Care Without Competence: The Private Home Care Mess in Valais

The Swiss ideal of growing old comfortably within one's own four walls rests heavily on the assumption that home care services operate with impeccable precision. In the canton of Valais, official records obtained through transparency requests by RTS and Le Nouvelliste reveal how naivety in oversight permitted private providers to turn mandatory health insurance into a field for predatory incompetence.

In recent years, Valais authorities were forced to prohibit five private Spitex companies from operating. The catalog of deficiencies is striking. Caregivers missed scheduled visits, made errors with medication dispensers, and in one case forced an elderly patient to explain their own medical needs. In another instance, a caregiver failed to notify a physician about a patient's coughing fit—a known risk factor for fatal falls among the elderly.

Understaffing was the primary engine behind these failures. Agencies routinely relied on unvetted personnel, including one employee hired after failing her professional examinations. One organization assigned a single qualified nurse to seventy patients, while another operated for an entire month without any qualified nursing staff whatsoever.

The disarray extended straight into financial records. Inspections uncovered incomplete patient files, unpaid staff wages, and withheld pension fund contributions. A minority of private operators exploited mandatory insurance coverage to bill for services outside the statutory framework, charging insurers for routine grocery shopping and general housework. Facing enforcement, impacted firms showed little remorse: an appeal against an operating ban failed in court, and one company filed defamation charges against former employees who acted as whistleblowers.

Public Spitex agencies stood in sharp contrast. Only a single public provider required organizational adjustments, and insurer Groupe Mutuel noted that excessive billing remains significantly rarer among public entities. Defending the sector, Thomas Birbaum, Grand Councillor and Secretary General of OSAD Valais, acknowledged the abuses while claiming that an extreme minority was dirtying the entire profession's reputation. Thanks to new quality grids and checks by the authorities, such cases could not repeat themselves, Birbaum maintained.

Written by Freya Stensrud freya.stensrud@alpineweekly.com