health authorities unable to measure abuse

Poorly cared for, malnourished, isolated pensioners… The revelations about the ill-treatment inflicted on residents of accommodation establishments for dependent elderly people (Ehpad) have multiplied since the publication in January of the investigative book The Gravediggers (Fayard) on the excesses of the Orpea group. But how widespread is abuse? How many of the approximately 700,000 nursing home residents have been victims? To date, the French health authorities are unable to say.

Asked in February, the government said it did not have reliable national statistics on the subject. However, a “annual national statistical report” situations of mistreatment in the medico-social sector is established every year by the Ministry of Health since 2010.

Read the survey: Abuse in Ehpad: cacophony in the follow-up of alerts and controls

These reports have so far been kept secret by the government, which at first refused to release them to the World. However, nothing prevents their publication, estimated the Commission for access to administrative documents (CADA), which we requested. Following the opinion issued by the CADA on July 7, the Ministry of Health finally sent us the last four editions of this national report, dated from 2018 to 2021.

Reports that go back to the dropper

In these annual reports, the monitoring alert mission of the General Directorate for Social Cohesion (DGCS), which depends on the Ministry of Health, is supposed to document the nature of the “exceptional and/or dramatic events threatening or compromising the health or safety of users” medico-social establishments. This includes nursing homes, but also establishments welcoming disabled adults and those of child protection.

However, far from producing an X-ray of reports of mistreatment or violence, these reports actually reveal that the ministry is almost blind to these phenomena, due to major shortcomings in the monitoring system and the feedback of information from the field.

Every year, the DGCS publishes a report on reports of violence and mistreatment in health care establishments, which reveal shortcomings in the monitoring of these events.

In principle, medico-social establishments must report any serious malfunction to the regional health agencies (ARS), which must then report the most serious cases to the national level.. However, the DGCS regrets not receiving “only a very low number of reports” from the ARS: barely ten cases of mistreatment each year, all types of establishments combined. In 2019, more than a third of the ARS (seven out of eighteen) did not report any reports. Year after year, the reports deplore that the central administration has only “very little data”thus distorting their analysis.

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