Documents | Cour des comptes

Download PDF, 730 Ko
Publication page
Envoyer à un ami
Partager cette page sur Facebook
Partager cette page sur X
Partager cette page sur LinkedIn

THE 2015

ANNUAL PUBLIC

REPORT

Follow-up of recommendations

Summaries

Summaries are intended to facilitate the understanding

and use of the report produced by the Cour des comptes.

Solely the original report is legally binding on the Cour des

comptes. The responses of administrations and other bodies

concerned are included in the report.

Disclaimer

Summaries of the 2015 Annual Public Report by the Cour des Comptes

INTRODUCTION

Responsible for ensuring the proper employment of public funds, the Cour des

Comptes examines management, policies and public accounts and gives an opi-

nion on their compliance with the applicable rules and standards as well as on

the efficiency and effectiveness of the actions carried out.

Beyond what constitutes its core duties, particularly since the beginning of the

2000s, it has had to respond to two complementary and recurring expectations:

firstly, proposing solutions to the shortcomings that it identifies; secondly, follo-

wing up how public-decision-makers respond to its work.

The legislator has gradually established these two expectations as obligations

that the Court is now required to fulfil.

It sets out to do so by issuing recommendations in its work and by systematically

carrying out periodic examinations of the follow-up to its recommendations.

The regional and territorial courts of accounts embarked on the same path in

2013.

The examination by the Court of the follow-up to its work is based on the follo-

wing organisation

(1)

• at the beginning of each inspection, an in-depth analysis of the implemented

following the findings of the previous inspection;

• in between two periodic inspections, if the need arises, the implementation of

a "follow-up" inspection, restricted to the examination of actions arising from

the previous inspection, or anticipating the next in-depth inspection;

• lastly, with the new article L. 143-10-1, introduced into French Code of

Financial Jurisdictions by the amending Finance Act of 29 July 2011, the legisla-

tor institutionalised the follow-up of the work of the Court, setting a particularly

ambitious configuration and applying obligations both for the recipients of

observations and for the Court itself:

- the addressees of the final observations of the Cour des Comptes are requi-

red to provide the latter with reports of the follow-up actions that they have

taken;

- for its part, the Court presents these follow-up actions in its annual public

report, based on the reports provided.

_________

1) These principles are incorporated into professional standards: Compendium of professional

standards, chapter 3 – C.

The present instalment first presents the

overall results of the follow-up car-

ried out by the Court regarding all its recommendations made public

during

the years 2011 to 2013 (chapter I). It then comprises a series of summaries of

the

11 follow-up investigations

that it has carried out.

These 11 texts are divided into three categories, represented by a specific

colour to reflect the level of implementation of the recommendations pre-

viously made by the financial jurisdictions:

- first category (green) (chapter II):

the Court has observed evidence of pro-

gress

(2);

- second category (orange) (chapter III):

the Court reiterates the importance of

taking action

(7);

- third category (red) (chapter IV):

the Court issues a warning

(2).

The formulation and follow-up of recommendations in accordance with

the ISSAI 300 standard

The follow-up of recommendations and the publication of the work of the

Cour des Comptes meet the professional standards and directives for best

practices for public-sector auditors approved by the International

Organisation of Supreme Audit Institutions (INTOSAI).

To this purpose, the ISSAI 300 standard establishes fundamental principles

for performance checks relative to the formulation and follow-up of recom-

mendations.

It states that "the auditors must take care to make constructive recommenda-

tions that are likely to significantly contribute to remedying the weaknesses or

problems highlighted during the audit". Quality criteria are established. In par-

ticular, the recommendations must "deal with the causes of problems and/or

weaknesses" and they must be made "in such a way as to avoid obvious truths

and not just reverse the terms of the conclusions of the audit".

The recipient of each recommendation, and the person responsible for taking

all initiatives, must be identified and mentioned. The direction and relevance

of the recommendations should be mentioned, stating "how they will contri-

bute to improving performance".

This standard has been transposed into the professional standards of the Cour

des Comptes.

