Key Benefits:
Public officials concerned: hospital public service institutions.
Purpose: organization and operation of occupational health services in hospital public service institutions.
Entry into force: the text comes into force on January 1, 2016.
Notice: the decree transposes into the hospital public service the legislative provisions from the Act No. 2011-867 of 20 July 2011 on the organization of work medicine.
References: the decree and the Labour code that it amends, in its drafting resulting from these amendments, can be found on the website Légifrance (http://www.legifrance.gouv.fr).
The Prime Minister,
On the report of the Minister of Social Affairs, Health and Women ' s Rights,
Vu le education code ;
Vu le Labour code ;
Vu le Public Health Code ;
Vu la Act No. 86-33 of 9 January 1986 amended with statutory provisions for the hospital public service;
Vu le Decree No. 82-453 of 28 May 1982 amended on occupational health and safety and on medical prevention in the public service;
Vu le Decree No. 88-386 of 19 April 1988 amended with respect to the conditions of physical fitness and leave of hospital public officials;
Considering the opinion of the Higher Council of the Hospital Public Service of 8 July 2015;
Considering the opinion of the Council on the working conditions of 25 June 2015;
Considering the advice of the National Standards Assessment Board dated 10 September 2015;
The State Council (Section of Administration) heard,
Decrete:
Chapter VI of title II of Book VI of the fourth regulatory part of the Labour Code is amended in accordance with the provisions of Articles 2 to 39 of this Decree.
Section D. 4626-2 is replaced by the following provisions:
"Art. D. 4626-2.-The occupational health service is organized in the form of:
« 1° An autonomous health service at the facility's own work;
« 2° A self-employed occupational health service established by agreement between several institutions.
"However, for institutions of less than one thousand five hundred agents, when the creation of an autonomous health service at work would prove impossible, the establishment may enter into a convention with:
"-a common service to several jurisdictions second paragraph of Article 11 of Decree No. 82-453 of 28 May 1982 amended on occupational health and safety and on medical prevention in the public service;
"a joint-enterprise health service as defined in articles D. 4622-22 et seq. »
Section D. 4626-3 is replaced by the following provisions:
"Art. D. 4626-3.-When the self-employed occupational health service is grouped by a convention, the Convention sets out, inter alia, the terms of service management and allocation of expenses. The management of the service may be entrusted to one of the institutions parties to the agreement. »
Section D. 4626-4 is amended as follows:
1° After the word "service" is inserted the word "autonomous";
2° The words: "the actual strength of all agents" are replaced by the words: "the physical strength of all agents".
After article D. 4626-4 of the Labour Code, an article D. 4626-4-1 is inserted as follows:
"Art. D. 4626-4-1. - The characteristics to which medical facilities and their equipment are met are determined based on the importance of self-service health at work, after consultation with the occupational doctor and the appropriate hygiene, safety and working conditions. »
Section D. 4626-5 is replaced by the following provisions:
"Art. O.C. 4626-5.-Where the self-employed health service is grouped by agreement, the total amount of expenditure is apportioned among interested institutions proportionally to the physical strength of all employees employed by each of them as at December 31 of the last calendar year. »
After article D. 4626-5, an article D. 4626-5-1 is inserted as follows:
"Art. D. 4626-5-1.- Self-employed health services are not subject to the provisions of articles D. 4622-48 to D. 4622-53 of this Code.
"The establishment that manages the self-employed health service at work addresses a statement describing the organization and operation of the service to the Regional Director of Business, Competition, Consumer Affairs, Labour and Employment. Within a period of four months, the institution may submit its observations to the establishment on the organization and planned operation of the service.
"The contents of the declaration are specified by joint decree of ministers responsible for health and labour. The statement is updated every five years."
Section D. 4626-6 is replaced by the following provisions:
"Art. D. 4626-6.-The Chief of Institution shall prepare an annual report on the organization, operation and financial management of the self-employed health service at work. It is developed according to a model established by joint decree of ministers responsible for health and work.
