Chapter VI: Internal organisation.

Public health establishments are free to define their internal organisation in order to carry out their missions, subject to the provisions of this chapter. The director and the chairman of the establishment’s medical commission shall jointly define the organisation of the establishment into centres of activity in accordance with the establishment’s medical project, after consulting, in university hospital centres, the director of the medical training and research unit. The centres…

The departments referred to in Article L. 6146-1 are the benchmark for the organisation, relevance, quality and safety of care, local supervision of medical and paramedical teams, supervision of interns and health students and quality of life at work. They are managed by a department head, who is responsible for the internal structure, in close collaboration with the health executive. In hospitals and university hospital centres, the head of department…

By way of derogation from articles L. 6146-1 and L. 6146-1-1, the director and the chairman of the medical commission of a public health establishment may decide to freely organise the medical operation and the provision of care, in accordance with the establishment’s medical project approved by the management board. This decision is taken with the approval of the medical commission of the establishment and the nursing, re-education and medico-technical…

Under conditions laid down by regulation, the director of a public health establishment may, on a proposal from the head of the department, after obtaining the opinion of the chairman of the establishment’s medical commission, admit doctors, midwives and odontologists practising on a freelance basis, other than statutory practitioners practising within the framework of the provisions of article L. 6154-1, and doctors, midwives and odontologists practising on a voluntary basis…

Public health establishments may use medical, odontological and pharmaceutical staff for temporary work assignments, under the conditions laid down in article 9-3 of law no. 86-33 of 9 January 1986 on statutory provisions relating to the hospital civil service. The temporary employment agencies mentioned in article L. 1251-1 of the Labour Code certify to the health care institutions, before the start of the temporary employment assignment of the professional proposed,…

The Director General of the Regional Health Agency, when informed by the public accountant of the irregularity of legal acts concluded by a public health institution with a temporary employment company, in application of Article L. 6146-3, or with a practitioner for the performance of temporary work, in application of 2° of Article L. 6152-1, shall refer these acts to the competent administrative court. The director of the establishment concerned…

Midwives are responsible for the general organisation of obstetric care and procedures within their remit. They take part in their evaluation and in research activities in collaboration with the practitioners of the clinical or medico-technical activity centre.

In each institution, the general coordination of nursing, rehabilitation and medico-technical care is entrusted to a director of nursing, rehabilitation and medico-technical care, who is a member of the management team and appointed by the director. A nursing, re-education and medico-technical care committee, chaired by the general coordinator of nursing, re-education and medico-technical care and made up of the various categories of care staff, is consulted on matters and under…

Unless otherwise provided, the terms and conditions for the application of this chapter shall be determined by decree in the Conseil d’Etat.

Notwithstanding articles L. 6144-1, L. 6144-2 and L. 6146-9, the director of the institution may decide, on a joint proposal from the chairmen of the institutional medical committee and the nursing, rehabilitation and medical-technical committee, after consulting the supervisory board, to set up a medical-care committee to replace these two committees. This decision must first receive the assent of the institutional medical committee and the nursing, rehabilitation and medical-technical committee….