INTRODUCTION

Summaries of the 2015 Annual Public Report by the Cour des Comptes

Chapter I - Follow-up of recommendations in 2014 . . . . . . . . . . . . . .7

Chapter II - The Court has observed evidence of progress . . . . . . .11

Escheated bank assets and life-insurance contracts: enhanced protection

for savers

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Partial unemployment: a renewed device, still insufficiently used . . . . .16

Chapter III - The Court reiterates the importance of taking action

The management of researchers: improvements still necessary . . . . . . .21

Palliative care still inadequate in France

. . . . . . . . . . . . . . . . . . . . . . . . . . . .24

The management of the Economic, Social and Environmental Council: a

will to reform, work to be continued

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

The public authority for the development of La Défense Seine Arche:

order insufficiently restored

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

The Jussieu construction site and the conduct of large property

transactions by universities in the Paris area: lessons to be learned . . .31

The "Château de Versailles Spectacles" company: progress to be

consolidated

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34

The real estate transactions of the Ministry of Foreign Affairs in the Paris

region: an unsatisfactiry outcome

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36

Chapter IV - The Court issues a warning . . . . . . . . . . . . . . . . . . . . . . .39

The network of sub-prefectures: between

status quo

and

experimentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41

An example of poorly-planned local public investment: the airports of

Dole and Dijon

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43

Summaries of the 2015 Annual Public Report by the Cour des Comptes

TABLE OF CONTENTS

Follow-up of the Court’s recommendations

Chapter I

Follow-up of recommendations in 2014

The degree of implementation of the recommendations made by the Court and

published during the last three years constitutes the main performance indica-

tor for the State's budget programme (programme 164 –

Cour des Comptes and

other financial jurisdictions

) relative to the financial jurisdictions.

This indicator is defined as the share, in the most significant recommendations

made during the period, of those that were followed by actual implementation.

To be considered as effective, implementation must not necessarily be total; it

may be only partial.

2012

(follow-up of

recommenda-

tions made in

2009, 2010

and 2011)

2013

(follow-up of

recommenda-

tions made in

2010, 2011

and 2012)

2014

(follow-up of

recommenda-

tions made in

2011, 2012

and 2013)

Increase in the

number of

recommenda-

tions between

follow-up for

2012 and

2014

Number of

recommenda-

tions

followed-up

1,213

1,671

1 924

+ 58,6%

including

recommenda-

tions

partially

or totally

implemented

862

1 033

1 343

+ 55,8%

representing

71,1%

62%

69,8%

Change to the indicator on the follow-up of recommendations for the last

three years

Source : Cour des comptes

Summaries of the 2015 Annual Public Report by the Cour des Comptes

Due to the increase in the number of publications by the Court, the number of

recommendations made and followed-up has clearly increased in 2014 (1,924

followed-up in 2014 compared to 1,671 in 2013 and 1,213 in 2012). Indeed,

2012 and 2013 were both marked by a high level of publications, with a great

impact on the number of recommendations to be followed-up in 2014.

Moreover, since 2012, the publication of summary proceedings and the recom-

mendations stemming from them has been almost systematic.

The recommendations follow-up indicator increased by 7.8 points from 62% in

2013 to 69.8% in 2014. Thus, out of 1,924 recommendations followed-up in

2014, the number of recommendations partially or totally followed-up was

1,343.

The increase in the indicator in 2014 is explained by two factors: a higher overall

rate of implementation in 2014, particularly for the recommendations issued in

2011 and 2012, and the improvement in the quality of the follow-up of recom-

mendations, which is now done systematically.

Follow-up of recommendations in 2014

Chapter II

The Court has observed evidence of progress

1 - Escheated bank assets and life-insurance contracts:

enhanced protection for savers

2 - Partial unemployment: a renewed device, still

insufficiently used

Escheated bank assets and life-

insurance contracts: enhanced

protection for savers

The situation of escheated bank

assets and life-insurance contracts

raises important issues regarding the

protection of savers, which the Court

highlighted in a communication made

upon a request from the Chairman of

the National Assembly's finance com-

mittee.

Bank assets may become escheated

either because the owner, who is still

alive, cannot be found or because

his/her death is not known to the ins-

titution or, even if known, no heir has

come forward. In the communication

to Parliament dated June 2013, the

amount of bank assets escheated was

estimated at around €1.2 billion, at

least.

The escheated contracts designate

the amounts due pursuant to life-

insurance contracts which are not

redistributed to the beneficiaries des-

ignated in the contracts, in spite of the

death of the subscribers. In its com-

munication, the

Court

estimated

escheated life-insurance and endow-

ment contracts, covering life-insu-

rance benefits not paid three years

after the death of the insured party or

two years after the expiry of the

contract, as well as endowment

contracts not claimed ten years after

expiry of the contract, at a minimum

of €2.76 billion in 2011.

