Ségur de la santé, update on investments in Nouvelle-Aquitaine

The Ségur de la santé is at the origin of an investment plan of 19 billion euros over 10 years. To manage projects locally, the strategy is driven by the territories. Thus, the regional health agencies (ARS) are responsible for pursuing the objectives set. Namely, accelerate the transformation of the offer of care and support in the territories, as well as improve the working conditions of professionals and the reception of people. In Nouvelle-Aquitaine, this strategy supports the multi-year investment plan in nursing homes. It contributes to the systemic reform necessary to ensure better support for the loss of autonomy.

The COVID-19 crisis has disrupted the social and medico-social sector. The latter is then in full mutation. Caregivers have obtained salary valuations for the efforts put in place to stem the health crisis and treat the sick. On 18 January, the employees of the medico-social call for a strike to demand the same revaluation.

Meanwhile, the State announces the establishment of a conference of social and medico-social support professions in the first quarter of 2022. The objective of this meeting is to dialogue around the career conditions of professionals in the sector. Indeed, it is becoming urgent to breathe new life into the sector, which is struggling and calling for mobilization. Agreements will have to be found that meet expectations. The conference originally scheduled before January 15 will be postponed to February 18. It will be necessary to remain attentive to know where the sector is heading and what impact the next decisions will have.

segur health care pathway
Improvement of the health system in France, shortcomings exacerbated by the health crisis

Ségur de la santé, a policy of reinvestment in public health in France

Faced with the alarming observation of the shortcomings of the health system during the health crisis, the Government is launching a vast reinvestment policy. On the agenda, 19 billion euros deployed over 10 years around different priorities. Thus, 9 billion will finance major projects and daily investment in health facilities. Then, $6.5 billion will be used to deleverage hospitals. 1.5 billion will contribute to the modernization of nursing homes. Finally, 2 billion will develop digital technology in the health sector.

Seven months after these announcements, the ARS unveiled their regional Strategy for Ségur investments. Working in consultation with actors in the field and local elected officials, they identify areas of work:

  • transform professions, and revalue caregivers;
  • define a new funding policy for the quality of care;
  • simplify the organizations and daily life of medical and nursing teams ;
  • federate health actors in the territories at the service of users.

The ARS plan significant investments in nursing homes, as well as in digital technology for the monitoring of care. On the agenda, the transformation of the EHPAD model and the diversification of care solutions for the elderly. On this second point, they announce the creation of new residences, including autonomous residences and inclusive housing. Or the renovation of the existing offer.

autonomy of seniors offers health housing residences EHPAD

Objective 1, the revaluation of caregivers: already hiccups

In terms of valuing caregivers, teeth are already grinding among professionals, not all concerned by the revaluation of salaries announced by the Ségur de la santé. Thus, the National Group of Directors General of Associations in the Educational, Health and Medico-Social Sector (GNDA), the APF France handicap, the Apajh, the French Red Cross, fehap, Nexem, Unapei, Cnape, Fisaf and Uniopss alerted elected officials in September 2021 to the dangers pressented to because of this inequity.

For good reason, the health and social sector goes through many associative actors, ousted from the devices. In fact, nearly 241,000 professionals in the private non-profit sector are concerned.

Moreover, for the other establishments affected by the increase in salaries, the allocations granted are insufficient to cover the expenses. Despite the nice announcements made, it seems that the device has lead in the wing before it even really starts.

If the treatment of health professionals is currently not up to the task, perhaps we can hope that the other axes of the health segur will obtain better results.

Nouvelle-Aquitaine, what investments for the largest region in France?

The largest region in France is also one of those with the greatest disparities. Very fragmented between cities, especially the Bordeaux metropolis, and isolated territories, it faces significant challenges in distributing the supply of care.

As these are structuring investments that commit us for the next 30 years, demographic changes will be a major criterion for the prioritization of projects, thus requiring us to project ourselves to meet the needs of the population while promoting the attractiveness of professionals.

Benoît Elleboode, Director General of ARS Nouvelle-Aquitaine

Also, to build its strategy, the ARS Nouvelle-Aquitaine collaborates with elected officials, the regional council, departmental councils, administrations, health and medico-social federations… Together, they draw the structuring of the care offer, the improvement of the public health system and support for autonomy, or sustainable development in the proposed solutions. In addition to these national priorities recalled by the Ségur de la santé, there are also regional particularities on the issues of obstetrics, perinatality and pediatrics and the support of children with disabilities.

The Regional Health Investment Strategy for the next ten years is historic for our region by the unprecedented scale of investment aid allocated in Nouvelle-Aquitaine (1.292 billion euros invested). It invites us to project ourselves, in the long term, in a territorial approach to health needs.

Benoit Elleboode

In figures, nursing homes in the Nouvelle-Aquitaine region will benefit from nearly €108 million between 2021 and 2024. More specifically, 36 establishments will receive €31.4 million from 2021. For daily equipment, the 13.8 million planned will benefit some 444 nursing homes. They will make it possible, for example, to set up a therapeutic garden, to equip the chambers with transfer rails or to air condition spaces.

On the digital side, the ARS of Nouvelle-Aquitaine is piloting an envelope of nearly 7.1 million euros for 2021. In particular, it seeks to generalize the use of the computerized user file by the various actors of the medico-social.


  1. The Prime Minister details the investment plan of the Ségur de la Santé, Government, 20 October 2021
  2. Ségur regional investment strategy for health in Nouvelle-Aquitaine, press kit of 2 December 2021
  3. Speech of Mrs. Brigitte Bourguignon, November 29, 2021, EHPAD “Le hameau de l’Argenté” of the Mont-de-Marsan Hospital Center
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