Macron still faces a battle to fund his ageing nation
The problem of an ageing population and how to fund pensions and dependency care that has bedevilled previous governments has now landed in President Macron’s lap.
It has been estimated that these costs will double in the next 20 years as people live longer and need more support.
France has fewer people in work and more and more over-60s – especially over-75-year-olds – needing care.
Costs are rising too, as longer lives do not necessarily mean extended healthy lives.
In his speech, the president said we must face up to the problems of advanced age and give them more visibility.
He said: “For years, we’ve acted as though it doesn’t really exist, but there are around a million and a half citizens who are dependent, which is an enormous burden on their families.”
He added that the sector of dependency care for the elderly is badly structured and it is hard to recruit people because the work is hard and badly paid.
He said: “From this autumn, we will finalise a strategy, defining what public money we will provide to finance this increasing problem of dependency in old age, and reorganising the sector so as to create jobs - both for those with few qualifications and for the well-qualified - and a whole industry to go with this, and a reduction of the costs that are left to family.
“We have to be ambitious about it and these policies must be fully in action by 2025.”
A Grand âge et Autonomie report recently compiled for the Health Ministry also looked at new financing and ways of maintaining independence.
It called for new-style care homes and renovating and improving existing Ehpad ones.
Increasing staff by 25% and training more high-quality staff are expected to cost €9.2billion over the next decade.
Finding the money is key but with the gilets jaunes protests denting any plan to simply raise taxes, the task has grown.
The report’s suggested means of funding, by setting up a separate social security fund paid for by a rise in social charges, has since been ruled out by spokeswoman for Mr Macron’s LREM party Aurore Bergé, but not definitively.
She said Mr Macron and her party had been elected on promises to “revalue work” while not increasing either public debt or taxes – and without rethinking the 35-hour week or raising retirement beyond 62.
She has previously stated that the party favoured a second journée de solidarité – working a public holiday – to fund elderly care, saying people were ready to “work more if we say the money will be used to cut taxes or fund Ehpads”.
However, cutting a public holiday was rejected by Mr Macron during his speech and subsequent question and answer session with the press.
The problem is not just funding, as 40% of people who need care go into Ehpads because there are insufficient means to care for them at home.
Care home costs are high, with residents or families paying on average €2,000 a month, 10 times the cost in Sweden.
A new health law is currently going through Parliament.
It should create 4,000 medical assistant posts by 2022 to cover routine tasks for doctors; allow chemists to prescribe simple medicines; name a dedicated GP for patients who cannot find one; create new hospitals and maternity services; improve continued training for doctors; and reform medical studies to relax the numerus clausus which artificially limits the number of medical students.