Actualité des ressources humaines hospitalières

FlickR - Logo Hôpital Cognac - pierre-alain dorangeQuelques décisions de jurisprudence récentes méritent l’attention des lecteurs en ce qu’elles contribuent à éclairer les gestionnaires sur le contentieux relatif aux affaires médicales principalement mais pas uniquement. Ainsi, et par exemple, on apprend – ce dont on se doutait ne serait-ce qu’intuitivement – qu’un médecin ne saurait exercer une tutelle sur un de ses confrères dans l’exercice de son art médical, en vertu du principe d’indépendance professionnelle.

Pas de tutelle entre médecins dans l’exercice de leur art médical

Ce principe fait en effet obstacle à ce que les décisions prises par un médecin dans l’exercice de son art soient soumises à l’approbation d’un autre médecin, juge le Conseil d’Etat dans un arrêt du 2 octobre 2009 ((CE, 2 octobre 2009, Centre hospitalier de Sens, n°309247.)). Ainsi est-il jugé que :

« Considérant que, s’il incombe au directeur d’un centre hospitalier de prendre les mesures que les impératifs de santé publique exigent dans son établissement, au besoin en saisissant les autorités administratives ou ordinales compétentes pour prononcer des mesures d’interdiction professionnelle, il résulte de ce qui a été dit ci-dessus que le principe de l’indépendance professionnelle des médecins fait obstacle à ce que les décisions prises par un praticien dans l’exercice de son art médical soient soumises à l’approbation d’un autre médecin ; que par suite, et sans qu’il soit besoin d’examiner les autres moyens soulevés par lui devant le tribunal administratif de Dijon, M. J. est fondé à demander l’annulation de la décision révélée par le courrier du 21 février 2006 du directeur du centre hospitalier en tant qu’elle soumet son activité pré-opératoire à une validation préalable par le chef du service d’oto-rhino-laryngologie de l’établissement ; »

Le directeur d’un CH peut suspendre l’activité d’un praticien

Aux termes d’une autre récente décision, il est indiqué par le Conseil d’Etat que le directeur d’un centre hospitalier peut suspendre l’activité d’un praticien ((CE, 24 juillet 2009, Grégoire, n°296641.)).

En effet, le directeur d’un centre hospitalier, qui exerce, aux termes de l’article L. 6143-7 du Code de la santé publique, son autorité sur l’ensemble du personnel de son établissement, peut légalement, lorsque la situation exige qu’une mesure conservatoire soit prise en urgence pour assurer la sécurité des malades et la continuité du service, décider, sous le contrôle du juge, et à condition d’en référer immédiatement aux autorités compétentes pour prononcer la nomination du praticien concerné, de suspendre ses activités cliniques et thérapeutiques au sein du centre  hospitalier, sans qu’y fassent obstacle les dispositions de l’article R. 6152-77 du Code de la santé publique ((CE, 4 janv. 1995, n° 128490 ; CE, 10 mars 2004, n° 240180.)).

Immédiatement informé de la mesure de suspension, le directeur de l’agence régionale de l’hospitalisation en a, à son tour, fait part au ministre.

La Haute juridiction s’est fondée sur les conclusions de deux rapports d’experts qui faisaient état de dysfonctionnements graves, notamment en raison d’un niveau insuffisant de l’équipe de chirurgie et de son encadrement, du taux de mortalité, de complications opératoires et de réinterventions affectant les patients opérés par l’intéressé. Elle ne s’est pas bornée à une pure constatation statistique mais s’est fondée sur un ensemble d’éléments et n’a pas entaché son arrêt d’erreur de droit.

Autre registre : celui du recul de la limite d’âge pour enfants à charge.

La limite d’âge, au-delà de laquelle un fonctionnaire ne peut plus acquérir de droit à pension et ne peut pas en principe continuer à exercer ses fonctions, entraîne la radiation des cadres d’office à compter du lendemain de leur anniversaire. Généralement fixée à 65 ans pour les emplois classés en catégorie A de la fonction publique, il existe nénamoins des possibilités de recul de la limite d’âge. Parmi celles-ci, l’alinéa 1er de l’article 4 de la loi du 18 août 1936 prévoit la possibilité pour les fonctionnaires ayant encore des enfants à charge, au moment où ils atteignent la limite d’âge, d’obtenir un recul de la limite d’âge d’un an par enfant sans que la prolongation d’activité puisse être supérieure à trois ans.