"When the self-employed health service is grouped by agreement, a joint report is prepared by the head of institution hosting the service. It retraces the activity of self-service health at work in each of the institutions concerned. A copy of this report is sent to each institution Party to the Convention. »
Section D. 4626-7 is replaced by the following provisions:
"Art. D. 4626-7.-The annual report is presented at the same time as the report referred to in section D. 4626-32 and the social balance sheet to the technical establishment committee, the medical establishment board and the hygiene, security and working conditions committee. It is transmitted to the Regional Director of Business, Competition, Consumer Affairs, Labour and Employment within one month, with any comments from these bodies."
Section D. 4626-8 is amended as follows:
1° In the first paragraph, the words "or the union" are deleted;
2° The second paragraph is deleted.
I.-The title of chapter VI, section 3, title II, of Book IV of Part IV is replaced by the following title: "Personals involved in occupational health services".
II.-It is created within the section referred to in I a sub-section 1 entitled "Working physician" and comprising sections R. 4626-9 to R. 4626-16 and a sub-section 2 entitled "Multidisciplinary teams" including section R. 4626-17.
Section D. 4626-11 is replaced by the following provisions:
"Art. R. 4626-11.-The occupational physician is bound by a contract with the establishment responsible for the management of the occupational health service in accordance with a contract model established by joint decree of ministers responsible for health and labour."
Section R. 4626-12 is replaced by the following provisions:
"Art. A. 4626-12.-The establishment shall inform the technical committee of establishment, the hygiene, safety and working conditions committee and the regional director of companies, competition, consumption, work and employment of the appointment or recruitment of the occupational doctor.
"Without prejudice to the regulatory provisions applicable in disciplinary matters to personnel referred to in section L. 952-21 of the Education Code and to the 1st of section L. 6152-1 of the Public Health Code, the decision to terminate the work doctor, break-up or non-renewal of his or her fixed-term contract shall be taken after notice of the work inspector. This notice is made after consultation with the appropriate hygiene, safety and working conditions committee and advice from the occupational inspector. »
Section R. 4626-13 is replaced by the following provisions:
"Art. R. 4626-13.-The occupational doctor personally performs all of his duties. In the establishments of which he or she is responsible, these functions are exclusive to any other function that may jeopardize the independence of the work doctor under section L. 4622-4 or that derogates from section R. 4127-99 of the Public Health Code.
"However, the occupational doctor may entrust certain activities, under his or her responsibility and through written protocols, including medical staff, internal staff, job authorization candidates, nurses, occupational health assistants. For professions whose conditions of exercise are governed by the Public Health Code, these activities are carried out within the limits of the respective competencies of health professionals determined by the provisions of this Code. »
After the article R. 4626-13, an article R. 4626-13-1 is inserted as follows:
"Art. R. 4626-13-1. - In university hospital centres, the functions of a work doctor may be entrusted to a professor at universities-practor hospital in occupational medicine under the conditions defined in articles R. 4626-12 and R. 4626-13. In this case, the provisions of articles R. 4623-4 and R. 4626-9 are not applicable. »
Section R. 4626-14 is replaced by the following provisions:
"Art. R. 4626-14.-The self-employed occupational health service includes at least one full-time working physician per one thousand five hundred officers.
"For any workforce or fraction of less than one thousand five hundred agents, a part-time work doctor is employed.
"The threshold of a thousand five hundred agents is increased to two thousand when the self-employed health service is assisted by the multidisciplinary team composed of all the agents mentioned in 1° to 3° of article R. 4626-17. »
In article R. 4626-15, after the word "service", the word "autonomous".
In R. 4626-16, the words: "health service in common work" are replaced by the words: "self-employed health service at work constituted by a convention between several institutions".
Section R. 4626-17 is replaced by the following provisions:
"Art. A. 4626-17.-In order to ensure the implementation of the medical, technical and organizational skills necessary for the prevention of occupational hazards and the improvement of working conditions, the establishment provides the self-care service at work with the means necessary for its proper operation and for the fulfilment of its tasks, including:
« 1° Nurses;
« 2° Occupational Health Assistant staff;
« 3° At the proposal of the occupational doctor, in a timely or permanent manner, persons or organizations with the skills necessary to prevent occupational hazards and improve working conditions.
