TRUE OR FALSE. Is it true that 80% of French people do not have access to palliative care, as Olivier Marleix states?

The leader of the Republicans in the National Assembly assures that “80% of French people do not have access to palliative care”. This is incorrect, it is estimated that 50% of French people who should be treated in palliative care do not have access to it.

While the bill on “assisted dying” announced by Emmanuel Macron will be presented to the Council of Ministers in April and examined in the National Assembly “as of May 27”, the question of access to palliative care regularly comes up in the debate. We hear everything and its opposite on the subject. “We are not up to par on palliative care, there are 80% of French people who cannot access it,” for example, declared on LCI the president of the Les Républicains group in the National Assembly, Olivier Marleix. True or false ?

50% of French people who should be treated in palliative care do not have access to it

This is incorrect, this figure is not updated. According to an estimate from the Court of Auditors, in a report published in July 2023, 50% of French people who should be treated in palliative care do not have access to it. This estimate is taken up by the French Society for Palliative Care.

To make its calculation, the Court of Auditors considered, based on projections, that 365,273 people who died in 2021 should have benefited from palliative care. However, 90,780 patients benefited from this end-of-life care in hospital, around 43,000 in home hospitalization and around 52,000 in community medicine. By doing a simple addition and division, we obtain this result: precisely 50.9% of patients who should have received palliative care had access to it.

A difficult estimate to make

The Court of Auditors itself recognizes that it is difficult to precisely measure this problem. On the one hand, it is complicated to assess how many patients should benefit from palliative care. It remains quite subjective. On the other hand, it is difficult to count how many people actually received this care, at the end of life, for those who were at home or in nursing homes. There is no official data from the Ministry of Health.

We also hear other figures in the public debate: two-thirds, 75% or even 80% of patients who should benefit from palliative care do not have access to it. This data is not updated. They are taken from a parliamentary report dating from 2015, before the vote on the Claeys-Leonetti law, or from a report from the General Inspectorate of Social Affairs (Igas) dating from 2017. The work of the Court of Auditors made it possible to obtain a new estimate.

+ 24% of palliative care beds, but still disparities across the territory

In recent years, the provision of palliative care has grown. In hospitals, the number of palliative care beds increased by 23.9% between 2013 and 2019. There are now more than 7,500 in France. The number of palliative care units, dedicated to the most complex cases, and mobile units has also increased. But the supply remains very unbalanced across the territory: 22 departments, for example, do not have a unit. Gers, Creuse, Mayenne and Vosges are some of them. Professionals also warn of a lack of staff, services sometimes have to operate in “degraded mode”, notes this information report from senators. The provision of palliative care at home also remains “insufficient”.

Furthermore, with the aging of the population, experts expect an increase in needs in the coming years: an increase of 23% by 2046 according to a projection by the Court of Auditors. Professionals are therefore calling for increased resources, whether in hospitals, nursing homes or at home.