Out of the 17 recommendations

issued by the Court, 12 were fully

implemented

under

the

law

13 June 2014 relative to inactive bank

accounts and escheated life-insurance

contracts, three were partially imple-

mented, and only two were not imple-

mented.

The law of 13 June 2014 streng-

thens the protection of the owners

of inactive bank accounts

The communication to Parliament

stressed that inactive bank accounts

which later became escheated were

governed by a deficient legal frame-

work. The only legal obligation impo-

sed on banks concerning escheated

bank assets was to transfer these to

the State at the end of the thirty-year

limitation. On the other hand, the

French Monetary and Financial Code

did not include any specific obliga-

tions concerning inactive accounts,

meaning those with no movements at

the initiative of the client and for

which the client has not come for-

ward.

Summaries of the 2015 Annual Public Report by the Cour des Comptes

Escheated bank assets and life-insurance

contracts: enhanced protection for savers

As the Court recommended, the law

of 13 June 2014 created a legal frame-

work specifically applicable to inactive

bank accounts. The main contribu-

tions are as follows:

- the obligation for credit institutions

to list inactive accounts each year and

to transfer the unclaimed funds, after

a certain period (three years after the

death of the owner, ten years after the

last recorded account movement), to

the

Caisse

des

Dépôts

Consignations;

- miscellaneous obligations incum-

bent upon credit institutions and the

Caisse, intended to protect the rights

of savers. This mainly involves infor-

mation to clients, but also the limita-

tion of bank charges deducted from

inactive accounts by the banks, and

the obligation for the Caisse not to

disburse the capital of transferred

bank assets.

The law of 13 June 2014 also includes

new guarantees for the beneficiaries

of life-insurance contracts

The communication to Parliament

stressed

that,

since

the

law

17 December 2007, insurance compa-

nies were specifically obliged to iden-

tify the deceased policyholders and

seek out the beneficiaries of life-insu-

rance contracts. However, this law was

not fully applied by insurance compa-

nies, even though it came into force

more than six years ago.

The law of 13 June 2014 provided for

improved information to subscribers

of life-insurance contracts and streng-

thened requirements with regard to

insurance companies in matters of

identifying deceased insured parties.

It also provides for the mandatory

transfer to the Caisse des Dépôts et

Consignations of amounts due pur-

suant to life-insurance contracts and

endowment bonds or contracts for

which no request for payment of

benefits or capital has been received

after a period of ten years from the

date of knowledge of death by the

insurer or the expiry of the contract.

The role of notaries strengthened

The communication to Parliament

emphasised that the lack of know-

ledge of the death of their clients by

the banks was partly related to the

fact that notaries did not have the

specific right, during succession, to

consult

the

database

bank

accounts (FICOBA) that lists all bank

accounts open in France. It recom-

mended making it mandatory for

notaries to consult the FICOBA during

a succession. The law of 13 June 2014

implemented this recommendation

and even went beyond it, since it spe-

cified access by notaries to the data-

base

life-insurance

contracts,

known as FICOVIE.

Summaries of the 2015 Annual Public Report by the Cour des Comptes

Escheated bank assets and life-insurance

contracts: enhanced protection for savers

Although the new legislative arran-

gements do not take effect until

1 January 2016, changes to the beha-

viour of those involved are already

notable

We note that professionals have

become more aware of the subject. In

particular, the

French

Prudential

Supervisory Authority (ACPR) has

strengthened its checks. The ACPR's

Sanctions Committee penalties com-

mission handed down rulings of heavy

financial penalties on 7 April 2014,

October

2014

and

19 December 2014.

Significant legal and technical work

remains to be done to ensure the

rapid implementation of the legisla-

tion.

The Court will remain particularly vigi-

lant concerning the issue of the pro-

tection of savers. It will continue to

closely monitor the implementation

the

arrangements

concerning

escheated bank assets and life-insu-

rance contracts.

Summaries of the 2015 Annual Public Report by the Cour des Comptes

Partial unemployment: a rene-

wed device, still insufficiently

used

In its thematic public report entitled

"The jobs market : improving policy

targets to cope with high unemploy-

ment"

(1)

(January 2013), the Court

had noticed a weak implementation of

the partial-unemployment system,

considered

too

complicated

and

unconducive, in spite of the repetitive

modifications made since the begin-

ning of the crisis in 2008. It recom-

mended merging the current systems

and approving the attractiveness of

partial unemployment for companies.

