques: “We are still short of staff, we have not seen any progress in the quality of service, reception, and the Government has not yet started drafting the law on old age,” she laments.
For Laurent Garcia, health care manager at Ehpad who was one of Victor Castanet’s sources for his investigation, “people working in the profession want to change things, but not the government. The book made it possible to lift the veil on the situation of the elderly, but this veil has fallen “.