For two hours last November, the residents of a care home in the Parisian suburbs were left on their own, which resulted in an outcry from campaigners. As austerity measures sweep through the French care sector, the incident highlighted a severe shortage of staff the impact it was having on the elderly and a severe shortage of staff across the country.
According the government's living together longer report, in 2010 the cost of care for the elderly in France was estimated at €34bn, 77% of which was covered by the public sector. Public sector union CGT claims that this is has since been cut by over a half – 55% – and had estimated that up to 15,000 beneficiaries would lost their care services in 2011.
With numbers of the over 80s set to rise by 104% by 2035, the situation is likely to worsen, with many of the elderly already falling below the poverty line.
In 2007, president Nicolas Sarkozy promised to create of a "fifth branch of social security to meet the challenges posed by an ageing population in need of care. But last summer, he put these plans on hold, citing the current economic climate.
The shortage of personnel and equipment has inevitably led to cases of abuse and negligence, with varying degrees of severity. Nursing interns, keen to share their experiences and observations, have reported staff absences and lower standards of care, for example only five-minute showers, broken televisions left unrepaired and patients left without food or water for hours. In one care home, the same pair of cleaning gloves were used to clean both the toilet and kitchen appliances to cut costs.
Up to 80% of people in France opt to receive their care at home but dwindling funds mean overstretched care workers aren't able to follow up all complaints of abuse by relatives.
Among nursing interns, there is a pervading feeling of hopelessness and many have permanently left the profession after completing their internships, often due to overwork.
Michel Julien, an auxiliary nurse from Lozère said: "Residents require around the clock help … but our working conditions keep getting worse. This has direct consequences on the wellbeing of the residents."
The government says that the public sector cannot shoulder the cost. Two years ago, a report from the Ministry for Soldarity and Social Cohesion (MSSC) on "dependency" set out a number of funding alternatives that would in effect leave insurance companies to plug the gaps. It has also called for a "restructuring" of the APA, the main living allowance for older people, that would exclude all but those most in need.
Organisations such as the Federation for the Quality of Life of Elderly People and the Association of Care Home Directors have expressed their concerns, stating that insurance "should under no circumstance replace existing public funds".
Pierre Béhar from the Union for Home Care Personnel, said: "With private insurance, care services for the elderly will depend on their financial contributions, so the level of care will depend on how rich or poor they are."
According to the living together longer report, the average the cost of care is around €1500 to €2000 per month, which many see as already prohibitive. Campaigners warn that more pensioners would be condemned to longer stays in hospitals and that relatives would have to give up work to look after them; which would have the opposite effect of cutting down the cost of caring for the elderly.
According to Ghislaine Raouafi from CGT, "the government wants to spend as little as possible from the public purse and leave the elderly, their families and workers to shoulder all the costs".
In it's report, the MSSC also stressed the importance of encouraging over 60s to work, citing the UK as an example. It conceded however that jobs are often precarious and that "seniors" work largely out of necessity, to supplement insufficient pensions.
Other proposals have found common ground with care organisations. They agree that services need to be better co-ordinated or grouped together as the fragmentation of the care system has made it harder for organisations to work together.
Finally, all agree on "pre-emptive" measures such as health and fitness programmes and local clinics for treatment of milder ailments in the hope of making medicalised care services a last resort.