Germany, which has experienced a

greater loss of GDP than France since

2009, has more effectively protected

its employment with partial unem-

ployment, massively funded by the

german unemployment insurance

system. To the opposite in France, the

system, mainly funded by the State,

has remained mostly circumcised to

large companies in the industrial sec-

tor (particularly automobile).

The main issue of the June 14, 2013

law reform to protect employment lay

in the definition of a new device, called

partial activity, made attractive for

the small companies.

An easier and more attractive device

for companies

The June 14, 2013 law simplified the

device by establishing a single com-

pensation, payed for by the State and

the UNEDIC, and eliminating the obli-

gation of contracting with the State

in order for companies to benefit of

the most favourable terms. The admi-

nistrative measures have been simpli-

fied (the procedures are now entirely

electronic), with longer periods of

authorised partial unemployment (six

months renewable), and confirmation

of the limit of 1,000 hours per year

and per employee.

The financial incentives have been

reviewed : the cost per hour of unem-

ployment for the employers is now

limited to 31% of a three times the

minimum wage salary (it is zero for a

minimum wage salary), whilst the

compensation for the employees has

been reduced.

The cost of the partial activity com-

pensation served to the employers by

the Service and Payment Agency

(ASP) in 2014 was about €220 million.

The hourly amount of the compensa-

_________

1) Cour des comptes,

Thematic public report

The job market: improving policy targets to cope

with high unemployment

. La Documentation française, January 2013, 170 P., available at

www.ccomptes.fr

Summaries of the 2015 Annual Public Report by the Cour des Comptes

Partial unemployment: a renewed device,

still insufficiently used

tion (over 80% of the gross hourly

minimum wage) is paid for by the

State up to roughly 60%, and the rest

by the UNEDIC on the unemployment

insurance funds.

The possibility of professional trai-

ning courses during periods of unem-

ployment has been encouraged by

two measures : the range of eligible

courses has been extended and the

salary

compensation

for

the

employees fixed at 100%.

The Court observes that the 2013

reform follows what had been its

recommendations.

A new system to be promoted and

evaluated

It is still too early to measure the

effects of the reform on companies’

strategies, but it seems that the num-

ber of demands is increasing and that

more companies are considering par-

tial unemployment.

As from now, public authorities are

encouraging

the

part

that

the

DIRECCTEs

(1)

have to play alongside

companies and professional networks

to make the new device popular

amongst the different job saving ins-

truments,

and

increase

its

use

amongst companies that were not

used to it, particularly small ones.

Due to lack of individual data for

monitoring

the

career

paths

employees

concerned

partial

unemployment, it has not been possi-

ble up to know to evaluate the impact

of this system on job saving The infor-

mation system development will open

new perspectives here, which should

allow to build up an evaluation pro-

cess.

The Court thus issues the following

recommendations:

- build tools to be able to measu-

rethe impact of the device on two

points:

- the employees matching skills to

their

jobs

and

secure

their

professional careers;

- the long-term preservation of

the concerned employees in their

jobs.

Recommendations

_________

1) DIRECCTE : regional services of the Labor and Employment ministry.

Summaries of the 2015 Annual Public Report by the Cour des Comptes

Chapter III

The Court reiterates the importance

of taking action

1 - The management of researchers: improvements still

necessary

2 - Palliative care still inadequate France

3 - The management of the Economic, Social and

Environmental Council: a will to reform, work to be

continued

4 - The public authority for the development of La Défense

Seine Arche: order insufficiently restored

5 - The Jussieu construction site and the conduct of large

property transactions by universities in the Paris area:

lessons to be learned

6 - The "Château de Versailles Spectacles" company: progress

to be consolidated

7 - The real estate transactions of the Ministry of Foreign

Affairs in the Paris région: an unsatisfactory outcome

The management of resear-

chers: improvements still

necessary

The eight public institutions of a

scientific and technological character

(EPST)

(3)

had 16,662 active statutory

researchers in activity in 2013, compa-

red to 17,005 in 2006, with a payroll of

€1.67 billion. The CNRS alone accoun-

ted for two thirds of the workforce.

Improved reception of young resear-

chers

The increased funding for project

research since 2006 and the clarifica-

tion of the legal situation of young

researchers have improved the condi-

tions

for

receiving

post-doctoral

researchers. As such, the number of

contractual researchers in the EPST

has substantially increased (+22%

between 2008 and 2013) and they

currently represent one third of

researchers (compared to one fifth in

2006).

