“Modest results”: the State Audit Bureau explains the health prevention policy

The Court of Reviewers has published a new report dedicated to health prevention by three major families of diseases – cancers and cardiovascular disease or CVD and diabetes. The Court notes that the results obtained were generally modest, despite similar financial efforts to those of neighboring countries.

While France spends about 15 billion euros for its health preventive policy, the Court of Audit, in a new report published on Wednesday, December 1, deplores the “modest results”.

Continuous expansion of the three diseases analyzed, and consequently the large numbers of patients involved (3.9 million people with diabetes, 5.1 million with cardiovascular disease and 3.3 million with cancer). Health insurance, or nearly 50 billion euros, court accounts.

Medical prevention programs (vaccination and screening), such as health promotion measures, suffer from insufficient support and insufficient dissemination to make significant impacts, Cambon Street sages analyzed. This is particularly the case with the systematic screenings for the three cancers involved (cervical, colorectal and breast), for which participation rates are much lower than those of our European neighbours. The court notes other shortcomings, including the number of screenings for type 2 diabetes, or NRT that only benefits 6.6% of the 13 million adults who smoke daily.

These findings are exacerbated by the strong social and regional disparities that characterize patients affected by these three diseases, to the regret of the Court. Disadvantaged low-income populations are affected the most. Likewise, certain areas such as the northeast quadrant, overseas territories and many urban districts located in sparsely populated areas are more affected than others.

As part of the Health System Modernization Act 2016 (LMSS), the government has adopted the “National Public Health Plan – Priority Prevention” (PNSP), which addresses all determinants of health. The report notes that for all major diseases, the PNSP is limited to referring to other plans without establishing any association or integration of goals, and that it is difficult to apply to the region, and cannot really be evaluated.

The Court recommends setting goals that are coherent among themselves and attached to them with quantitative indicators, in order to monitor their implementation over time, and to allow a clear distribution of roles between the various national and regional actors (particularly the ARS).

The report also recommends the use of digital leverage, which would make it possible in particular to identify social and regional inequalities in the greatest possible level of detail, and to target priority audiences who do not yet have access to prevention.