STANDARD CONTRACT FOR LIBERAL PROFESSION ACTIVITY REFERRED TO IN ARTICLE R. 6154-4.
Between :
The establishment…… (name of the public health establishment) represented by its director,
And :
M……. (surname, first name, hospital duties, address, qualification and date of qualification, registration number with the departmental medical association),
it is agreed as follows:
Article 1
M……. carries out a self-employed activity in…… (mention the department where the person concerned carries out his activity), under the conditions set out in articles L. 6154-1 to L. 6154-6 and articles R. 6154-4 to R. 6154-26 of the Public Health Code, which are appended to the present contract and of which he has taken note.
Article 2
In compliance with article L. 6154-2 of the French Public Health Code, ……. declares that he/she personally and on a principal basis carries out an activity of the same nature in the public hospital sector.
He undertakes :
1° Not to devote more than :
-20% ;
-or 10% (delete as appropriate) of the weekly hospital service to which he/she is obliged;
2° To identify himself in the information system as the person carrying out the procedures and consultations, specifying that these are carried out as part of his personal public activity;
3° To provide the director of the establishment and the chairman of the commission for private practice quarterly with the schedule of services performed and a summary statement of private practice activities, specifying the number and nature of the procedures and consultations performed in respect of each of them;
4° To ensure that the number of consultations and procedures carried out in the course of private practice is less than the number of consultations and procedures carried out in the course of personal public practice;
5° To respect the principles set out in the establishment’s charter for private practice within the hospital;
6° Not to commence their private practice until their contract has been approved by the Director General of the Regional Health Agency in accordance with the provisions of article L. 6154-4.
Article 3
Collection of fees
Either :
M……. chooses to collect his fees by direct agreement with the patient. He undertakes to pay quarterly the amount of the fee for which he is liable to the hospital;
Or:
M……. chooses to collect his fees via the hospital administration. The latter undertakes to pay him the fees collected on a monthly basis.
The hospital administration will deduct the amount of the fees owed to the hospital by ……. on a quarterly basis.
Article 4
The fees or fee bands for consultations are displayed in the waiting room, in accordance with the provisions of article R. 1111-21 of the Public Health Code relating to information on the fees charged by private practitioners.
Article 5
M……. shall ensure that professional secrecy is respected by all persons called upon to assist it in its practice. The establishment undertakes to ensure that medical files and documents are kept safe from indiscretion under the responsibility of ……..
Article 6
M……. practices under his own full responsibility; to this end, he shall take all necessary steps to ensure that his professional activity is covered by an appropriate insurance policy, which he shall provide to the establishment’s director at the latter’s request.
Article 7
The hospital shall provide M……. with the necessary resources to enable him/her to practise his/her art, taking into account the speciality practised.
Article 8
M……. shall make arrangements with his hospital colleagues to ensure continuity of care in the event of his absence.
Article 9
This contract is concluded for a period of five years and takes effect from the date of its approval. It shall expire if a request for renewal has not been made within six months of its expiry.
It may be amended under the conditions and according to the procedures required for its establishment.
The contract is terminated automatically if Mr … works less than eight half-days per week, if he gives up the practice of a liberal profession or if the authorisation to practice such a profession is withdrawn.
Article 10
In accordance with the provisions of IV of article L. 6154-2 of the Public Health Code, in the event of temporary or definitive departure, except when he ceases to carry out his duties in order to claim his pension rights, Mr … undertakes not to settle, for a period of … months, and within a radius of … kilometres, in the vicinity of the establishment he is leaving. This period shall be a minimum of six months and a maximum of twenty-four months, and the radius shall be a minimum of three kilometres and a maximum of ten kilometres.
In the event of non-compliance with this clause, Mr … shall pay the establishment compensation calculated as follows: 25% of the average monthly amount of fees received by Mr …, including royalties, over the last six months, multiplied by the number of months during which the clause is not complied with.
The provisions of the two preceding paragraphs do not apply to practitioners working for the Assistance publique-hôpitaux de Paris, the Hospices civils de Lyon and the Assistance publique-hôpitaux de Marseille.
Article 11
In accordance with article L. 4113-9 of the French Public Health Code, ……. will notify the present contract to the Conseil Départemental de l’Ordre des Médecins.