Nevertheless,

this

improvement,

which is very positive for the attracti-

veness of French research, neverthe-

less may result in job insecurity for

young researchers, of which the insti-

tutions are aware, but that laborato-

ries must contain when recruiting

Recruitment of statutory researchers

unrelated to national priorities

The opportunity offered by the great

wave of retirement during the 2000s

(from 2006 to 2013, more than 20% of

researchers who were active in 2006

have retired) to reallocate recruit-

ments to research’s main priorities

was not seized. In contradiction with

the duration of projects, mainly fixed

short term researchers are assigned

to the priority topics of the national

strategy for research and innovation

(SNRI).

Since 2006, the rate of recruitment of

statutory researchers has dropped

significantly

and

the

anticipated

reduction in retirements over the

coming years means that this trend is

likely to continue. In this context, in

order to better adress cientific priori-

ties and better anticipate changes, the

definition of a long-term recruitment

plan , global and by discipline, is requi-

red, based on the budgetary capacity

made advailable by leaving staff.

_________

3) National Centre for Scientific Research (CNRS), the French Institute of Science and

Technology, for Transport, Development and Networks (IFSTTAR), the National Institute for

Demographic Studies (INED), the National Institute for Agricultural Research (INRA), the

National Institute of Health and Medical Research (INSERM), the National Institute for

Research in Computer Science and Automation (INRIA), the Research Institute for

Development (IRD) and the National Research Institute of Science and Technology for

Environment and Agriculture (IRSTEA).

Summaries of the 2015 Annual Public Report by the Cour des Comptes

The management of researchers:

improvements still necessary

Supporting career paths

As the number of applicants is gro-

wing while the number of recruit-

ments of research fellows has drop-

ped by 22% between 2006 and 2013,

selectivity when entering EPST is

increasingly high and the average age

of recruitment is significantly increa-

sing. It is now between 30 and 34

years old, which has several conse-

quences in terms of remuneration

level, career development and retire-

ment credits.

The "careers plan" introduced in 2009

selectively

improved

researchers‘

career development, but the main

problems identified in 2003 remained:

difficulty to reach the highest grades

(25% to 30% of researchers remain at

the last grade of first-class research

fellow), low personnel mobility and

limited impact of individual appraisal

on career development and remune-

ration. This situation is all the more

paradoxical as requirements in terms

of scientific quality and experience for

recruitment are increasing. These fin-

dings may eventually harm career

attractiveness.

A remuneration policy that lacks

coherence

Due principally to the "career plan",

the average gross remuneration of

researchers, index-related salary and

all bonuses, has increased between

2009 and 2013.

Changes in the specific compensation

for functions of collective interest

now provide greater reward for taking

on responsibility. However, the proce-

dures for assigning the doctoral and

research supervisory bonus, which

succeeded the scientific excellence

bonus, do not appear fully satisfactory

and require reform in order to better

take into account individual apprai-

sals.

Moreover, it is not fair that, in a an

insufficiently controlled context, the

compensation relative to the time

savings account weighs so much

affects the payroll expenditure of the

establishments, sometimes exceeding

the budgets assigned to responsibility

or performance bonuses.

Summaries of the 2015 Annual Public Report by the Cour des Comptes

The management of researchers:

improvements still necessary

Consequently, the Court issues the

following recommendations:

To the Ministry of Research:

–

organise the feedback of infor-

mation and improve the coordination

of the EPST’s strategic plans (recom-

mendation reiterated);

–

encourage the integration of

statutory researchers into the body

of teacher-researchers (recommen-

dation reiterated);

–

reform the procedures for the

assignment of the doctoral and

research supervisory bonus, by lin-

king it to the individual evaluation.

To the Ministry and to the public ins-

titutions of a scientific and technolo-

gical character (EPST):

–

jointly

define

long-term

recruitment plan per discipline and

competence according to strategic

priorities;

–

improve knowledge of contrac-

tual researchers and their professio-

nal development by carrying out

cohort monitoring studies;

–

strictly control the implemen-

tation of the time-savings account

and limit its budgetary impact.

To the EPST:

–

improve the selection of post-

doctorate candidates in order to

ensure that they have genuine pro-

fessional prospects.

