France has a strong welfare state, but shortcomings in the French care system have led some citizens to seek care in other European countries. 6,500 French citizens living with disabilities were in Belgian institutions due to the lack of appropriate structures in France. The figure has since grown to 8,500. The move from France to Belgium concerns different types of disability, including mental health and autism.
Wallonia is a Francophone region in southern Belgium. 8,233 French citizens with disabilities live in institutions located there. This cross-border presence has a long history.
For French parents, placing their children in a Belgian institution is not so much a choice as the only alternative they have. France has a limited number of structures able to provide care to children and adults with disabilities.
The situation is particularly severe in the Île-de-France region, which surrounds the French capital. In 2019, the Seine-Saint-Denis department (which is part of Île-de-France) documented 1,000 adults and 400 children without a care solution. People with multiple or severe forms of disability are particularly likely to be left out by the system.
French parents also turn to Belgium because of the superior quality and range of support on offer. Belgian schools are often perceived as providing services that better adapted to the individual development of persons with disability. A common perception among the parents is that the Belgian system for children places greater emphasis on the educational aspects while the French system focuses more on the medical dimension and is therefore less efficient when it comes to stimulating children’s autonomy.
Belgian institutions supporting French citizens are de facto financed by the French welfare system, which shoulders the costs for such services. Combined with high demand and cheaper legal requirements, the state funding has led to the proliferation of institutions on the Belgian side of the border, both non-profits (associations) and profit-oriented (private companies). The Belgian government refers to the latter as “services approved and financed by a foreign authority” (in French, SAFAE) and institutions providing them have a legal status distinct from similar Belgian structures.
Institutions in Wallonia that provide services to French citizens, known under the French acronym SAFAE, receive financing by France’s social-security system.
How the families experience this arrangement depends on variables such as their geographic proximity to Belgium, access to transportation, disposable income and their own fitness. For relatively well-off residents of Île-de-France region, placing their child in a Belgian institution might be a feasible solution, while for more modest households in the South of France, it would be a much more difficult choice.
While most parents are relatively satisfied with the care provided in Belgium, some parents still emphasise how distance impacts their ability to maintain a family life with their child abroad.