PRESS RELEASE
18 September 2024
Public thematic report
ACCOMMODATION OF FRENCH NATIONALS
WITH DISABILITIES IN WALLONIA
French law on persons with disabilities does not make the funding of accommodation
conditional on its location within the country. Slightly more than 7,000 adults were
accommodated in Wallonia in 2022.
This observation led the French Court of Accounts to
undertake a specific investigation into the issue. This report presents the results of this
work, which was divided into two parts. The first, carried out in France in the three regions
mainly concerned, described the background of French nationals accommodated in
Wallonia and determined their common characteristics.
The second part focused on the
conditions for the development of the Walloon accommodation offer over the last 20 years
and on the current control system for Walloon establishments. This second phase of the
investigation was conducted in close collaboration with the Court of Audit of Belgium,
constituting a first joint audit carried out with a supreme audit institution from another
European Union Member State.
A long-standing and growing phenomenon that the French authorities have sought to
contain
The main reasons why French nationals with disabilities have moved to establishments in
Wallonia are their geographical and linguistic proximity to France, and a legal framework that
has long been less strict than that governing French operators. The creation of establishments
in Belgium, facilitated by the certainty that places would be available and that they would be
financed by France, attracted new entrepreneurs, some of whom were far removed from the
medico-social field, to work alongside the incumbent operators. The number of places available
has grown steadily, and currently accommodates just under 8,200 French nationals (around
7,000 adults and 1,200 children, adolescents and young adults), at a cost to the French public
purse estimated by the French Court of Accounts
at €0.5 billion annually. In order to control
this expenditure, the public authorities have pursued a twofold objective : to prevent people
from leaving by developing solutions throughout the country ; and to contain the expansion of
care provision by limiting the number of authorised places and controlling the level of related
funding. The 2021 moratorium froze the number of places available as of 28 February 2021 and
made it possible to fund more than 1,800 alternatives to leaving for Belgium by allocating €90
million to the
Grand Est
,
Hauts-de-France
and
Île-de-France
regional health agencies. However,
most of the solutions proposed were home services or temporary accommodation. While these
solutions are in line with public policy on inclusion and the development of alternatives to
institutionalisation, they are not suited to the situations of those seeking a place in Belgium,
who require permanent accommodation.
The number of people receiving support in Belgium highlights the shortcomings of the
French system
The French Court of Accounts sought to describe the adult population cared for in Wallonia in
order to determine what needs were being met by the Belgian system that were not being met
in France. By analysing census data and a sample of records for people accommodated in
Wallonia, it was possible to draw up a typology. While those receiving support in Belgium are
not radically different from those remaining in France, there is an over-representation of
people with the least access to French medico-social establishments and services. A large
number of people suffering from behavioural and conduct disorders, combined with a mental
disability or intellectual impairment, are thus present in Belgium. The accommodation of these
people is a specific feature of the Belgian system.
It has also been possible to document the
disruptions in people’s lives that have led French nationals to move to Wallonia: transition to
adulthood without a place in French medico-social establishments and services, presence in
Belgium since childhood, or exclusion from the French medico-social sector due to serious
behavioural problems.
Mechanisms for controlling the use of French public funds require strengthening
Ten years after the entry into force of a framework agreement between the French and
Walloon governments, signed in 2011, the French Court of Accounts carried out a review of
procedures and controls in Walloon establishments accommodating disabled French nationals.
Serious failings (physical or verbal abuse, deprivation of food as punishment, lack of care
sometimes leading to death, spoiled foodstuffs, rationing of meals, poorly maintained or
dilapidated buildings, lack of supervision putting residents at risk, negligence in the distribution
of medicines, failure to respect privacy and intimacy, undue billing using residents’
Vitale cards
,
financial fraud, etc.) have been found in more than 60 establishments since 2015. According to
the competent authorities, the inspections carried out show that these failings affect around
twenty establishments accommodating French nationals with disabilities each year. In the
French Cour
t’s view, the repeated and serious nature of these findings calls for a review of the
ways in which the authorities responsible for this issue on both sides of the border work
together. The Court also calls on the French authorities to exercise greater vigilance with regard
to the quality and safety of the care provided to these residents, which must be comparable to
that of the establishments under their direct supervision. Finally, while several audit reports
have highlighted management anomalies (payment of very high dividends and remuneration,
complex financial arrangements, etc.), the current legal framework does not allow the French
authorities to control the use of the public funds they contribute to Walloon establishments
accommodating French nationals with disabilities.
“
Despite the major risks associated with the existence of multiple funding bodies and applicable
legal regimes, neither the French French Court of Accounts nor the Court of Audit of Belgiumhas
the authority to directly control the use made of funds contributed by the French public
authorities and benefiting private operators accommodating people with disabilities in
Wallonia
”, emphasises Pierre Moscovici, First President of the French Court of Accounts.
Read the report
PRESS CONTACT
Sarah Gay
■
Press Relations Officer
■
T +33 (0)6 50 86 91 83
■
sarah.gay@ccomptes.fr