The latest reshuffle raises the question of the continuity of public policies. Example with the Ministry of Health, where the rotation of incumbents is high and the scope is changing.
She has been waiting for a law on old age for several years. Annabelle Vêques, general director of the National Federation of Associations of Directors of Establishments and Services for the Elderly (Fnadepa) had even obtained a meeting, in January, to move this matter forward. Missed. Since the ministerial reshuffle of January 11, “the phone calls have been ringing in the void. » The previous firm has packed up and we now have to start from scratch and establish contact with completely new contacts. In this case, the new minister Catherine Vautrin.
Under the Macron era, Annabelle Vêques got used to these moments of hesitation. The Ministry of Health has gained a host of superlatives, not necessarily flattering: the most ephemeral positions, the most frequent rotations… Seven ministers in almost seven years, a real parade: Agnès Buzyn (almost three years in office), Olivier Véran (two years), Brigitte Bourguignon (two months), François Braun (one year), Aurélien Rousseau (five months), Agnès Firmin Le Bodo on an interim basis (twenty-two days) and, since January 11, Catherine Vautrin. The scope of the moroccos also fluctuates: Ministry of Health and Solidarity, Ministry of Health and Prevention, and even a large format portfolio for Catherine Vautrin in charge of Labor, Health and Solidarity.
As a result, files are lugged from one ministry to another. In a sector in distress – overloaded hospitals, medical deserts, drug shortages – and at the heart of citizens’ concerns, can we afford this crazy waltz? “That is better than a single minister without investment and without direction,” retorted Emmanuel Macron during his January press conference. But how can we ensure that the roadmap is respected?
Everyone has their own emergencies
While political life gets underway again, the ministry does not stand still, avenue Duquesne. Within this immense building, a horde of shadowy actors ensures minimal monitoring. In the jargon, it is called the central administration. With each reshuffle, civil servants submit a “ministerial file” of several hundred pages, in order to detail the projects in progress. “It’s time for battle,” confides an agent. We must ensure that emergencies rise to the top of the pile and attract the attention of the new minister. » Which should in theory arbitrate among this traffic jam.
“No minister arrives to completely implement the reform of his predecessors,” deplores Agnès Buzyn. Forgotten, for example, this proposed tax on bottles of alcohol studied last summer by Bercy and François Braun, before he was dismissed. As for the Conference on pediatrics and child health, promised last winter in the face of the triple epidemic of flu, Covid-19 and bronchiolitis, the announcements are also awaited… If his successor Aurélien Rousseau had mentioned a date for early 2024, since then the subject has remained a dead letter.
“Some public policies take years to be implemented and, in the meantime, we often have to deal with unforeseen events,” explains a former chief of staff. Especially since priorities differ depending on the holders of the morocco. And that lightning passages slow down the progress of files even more. However, some end up emerging, often thanks to a helping hand from the top. Like the “Rist” law aimed at unclogging general practitioners’ offices. Instigated by Olivier Véran, it was only formalized three years later, under pressure from the former emergency doctor François Braun, who was very sensitive to the congestion of the health care system and who had a personal influence in bringing about this reform. But other bills are still dragging on…
The old age law: an Arlesian
The old age law, a promise from candidate Macron, is still awaited by many professionals. Launched from the ministry of Agnès Buzyn who promised an “ambitious reform in 2019”, the file has since been passed from minister to minister… Finally, the government backpedals due to lack of funding, the bill is abandoned in 2021. “The files can fall back to the bottom of the pile but never disappear,” assures political scientist Jean-Michel Eymeri-Douzans*. As proof, in the fall of 2023, the subject resurfaces under the name Aging well, this time carried by the Minister of Solidarity and Families Aurore Bergé (in this position for five months). A circuit that sometimes makes you dizzy. Because, ultimately, the file has just returned to Catherine Vautrin, who announced a “law on old age by the end of the year”. Back to square one.
* Co-author of The reign of the entourage. Executive cabinets and advisors (Ed. Presses de Sciences Po).
How many Ministers of Health under the Fifth Republic?
39 changes of ministers in the Health portfolio since 1959. It is the most “unstable” ministry of the Fifth Republic.
Source: National Assembly.