Recommendations

Summaries of the 2015 Annual Public Report by the Cour des Comptes

Palliative care still inadequate

in France

In 2007, the Court pointed out how

slow the development of palliative

care had been in France. It called for

the implementation of a more active

policy in this field, based on a better

evaluation of needs, addressing geo-

graphical inequities, and emphasising

the development of palliative care at

home and in the medical-social sector.

Since then, a national programme to

develop palliative care was implemen-

ted in 2008, this field being one of the

government's three major public

health priorities, along with cancer

and Alzheimer's disease. The Court

endeavoured to assess whether this

programme provided a better res-

ponse to the needs of patients and

their families.

Access to palliative care still very

insufficient overall

In 2011, as the Court recommended,

the national Observatory on End of

Life issued a first estimate of the num-

ber of persons likely to need palliative

care. According to this study, out of

the 535,451 persons who died in

2008, 64% would have required pallia-

tive care.

No comprehensive estimate of the

number of beneficiaries of palliative

care over a given year is available. This

lack of reliable, comprehensive and

up-to-date data illustrates the persis-

tent difficulty in making palliative

approach a real priority in public

health, in contrast to other countries

where it is much more developed, par-

ticularly in Anglo-Saxon countries.

Only partial information exists, which

shows limited use of palliative care,

despite an increasing trend in benefi-

ciaries between 2009 and 2013. In

hospitals, only one third of the

238,000 patients who died in 2009

during short-stay hospitalisation and

were in need of palliative care actually

benefited from it.

The development of palliative care

primarily focused on hospitals

The programme to develop palliative

care aimed at organising three levels

of management, from the simplest

(ordinary beds) to the most complex

cases (in specialised units). In between

these two levels, palliative care is pro-

vided in so called “palliative care iden-

tified beds”, which can be put in place

as needed in any hospital ward. In

addition to this, most hospitals have a

mobile palliative care team, which can

provide a specialised assistance to the

establishment's various departments.

Overall, the objectives set by the

Summaries of the 2015 Annual Public Report by the Cour des Comptes

Palliative care still inadequate in France

national programme were achieved

with regard to the creation of beds. As

far as mobile teams are concerned, in

spite of their development, major dis-

parities in their resources and their

practices are to be underlined.

In addition to that, major geographi-

cal inequalities remain both between

and within regions: equipment rates

vary considerably from one region to

another.

Financial incentives have contributed

to the development of palliative care

in short-stay and “hospital at home”

facilities, but this is not yet the case in

rehabilitation and long term care ins-

titutions. Training of physicians and

other health professionals who are

the main asset to enhance palliative

care awareness has improved but

remains highly insufficient.

Palliative care outside the hospital

still to be developed

Progress has been much more limited

in providing home care, even though

this type of service meets the prefe-

rence

the

great

majority

patients. The same is true for care in

nursing homes.

While the development of chronic

pathologies calls for new practices

and integrated care, coordination of

primary care professionals, networks

of palliative care, “hospital at home”

and home nursing services is gene-

rally poorly organised.

This issue has not been a priority of

the national health-insurance in its

negotiations with health professions.

Support for patients requiring pallia-

tive care in nursing homes is hindered

in particular by the lack of medical

and nursing staff as well as an insuffi-

cient access to mobile palliative care

teams.

Support for patients’ families remains

unsatisfactory. The system of “family

solidarity leave” was not effectively

implemented until 2008, nine years

after the law under which it was insti-

tuted. It is rarely used. Financial bene-

fit for supporting persons at the end

of their lives was not established until

2010, five years after the proposal

made by a parliamentary mission. The

arrangement, which is limited (pay-

ment by the social security of hours of

domestic

help

and

equipment),

appears poorly known and under used

***

Of the three public-health priorities

declared in 2008, development of pal-

liative care thus appears as the one

which, in spite of the progress made,

has

been

least

successful.

The

approach has remained institutional,

focused on hospitals, and yet often

characterised by an essentially cura-

tive and technical medical culture,

whereas patients and their families

would rather prefer home-based care

and support with a greater concern

for humanity.

Summaries of the 2015 Annual Public Report by the Cour des Comptes

While population ageing and develop-

ment of chronic pathologies are likely

to increase the demand for palliative

care, adapting our health system to

these expectations must remain a

priority.

