The Our Public Services collective analyzed two decades of public policies and compared them to changing needs, in education, health, justice, security and even transport.
“The means of public services have been increasing less rapidly than social needs for twenty years”that is to say that the needs of citizens, warns a report published Thursday September 14 by the collective Our public servicesand written by around a hundred public service agents, researchers and citizens.
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According to the authors, public policies have not been able to adapt as quickly to changes in society. “The needs of society are evolving, society is transforming and the means of public services are not keeping up, explains on franceinfo Arnaud Bontemps, magistrate at the Court of Auditors and spokesperson for the collective. For fifteen years, we have had a growing constraint on resources, on public service spending, fewer civil servants, fewer taxes, which create a growing gap, a gap.” The private sector therefore takes advantage of this to develop, by offering a response to these unmet needs. “It is in this gap that a space opens up for the private sector, continues Arnaud Bontemps. And in return, this development of the private sector destabilizes the public service.”
To arrive at this observation, the report is based on the analysis of two decades of public policies, in comparison with the evolution of needs in education, health, justice, security and even transport. Overview of the main axes of the study.
Health
The annual number of emergency room visits increased from 17 million in 2010 to 21 million in 2019, an increase of “more than 20% in less than ten years”. The aging of the population and “massive growth” chronic diseases weigh on the health system, warn the authors of the report. That “requires better coordination and distribution of care”. At the same time, private clinics “increase their place”.
According to Arnaud Bontemps, we are thus witnessing “a bypass of the public sector by the private sector”. “The private sector, in particular for-profit clinics, concentrates on surgery, that is to say procedures which are very programmable and very profitable. We leave the most precarious patients, the most vulnerable, to the public hospital. emergencies and the most serious care, for example resuscitation.” A system is thus developed with two different models “depending on whether or not we have the means to bypass the public service”.
Justice
Concerning justice and security, the “feeling of insecurity felt by the population remains high”. But despite the increase in allocated resources, the authors note a “deterioration of the quality and effectiveness of the judicial response”. The time taken to judge a civil case before the high court, for example, increased from seven months in 2005 to 14 months in 2019.
Education
The report also notes a “massification phenomenon” in education: there are more and more high school graduates and students. “The proportion of higher education graduates has doubled in 25 years among 25-34 year olds.” In this context, more and more parents are turning to private schools and private lessons, but the majority of “favored families”. There “share of children with strong cultural capital” in private schools under contract has gone from “29% in 2003 to 40% in 2021”.
Public policies in education “fail to renew themselves” to take into account these inequalities and the well-being of students, insists the report. According to its authors, private services are more costly for the State, and they do not allow “unconditional welcome”, unlike public services. Inequalities therefore still tend to widen.
“This development of a private service gradually leads to the transformation of the public service into a minimum and degraded service, and, therefore, the progressive loss of its universal vocation“, alerts the collective, which hopes to spark a public debate after this unprecedented report.