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Thesis

French

ID: <

10670/1.e9l179

>

Where these data come from
The public hospital utility

Abstract

The public hospital utility has been established by the law of December, 31st, 1970, which gives a functional definition. Although the legislator promotes a hospital-centered model, it doesn’t exclude the private establishments associated to the public hospital utility by means of methods of participation which penalize it. Weakened by successive hospital reforms, the public hospital utility will atrophy until the reform of July, 21st, 2009 which deletes the notion and substitutes it by the concept of public service missions. This functional conception is in accordance with the service public theory and compatible with the definition of general interest service defended by the European Union law, but isn’t in keeping with facts. The theoretical functional definition supported by the lawmaker is replaced, in practice, by an organic conception resulting from details of implementation of public hospital utility decidedly favorable to sector public. Indeed, public health establishments benefit from a singular status characterizing its predominance. The law of January, 26, 2016 confirms the resonance of the organic conception by rehabilitating the notion of public hospital utility, and by maintaining public sector institutions in its role of natural actors of this public utility. Questions remain, nonetheless, concerning the durability of the health system. It must step back for a public health service, integrating the public hospital utility, able to head the action of all health protagonists and to guarantee the progress of an accessible, egalitarian and qualitative fitness trail.

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