"The multidisciplinary team thus formed is moderated and coordinated by the occupational physician.
"Multidisciplinary team members exercise their functions independently.
"The independence of individuals and organizations associated outside the establishment is guaranteed under a convention that specifies:
“the actions entrusted to them and the modalities of their exercise;
"the means at their disposal, as well as the rules ensuring their access to places of work and the conditions for the fulfilment of their missions, including those that ensure the free presentation of their observations and proposals.
"Social services can be associated with the implementation of the actions of the self-service team at work. »
Section R. 4626-18 is repealed.
The title of chapter VI, section 4, of Book IV, title II, of the fourth part is replaced by the following title: "Actions and means of the members of the multidisciplinary occupational health team".
Section R. 4626-19 is replaced by the following provisions:
"Art. R. 4626-19.-The occupational physician is informed as soon as possible by the head of establishment of any occupational illness, illness contracted during work and work accident reports.
"If he considers it necessary, he shall prepare a report on the measures to be taken to avoid the repetition of such facts. This report is addressed to the hygiene, safety and working conditions committee and to the head of institution who sends a copy to the guardianship authority, and is made available to the labour inspector and the occupational inspector.
"The occupational doctor is also informed of the referral of the medical committee or departmental reform committee. He writes a report under the conditions specified in Article 9 of amended Decree No. 88-386 of 19 April 1988 on the conditions of physical fitness and sick leave of hospital civil servants. »
In article R. 4626-20, after the first paragraph, it is added a paragraph as follows:
"The head of institution shall take all measures to allow the working physician to perform that third-time in the course of the actions referred to in R. 4624-1. »
Section R. 4626-21 is replaced by the following provisions:
"Art. A. 4626-21.-The occupational physician shall, in a consultative capacity, attend the meetings of the Technical Establishment Committee and the Medical Establishment Committee when the agenda of these bodies includes matters of health, safety and working conditions."
Section R. 4626-23 is replaced by the following provisions:
"Art. A. 4626-23.-The occupational health care practitioner provides for additional examinations tailored to the individual's background, the position that will be occupied and in the prevention of communicable infectious diseases.
"The occupational physician shall conduct or carry out additional examinations under the provisions in force for certain categories of workers exposed to special risks under the conditions laid down in R. 4626-31. »
Section R. 4626-24 is repealed.
In the first paragraph of section R. 4626-25, the words "or the union secretary general" are deleted.
Section R. 4626-26 is replaced by the following provisions:
"Art. R. 4626-26.- Agents receive a medical examination at least every twenty-four months.
"Medical examinations or, pursuant to the first paragraph of section R. 4623-31, nurse interviews may be conducted more frequently, at the discretion of the occupational doctor. »
Section R. 4626-27 is replaced by the following provisions:
"Art. R. 4626-27.-Benefits from enhanced medical supervision:
« 1° The agents mentioned in article R. 4624-18;
« 2° Agents reintegrated after long-term or long-term sick leave."
Section R. 4626-28 is replaced by the following provisions:
"Art. R. 4626-28.-The working physician determines the modalities of enhanced medical supervision taking into account recommendations of good practices. »
The title of paragraph 4 of section 2 of chapter VI, section 4, of title II, of Part IV is replaced by the following title: "Pre-resumptive and resumed work reviews".
Section R. 4626-29 is replaced by the following provisions:
"Art. R. 4626-29.-The officer is receiving a retake examination by the occupational doctor:
« 1° After maternity leave;
« 2° After an absence due to professional illness;
« 3° After a absence of at least 30 days due to work, illness or non-occupational accident or, at the initiative of the occupational doctor, for a absence of less than 30 days.
"The recovery review is organized within eight days of the resumption of work by the agent."
