Old age and dependency: what the candidates for the presidential election are proposing

The book investigates The Gravediggers by journalist Victor Castanet highlighted the scandalous living conditions in nursing homes, three months before the first round of the presidential election. The situations of mistreatment and profit seeking to the detriment of the comfort of the residents described made the candidates react to the problem of old age and dependency. In September 2021, the abandonment of the law Old age and autonomy had aroused strong reactions in France since it had been promised on numerous occasions by different governments.

All of the candidates for the presidential election were questioned on the measures to be taken to improve care for the elderly, the status of establishments and the fifth branch Autonomy of Social Security. The 10 who answered us are unanimous on the implementation of a reinforced control of Ehpad and a greater consideration of caregivers and caregivers. On the left, we tend to promote a public dependency service, while on the right, we advocate legal regulation of the sector.

Left: towards a nationalization of dependency

Jean-Luc Melenchon is in favor of a public dependency service. To do this, he offers “the transformation of private for-profit nursing homes into associative, cooperative or public structures” and development “a public network of home help and care services”. He also wishes “revalue the personnel of the medico-social sector at home and in institutions” and “create 210,000 caregiver positions in medical accommodation structures”. The LFI candidate promotes a “more human” approach in nursing homes. He suggests a complete break with “the deterioration of the allocations allocated to nursing homes in recent years” in order to offer “graduated, adapted, benevolent care that respects the dignity of each person”. About the fifth branch Autonomy of the Social Security, the candidate counts “Incorporate it into the principle of national solidarity, with funding commensurate with needs, through employee and employer contributions, within the framework of direct management by Social Security”.

Yannick Jadot wishes meanwhile “freeze the opening and development of for-profit nursing homes”. He proposes “the revaluation salaries, diplomas and career paths related to the professions of support for autonomy”. The environmentalist candidate also promotes “benevolent, caring support adapted to the needs of people with loss of autonomy”, which will notably involve the creation of “training in well-treatment”. According to him, it is necessary “strengthen the public funding of non-profit nursing homes” and the “industry-wide checks”. Regarding the fifth branch of Social Security, the candidate associates “the prevention and management of loss of autonomy, in line with the recommendations of the Libault report” (2019).

Anne Hidalgo above all proposes to increase “50% Personalized Autonomy Allowance”. According to the PS candidate, this increase will allow “more hours of home help for the elderly”, and “employees who will be better paid”. She also insists on increasing the number of caregivers, i.e. “40,000 more jobs during the five-year term”. For nursing homes, it requires “a national control plan, involving the Defender of Rights who will be able to control the establishments”and “a training and recruitment plan for old age professions”. Finally, it defends the establishment of a “public service to support the loss of autonomy, which will support families and carers” and the “strengthening the status of carer”.

Philippe Poutou chooses to use Olivier Besancenot’s slogan concerning old age: ”Our grannies are worth more than their profits”. According to the NPA candidate, there is a “incompatibility between a society based on private property and the pursuit of profit on the one hand, and the satisfaction of the basic needs of the population, including health, on the other”. For private nursing homes, it offers “expropriation of shareholders” and “the integration of these establishments, with their staff, into the public service”. Poutou demands “a training employment plan”making it possible to train 200,000 caregivers to reach “ratio of one agent for one resident”. According to him, it is up to Social Security to “fully fund the loss of autonomy”, Under the form “of a fifth branch” Where “an extension of health insurance”.

Nathalie Arthaud condemns the lack of staff in nursing homes. “We need reinforcements now, urgently, to relieve the workers of the establishments who are particularly affected”. She proposes increasing the salaries of caregivers and “reinforce the presence of paramedics, hospital service agents, stretcher bearers and non-medical workers”. For the candidate Workers’ struggle, “all the needs necessary to compensate for the loss of autonomy – whether linked to a disability or to aging – should be taken care of by the community”

Right: Supervision and return of the Old Age Law

Valerie Pécresse undertakes to reform old age. “It is time to take full measure of the changes introduced by a longevity society and finally pass a law on old age that addresses this major issue for millions of French men and women.. It plans to “bring more home care” and “develop temporary accommodation, day care and respite platforms for caregivers throughout the country”. Candidate LR proposes “a ratio of 8 caregivers for 10 residents”and “a major training and recruitment plan in the territories”. Regarding the status of EHPADs, it requires a “evaluation of nursing homes by the residents themselves and their families” and “an unexpected and systematic control of large groups”. She intends to give “finally a reality” to the fifth branch Autonomy of the Social Securitywhich “should articulate with the new missions of the departments”and “their skills in the entire field of medico-social”.

Marine Le Pen proposes to finally pass the law Old age and autonomy. Within the framework of this law, it advocates the “home support for the elderly”the “frailty screening”, the “caregiver support”the “reinforcement of the rate of supervision and medicalization of nursing homes” and the “strengthening of nursing home controls”. It will make these measures also those of the fifth branch of Social Security. According to the RN candidate, we must change the status of nursing homes and “impose supervision quotas and rules of good practice applicable to both private nursing homes and public nursing homes with rigorous controls”.

Nicolas Dupont-Aignan, as for him, wishes “toughen the penalties for caregivers or supervisors” guilty of abuse and “multiply checks in nursing homes. The candidate joins Marine Le Pen on home care for the elderly, which would go through “housing adaptation” and “an improvement in liberal care”. He proposes to increase “25% the management rate in nursing homes, i.e. 80,000 additional positions”. For the candidate Stand up France, the sustainability of the fifth branch of Social Security is “not sufficient”. He intends to do “vote by Parliament a major multi-annual programming law” for “promoting the autonomy of the elderly”. Finally, he pleads for giving a more important place to old age in society. “The issue of old age and autonomy must find its place at the University and in research institutes, in order to revalorize increasingly essential professions” he told Doctissimo.

The other candidates

Emmanuel Macron wish “the increase in the remuneration of carers at home and their quality of life at work”. The candidate LREM also proposes to create a “territorial service in connection with the departments”in order to “coordinate home support procedures and services” and “relieving caregivers”. He too wants to increase the rate of caregivers by 25% by 2027. As for nursing homes, he advocates a reinforced control policy. “To improve the transparency of the use of public funds, we will strengthen the methods of control. Each establishment will thus be checked every 2 years compared to 10 years today”he told Doctissimo. The candidate considers the fifth branch of Social Security as “crucial progress in meeting the challenge of ageing”. It will guarantee “the quality of the public service of autonomy for the elderly, people with disabilities and their relatives thanks to the simplification of procedures” and “the development of actions to combat isolation and actions to prevent the loss of autonomy or excessive disabilities”.

John Lassalle proposes to “support carers of people in a situation of dependency”. To respond to the problems of old age, the candidate wishes “guarantee by the Constitution and under intergenerational solidarity, the absolute maintenance of the purchasing power of pensioners in the face of inflation”. Finally, the candidate suggests the creation of a “ministry autonomous and full-fledged exclusively dedicated to pensioners and retirees”.

The candidates of the PCF Fabien Roussel and of Reconquête Eric Zemmour did not answer our questionnaire, which is why their proposals do not appear in our article. You can find all the answers to our questionnaire on the health issues of the different candidates: Emmanuel Macron, Marine Le Pen, Jean-Luc Melenchon, Valerie Pécresse, Yannick Jadot, Anne Hidalgo, Nicolas Dupont-Aignan, Philippe Poutou, John Lassalle and Nathalie Arthaud.