By 2050, France will be facing an inescapable demographic reality: according to INSEE figures, more than four million senior citizens will be losing their independence. This alarming forecast raises crucial questions about how our society plans to care for its senior citizens. To maintain a constant proportion of people in residential care by department, gender, age group and degree of loss of autonomy, it is imperative that the number of permanent accommodation places increases significantly: up 20% by 2030 and more than 50% by 2050.
Faced with this enormous challenge, it is clear that the government alone will not be able to shoulder the burden. The private sector will have a key role to play in meeting this major societal challenge. Greater collaboration between the public and private sectors is therefore needed to guarantee a secure future for our elderly.
The key role of the private sector in managing dependency care
The first challenge is financial and organisational. Public resources are under pressure, and a decent standard of living must be absolutely guaranteed by limiting the strain on existing infrastructure and staff. It is therefore essential to reinvent the current model.
Although the government is supporting alternative solutions to EHPAD (residential care homes), such as home improvements for senior citizens, shared housing and inclusive housing, these initiatives will remain insufficient. Such alternatives are certainly commendable and provide a degree of flexibility in the care of the elderly, but on their own they will be unable to meet the massive needs that are emerging. A more global and collaborative approach is required to strengthen coordination between the various operators and public authorities, reform funding and optimise resource management.
Private players, despite facing a crisis of confidence as a result of the controversies that have shaken the sector in recent years, are emerging as the main viable long-term solution. Combined with strengthened governance and clear objectives, the partnership between the public and private sectors will make it possible to respond effectively to growing needs while ensuring responsible management of resources. It is time to overcome mistrust and strengthen synergies to (re)build a more resilient support system.
The government must play its role as guarantor
A number of measures are required. First, it is essential to define and reinforce the standards specific to the sector, so that they are adapted to the expected growth in the ageing population and to ensure a constant quality of service. Funding and pricing mechanisms also need to be reviewed to ensure that services meet the real needs of seniors. At the same time, close collaboration with the private sector will be necessary, with the government offering tax incentives, targeted subsidies and encouraging partnerships that guarantee accessible, high-quality services.
Staff training must obviously be at the heart of this approach, with the establishment or reinforcement of specific training standards and qualifications. Similarly, increased monitoring and ongoing regulation are critical to ensure that current regulations are complied with, quality standards are maintained and effective reporting mechanisms are put in place.
A multi-dimensional approach to meet France’s specific challenges
While the models of our European neighbours provide valuable lessons, they do not offer a miracle solution or one that is directly applicable to France’s specific situation. In Sweden, the long-term care system is a benchmark for the care of the elderly, emphasising quality and continuity of care. The Netherlands stands out for its innovative approach to housing adapted to the needs of older people who are losing their independence, encouraging them to remain in their own homes. Germany, with its compulsory long-term care insurance, offers a sustainable funding model to cover the needs associated with long-term care. Denmark, for its part, is focusing on the creation of age-friendly communities to promote social inclusion. Finally, Norway stands out for its commitment to the active participation of older people in decisionmaking that affects them, thereby promoting their autonomy and dignity. All these models have specific advantages but are adapted to different national contexts and cannot be directly transposed. There would be undeniable virtue in drawing inspiration from these good practices, but none of them will have sufficient impact if France does not first carry out a thorough reform of its dependency care system.
It is clear: managing the growing dependency of senior citizens in France is a major challenge that requires a multidimensional approach. Collective efforts to define quality standards, encourage innovation, guarantee transparency and ensure adequate funding must be at the heart of it. This is the key to guaranteeing our elderly the dignity and care they deserve.