who is the competent judge? [très courte VIDEO et article]

Which court has jurisdiction to hear a dispute between a patient and a public hospital relating to treatment provided by a surgeon with a private practice contract?

Let's see the answer in a very short video and a brief article.

I. VERY SHORT VIDEO (59 seconds)

https://youtube.com/shorts/SCfmUdR21rk

https://youtube.com/shorts/SCfmUdR21rk

II. SHORT ARTICLE

Response from the Conflicts Tribunal:

• Errors committed by a hospital practitioner during acts carried out within the framework of the public hospital service in principle engage the sole responsibility of the hospital center to which this practitioner belongs, which it is up to the patient to pursue before the administrative jurisdiction.
• On the other hand, faults committed by a hospital practitioner during his professional activity are committed outside the exercise of his hospital functions and involve his sole responsibility which it is up to the patient to pursue before the courts.

To establish in which legal framework the disputed medical intervention took place, the Court uses the technique of the bundle of clues, assessing the elements of the file in the light of the provisions of the public health code, in their version applicable to the dispute .

Under Article L. 6144-3 of the Social Security Code, “the practitioner exercising a liberal activity chooses to collect his fees directly or, by way of derogation from the provisions of Article L. 162-2 of the Social Security Code. social security, through the hospital administration” and “Liberal activity gives rise to the payment to the establishment by the practitioner of a fee under conditions determined by decree”.

Article R. 1112-22 of the same code provides that “When patients other than beneficiaries of medical aid opt for the special regime or the liberal activity of hospital practitioners, the option is formulated in writing, as soon as entry of the patient, by himself, a member of his family or a close relative, after the person concerned has become aware of the particular conditions implied by the choice of one or the other of these categories. The commitment to pay the supplements to the rate of services, which must be precisely indicated, is signed at the same time, subject, with regard to those insured by social security, to agreements between public health establishments and organizations taking charge of the healthcare costs”.

The terms of care for the patient in the self-employed sector are regulated in particular by the provisions of articles R. 6154-3 of the social security code concerning the direct collection of fees, R. 6154-6 of this code concerning living expenses, R. 6154-7 of the same code concerning the indications relating to the rules applicable due to this choice as well as to the written expression of the choice and by a reference to the provisions of article R. 1112-23 of the said code, which makes it impossible to transfer a patient, admitted in a sector of liberal activity or in the public sector, to the other sector.

In the present case, the applicant had, after a skiing accident, been admitted to a public health establishment and requested compensation for his damage resulting from intervention by a hospital practitioner.

It does not emerge, according to the court, from the documents in the file that, during this hospitalization, the applicant expressly expressed in writing his choice to be treated under the liberal activity of this practitioner or that he would have paid fees directly.

In the absence of any other sufficiently precise and concordant element making it possible to establish that the patient would have been cared for in the practitioner's private sector of activity, this court therefore states that the acts of hospital care in dispute must, consequently, be considered as having been carried out under the practitioner's hospital functions.

It follows from this that the dispute between the patient and the public health establishment falls within the jurisdiction of the administrative court.

Source :

Conflict Tribunal, October 7, 2024, no. C4321 (or 4321 or c-4321 depending on the publishers), in the Lebon collection