After article R. 4626-29, an article R. 4626-29-1 is inserted as follows:
"Art. R. 4626-29-1.-A pre-resumption examination may be organized under the conditions set out in articles R. 4624-20 to R. 4624-21."
Section R. 4626-30 is replaced by the following provisions:
"Art. R. 4626-30.-The working physician may prescribe the necessary additional examinations:
« 1° Determining the ability of the officer to the workstation and, in particular, screening for conditions involving counter-indication to the workstation;
« 2° In the screening of a professional or professional disease that may result from the professional activity of the agent;
« 3° Screening of conditions that may expose the agent's entourage to contagion risks.
"For this purpose, the occupational doctor is informed by the chief of establishment, as soon as possible, of any change in assignment and may, on this occasion, take the initiative to conduct a further examination of the officer."
Section R. 4626-31 is replaced by the following provisions:
"Art. R. 4626-31.- Medical examinations provided for in this subsection are:
« 1° At the expense of the institution when it has an autonomous occupational health service or when it is bound by agreement to a common service to several jurisdictions. The facility provides the working physician with the means to ensure that the anonymity of the examinations is respected. To the extent that these examinations cannot be performed at the facility, the working physician chooses the body responsible for practicing them;
« 2° At the expense of the inter-enterprising health service when the facility relies on this structure, unless otherwise stated in the agreement signed with the inter-enterprising health service."
Section D. 4626-32 is replaced by the following provisions:
"Art. D. 4626-32.-The occupational physician shall prepare an activity report each year, after consultation with the multidisciplinary team, to be annexed to the social assessment.
"This annual report is presented at the same time as the one referred to in section D. 4626-6 and that the social balance sheet is presented to the technical establishment committee, the medical establishment board and the hygiene, safety and working committee. It shall be transmitted with any observations of such proceedings within one month to the consignee provided for in Article D. 4626-7. »
Section D. 4626-33 is replaced by the following provisions:
"Art. A. 4626-33.-A occupational health medical record is constituted by the working physician under the conditions laid down in Article L. 4624-2 of the Labour Code.
"In accordance with the provisions set out in sections L. 1110-4 and L. 1111-7 of the Public Health Code, the occupational physician collects and updates the administrative, medical and professional information required for individual and collective occupational health actions with the officer and services concerned. These data are kept in the occupational health records. The same is true of the opinions of the various medical authorities formulated pursuant to article 71 of Act No. 86-33 of 9 January 1986, amended with statutory provisions relating to the public hospital service.
"When the officer leaves the institution, a double of the medical record is returned, with his agreement, to the doctor of the work of his new assignment. In the event of an officer's refusal, only the list of immunizations and the results of tuberculin tests are transmitted to the occupational doctor. »
Section D. 4626-34 is repealed.
Section D. 4626-35 is replaced by the following provisions:
"Art. A. 4626-35.-The occupational physician shall, at the end of each of the medical examinations provided for in subsection 2 of section 4, with the exception of the pre-resumptive examination referred to in section R. 4626-29-1, establish a medical certificate of fitness in three copies.
"He shall hand over a copy to the officer, classify a copy in his occupational health record, and transmit the third to the employer by any means giving certain date, which shall keep it in the officer's administrative file. This copy is submitted at any time upon request to the Labour Inspector and to the Labour Inspector.
"This fact sheet contains no information on the nature of the affections the agent would or would have been affected. It refers only to counter-indications and recommendations regarding the possible allocation to certain workplaces. »
This Order comes into force on January 1, 2016.
The Minister of Social Affairs, Health and Women's Rights, the Minister of Labour, Employment, Vocational Training and Social Dialogue and the Minister of Decentralization and Public Service are responsible, each with respect to it, for the execution of this Order, which will be published in the Official Journal of the French Republic.
Done on December 4, 2015.
Manuel Valls
By the Prime Minister:
Minister of Social Affairs, Health and Women ' s Rights,
Marisol Touraine
The Minister of Labour, Employment, Vocational Training and Social Dialogue,
Myriam El Khomri
Minister of Decentralization and Public Service,
Marylise Lebranchu