The Court issues the following

recommendations:

–

maintain a clearly identified

policy on development of palliative

care, supported by a specific action

plan, as part of the national health

strategy (reiterated recommenda-

tion) ;

–

give priority to the develop-

ment of palliative case at home and

in nursing homes (reiterated recom-

mendation);

–

use

the

inter-professional

agreement currently under negotia-

tion between the national health

insurance and health professions to

support this objective and develop

home interventions by multidiscipli-

nary teams;

–

in addition, pursue the deve-

lopment of support systems for next

of kin caregivers;

–

target

precisely

the

extension of hospital based palliative

care in order to reduce regional dis-

parities;

–

put in place specific proce-

dures for funding palliative care

within rehabilitation and long term

hospitals so as to foster long term

palliative care.

Recommendations

Palliative care still inadequate in France

Summaries of the 2015 Annual Public Report by the Cour des Comptes

The management of the

Economic, Social and

Environmental Council: a will

to reform, work to be continued

The

Economic,

Social

and

Environmental Council (ESEC), which

has 140 members of staff and an

annual budget of €38 million, has the

task of issuing opinions on govern-

ment bills. Since the constitutional

reform of 2008

(4)

, it may also have

matters referred to it by Parliament

and through petitions, concerning any

problem of an economic, social or

environmental character.

A special financial regime

Its specific budgetary regime, which

does not differentiate between the

authorising officers and accounting

officers, is not justified. Invoices are

paid more slowly and the accounts are

run less rigorously than under the

common law regime, while public pro-

curement is still not fully controlled.

Progress in staff management

Progress has been seen in the field of

human resources thanks to the crea-

tion of an administration system and

the beginnings of dynamic staff

management, which is based to a

greater

extent

seconded

contracted staff. But staff promotion

remains too rapid, the "job ceiling" is

over-valued, and working hours are

below

the

legal

duration.

Furthermore, the legal basis for the

compensation payment of personnel,

decided by the Chairman, has not

been established.

A pension fund still in deficit

In spite of reforms, the pension fund

for former members of the Council

remains in long-term deficit due to

contributions that are too low in rela-

tion to the level of pensions provided,

which requires the ESEC to compen-

sate the difference from its ordinary

budget.

***

The Court therefore recommends

that the accounting regime of the

ESEC be brought into line with com-

mon law, that the organisation of wor-

king time be reviewed, that the regula-

_________

4) Constitutional law of 23 July 2008 on the modernisation of the institutions of the Fifth

Republic.

Summaries of the 2015 Annual Public Report by the Cour des Comptes

The management of the Economic, Social and

Environmental Council: a will to reform, work to

be continued

The Court issues the following

recommendations:

–

place the ESEC under a budge-

tary and accounting regime com-

pliant with the provisions of the

decree of 7 November 2012 (recom-

mendation reiterated);

–

continue the reorganization of

working time in accordance with the

regulatory framework in force;

–

give a regulatory basis to the

compensation arrangements ;

–

continue adjusting the parame-

ters for calculating contributions and

retirement pensions (double contri-

bution, basis for calculation, amount

of State contribution, etc.);

–

move the members' pension

scheme towards a defined-contribu-

tion scheme, which does not commit

the State beyond the initial funding

granted and applicable to all pen-

sions that have not yet been settled.

Recommendations

tory basis for compensatory arrange-

ments be consolidated and that

reform of the pension scheme be

continued in order to bring it into

balance.

Summaries of the 2015 Annual Public Report by the Cour des Comptes

The public authority for the

development of La Défense

Seine Arche: order insuffi-

ciently restored

The public authority for the develop-

ment of La Défense Seine Arche (EPA-

DESA) is the successor of the public

authority for the development of La

Défense (EPAD) created in 1958 to

contribute to the creation of an inter-

national business district built on an

esplanade at La Défense. The area of

intervention of the EPADESA extends

over four municipalities: Nanterre,

Puteaux, Courbevoie and La Garenne-

Colombes, representing 564 hectares.

In its 2013 annual public report, the

Court made several observations and

recommendations

regarding

the

EPADESA.

Improvement of information and

more rigorous management of the

authority

Internally, the authority has cleaned

up its management, improving the

quality of financial information that it

delivers to the supervisory authority

and board of directors. Since 2011, the

authority has gradually created long-

term documents including business

forecasts and a long-term plan. Since

2013, these documents have provided

a better record of the progress of

various operations and their contribu-

tion to the results.

In terms of wages, the authority now

applies the same wage increase cei-

lings to executives as those which

apply

other