Lorsque l’agent remplit ces conditions, il est en droit de demander à l’autorité administrative compétente, préalablement à la date du jour où la limite d’âge est atteinte, de se prononcer sur son droit à bénéficier du recul de la limite d’âge ((CE 18 mars 1983, garde des Sceaux c. Muziotti, Lebon 112, concl. Lateboulle.)).

Dans l’affaire du 25 septembre 2009, le Conseil d’État ((CE, 25 septembre 2009, M. V., n°300781.)) précise que ce recul de la limite d’âge est alors de droit. Ainsi, l’autorité administrative compétente doit s’abstenir de radier des cadres l’agent remplissant ces conditions même si le délai de recours contre la décision lui refusant le bénéfice de la prolongation de son activité pour enfants à charge préalablement prise par l’autorité administrative est expiré. L’expiration du délai de recours contre cette décision n’a pas d’incidence sur le délai dont dispose l’intéressé pour demander l’annulation de la décision le radiant des cadres.

En l’espèce, un praticien hospitalier avait demandé à bénéficier d’un recul de limite d’âge pour enfants à charge, laquelle demande a été refusée par le ministre de la santé qui l’a radié des cadres le jour de son soixante-cinquième anniversaire. Le refus de cette demande était motivé par le fait que ce praticien serait physiquement inapte à son emploi. Le Conseil d’État considère que ce motif n’est pas au nombre de ceux pouvant légalement fonder cet arrêté. En effet, le motif de l’inaptitude physique permet à l’autorité administrative d’engager la procédure de mise à la retraite d’office pour inaptitude physique sans prendre en compte la limite d’âge de l’emploi de l’agent.

Un engagement de servir peut être issu d’un contrat

Pour finir sur une note moins technique, il ressort d’un jugement du Tribunal administratif d’Amiens ((TA Amiens, 14 mai 2009, Thuillier, n°0700801, AJDA 2009, p. 1630.)) qu’un engagement de servir dans la fonction publique hospitalière peut être issue d’un contrat.

La requérante a été engagée par le centre hospitalier Philippe-Pinel pour exercer les fonctions d’élève aide médico-psychologique. Son contrat prévoyait qu’après avoir obtenu le diplôme correspondant, elle s’engageait à servir pendant un certain temps. Cependant, après l’obtention de son diplôme, elle a décidé d’interrompre son activité professionnelle. Le centre hospitalier a alors émis un commandement de payer à son encontre dans les conditions prévues par le contrat. La débitrice a alors demandé au tribunal administratif d’Amiens l’annulation de ce commandement et de déclarer nulles les stipulations du contrat lui faisant obligation de rembourser les sommes engagées par son employeur en cas de non-respect de l’obligation de servir.

Le tribunal a rejeté sa requête. Il relève que, certes, l’engagement qu’elle avait souscrit ne correspondait pas aux dispositions du décret du 5 avril 1990. Mais il juge « que ces dispositions, qui mettent à la charge de bénéficiaires de certaines formations promotionnelles une obligation de servir dans la fonction publique hospitalière, n’ont eu ni pour objet ni pour effet de faire obstacle à ce qu’un engagement de servir puisse être contractuellement souscrit par les bénéficiaires de formations donnant accès à d’autres corps, grades ou emplois que ceux qu’elles prévoient, en contrepartie de la prise en charge financière de celles-ci par leur employeur».

Il relève en outre « qu’il ne résulte pas de l’instruction que la convention signée le 26 août 2005 par Mme (…), qui n’a formulé d’ailleurs aucune réserve quant à la validité de l’engagement de servir dont s’agit avant la présente action contentieuse, présenterait un déséquilibre en faveur du centre hospitalier Philippe-Pinel tel qu’elle n’exprimerait pas le consentement libre et éclairé de l’intéressée ».

Il s’agit classiquement en somme du contrôle du respect de la parole donnée.

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