Key Benefits:
Publics concerned: armed health service, armed hospitals, patients, regional health agencies, health institutions.
Purpose: Update the regulatory framework for public health activities carried out by the armed health service.
Entry into force: the text comes into force on the day after its publication.
Notice: This decree sets out the conditions in which hospitals of the armed forces participate in public service missions provided by health institutions.
It provides that, subject to the priority given to the armed forces, the hospitals of the armed forces shall host any patient under the same conditions as other hospitals. As is the case with health facilities, these hospitals must, if they are not able to treat a person whose condition constitutes an emergency, direct the patient to the nearest health care facility with appropriate treatment facilities.
A reciprocal consultation procedure is established between the regional health agencies and the hospitals of the armies (regional health care organization scheme, participation in a health network or a health cooperation group).
It is also expected that the military hospitals will participate in the work of the territorial conferences.
The Multi-Year Protocol of Objectives and Means of Armed Hospitals, referred to in theArticle R. 174-34 of the Social Security Code, now specifies the obligations of the armed health service for the performance of the public service missions that it undertakes or contributes to ensuring and, where appropriate, the calculation of their financial compensation.
References: the provisions of Public Health Code and Social Security Code Amended by this decree may be consulted, in their drafting, on the website Légifrance (http://www.legifrance.gouv.fr).
This decree is taken for the application of the Act No. 2009-879 of 21 July 2009 reforming the hospital and relating to patients, health and territories.
The Prime Minister,
On the report of the Minister of Defence and Veterans and the Minister of Labour, Employment and Health,
Vu le Defence codeincluding articles L. 1142-1, L. 1142-8 and R.* 1142-1;
Vu le Public Health Codeincluding articles L. 6111-1, L. 6112-2 and L. 6147-7;
Vu le Social Security Codeincluding article L. 174-15;
The State Council (Social Section) heard,
Decrete:
I. ― Section 1, consisting of sections R. * 6112-1 to R. * 6112-13, Chapter II of Title I of Book I of the sixth regulatory part of the Public Health Code is repealed.
II. ― Section 7 of Chapter VII of Book I, Title IV of the sixth regulatory part of the same code is replaced by the following provisions:
“Section 7
" Contribution of the armed health service
Public Health Policy
"Art. R. 6147-112. - Subject to the priority it must give at all times to the satisfaction of the needs of the armed forces and taking into account the specificity of its missions, the armed health service contributes to public health policy in accordance with the provisions of this section.
"Subsection 1
« Participation of hospitals in the armed forces
Missions of Health Institutions
"Art. R. 6147-113.-Armed hospitals on the list provided for in Article L. 6147-7 are considered to be university hospital centres referred to in Article L. 6141-2.
"Art. R. 6147-114.-Armed hospitals on the list provided for in Article L. 6147-7 are provided for patients with a health status of the activities referred to in Article L. 6111-1, within the limits of the facilities and care activities on the same list.
"When an armed hospital is unable to treat a person whose state is an emergency case requiring immediate hospitalization, it is directed to the nearest health facility with the necessary means.
"The conduct of these activities is subject to an assessment during the annual assessment scheduled forArticle R. 174-34 of the Social Security Code.
"Art. R. 6147-115.-When required by the armed forces, the Minister of Defence shall take over all or part of the means referred to in R. 6147-114.
"Unless exceptional circumstances or emergencies, he warned the Minister of Health two months in advance, the Director General of the Regional Health Agency of Ile-de-France, and the Directors General of the Regional Health Agencies in which the hospitals of the concerned armies are established.
"Art. R. 6147-116.-The regional health agency in the jurisdiction of which an armies hospital is established is consulted by the latter for any project related to its facilities and care activities referred to in Article L. 6147-7, its participation in a health network or in a health cooperation group and any element likely to influence the provision of care.
"The host hospital is consulted by the regional health agency, in which it is established, for the development and revision of the regional care organization scheme referred to in Article L. 1434-7.
"The host hospital participates in the work of the territory conference, referred to in Article L. 1434-17, of the territory of health in which it is located.
"Subsection 2
“Cooperation in the field of care,
Training and Research
"Art. R. 6147-117.-The armed health service is empowered to receive personnel from health institutions to follow lessons, perform internships or participate in care or research activities.
"Health institutions are empowered to receive personnel from the military health service.
"A convention is then established between the Minister of Defence or his representative and the legal representative of the institutions concerned.
"Subsection 3
“Public service missions
"Art. R. 6147-118.-I. ― The military health service may exercise all or part of the public service missions defined in Article L. 6112-1, under the conditions provided for in the ninth paragraph of Article L. 6112-2.
“II. ― The multi-year protocol of objectives and means mentioned inArticle R. 174-34 of the Social Security Code specifies the obligations of the armed health service for the performance of the public service missions that it undertakes or contributes to ensuring and, where appropriate, the calculation of their financial compensation.
"Subsection 4
“Other public health activities
"Art. R. 6147-119.-Armed hospitals may be authorized by the Minister of Health to practise vaccinations required by the international health regulations.
"The Minister of Defence can lend during serious epidemics the assistance of the armed health service to the implementation of a massive vaccination campaign. Expenditures resulting directly from these interventions are covered by the Ministry of Health budget.
"The armed health service is empowered to conduct specialized biological and medical expertise requiring the use of special facilities or equipment.
"It can contribute to government emergency health plans.
"Subsection 5
« Concours du service de santé des armées
disaster or disaster
"Art. R. 6147-120.-The examination of the armed health service may be decided, at the request of the administrative authority, by the military authority to deal with emergencies resulting from disasters or disasters of a particular magnitude.
"A protocol specifies measures to ensure coordination of civilian and military health facilities, including the reception and treatment of a massive influx of wounded or sick.
"This protocol is signed jointly by the Minister of Defence and the Minister of Health for a period of five years. It is revisable at any time at the request of either of the signatories. »
In article R. 174-34 of the Social Security Code, after the third paragraph, a fourth paragraph shall be inserted:
"This protocol sets out the obligations of the armed health service for the performance of public service missions that it provides or contributes to ensuring and, where appropriate, how to calculate their financial compensation. »
The Minister of Defence and Veterans Affairs, the Minister of Labour, Employment and Health and the Secretary of State to the Minister of Labour, Employment and Health, responsible for health, are responsible, each with regard to him, for the execution of this decree, which will be published in the Official Journal of the French Republic.
Done on 30 January 2012.
François Fillon
By the Prime Minister:
Minister of Defence
and veterans,
Gérard Longuet
The Minister of Labour,
employment and health,
Xavier Bertrand
Secretary of State
to the Minister of Labour,
employment and health,
Health Officer
Nora Berra
