L’interdiction d’exercer la chirurgie ne peut se fonder sur le code de la consommation

Clinique NDM - BlocChirurgicalWebLa santé n’est pas, paraît-il, un commerce. Ce qui paraît certain en tout cas, c’est que les soins ne sont pas une marchandise. En effet, le préfet ne peut pas interdire à un médecin d’exercer la chirurgie en se fondant sur l’article L.221-8 du code de la consommation, a affirmé le Conseil d’Etat dans un arrêt du 25 septembre 2009 (arrêt n°311597). C’est sur cette base légale qu’en l’espèce le préfet du Puy-de-Dôme avait pris un arrêté interdisant à un médecin d’exercer la chirurgie esthétique dans son cabinet.

Si les faits de l’espèce, tels que rapportés dans l’arrêt, incitaient au prononcé d’une mesure de suspension, ou même d’interdiction d’exercice, cette mesure a été prise sur un fondement juridique erroné.

Qu’on en juge par les faits :

« Considérant qu’il ressort des pièces du dossier soumis aux juges du fond que le préfet du Puy-de-Dôme, se fondant sur les dispositions de l’article L.221-6 du code de la consommation et sur les constatations opérées par les services de la direction départementale des affaires sanitaires et sociales et de la direction départementale de la concurrence, de la consommation et de la répression des fraudes selon lesquelles M. V., médecin exerçant à Chamalières (Puy-de-Dôme) pratiquait de façon habituelle dans son cabinet, sans être titulaire des autorisations exigées par la réglementation en vigueur, des interventions chirurgicales de chirurgie esthétique et vasculaire réalisées sous anesthésie dans des conditions d’hygiène et d’organisation menaçant la sécurité de ses patients, a, par un arrêté en date du 28 août 2003, mis en demeure l’intéressé de cesser immédiatement toute activité chirurgicale à défaut de justifier d’une autorisation administrative d’exercice de la chirurgie ambulatoire ; que M. V. a demandé au tribunal administratif de Clermont-Ferrand l’annulation de cette décision ; que par un jugement du 26 février 2004, le tribunal a rejeté sa demande ; que, par un arrêt du 16 octobre 2007, la cour administrative d’appel de Lyon a annulé ce jugement et, après évocation, rejeté la demande de première instance de M. V., qui se pourvoit en cassation contre cet arrêt ; »

Voilà pour le cadre factuel de l’affaire.

Quelles sont les dispositions applicables aux faits de l’espèce ? Le Préfet s’est fondé sur le code de la consommation et, en particulier sur les articles L.221-5 et L.221-6. Mais que disent-ils ?

L’article L.221-5 dudit code dispose :

« En cas de danger grave ou immédiat, le ministre chargé de la consommation et le ou les ministres intéressés peuvent suspendre par arrêté conjoint, pour une durée n’excédant pas un an, la fabrication, l’importation, l’exportation, la mise sur le marché à titre gratuit ou onéreux d’un produit […] / Ils peuvent, dans les mêmes conditions, suspendre la prestation d’un service […] ; »

Aux termes de l’article L.221-6 du même code, dans sa rédaction applicable à la date de la décision attaquée :

« Les agents qui ont procédé aux contrôles transmettent au représentant de l’Etat dans le département les résultats de leurs investigations accompagnés de leurs propositions sur les mesures à prendre. Celui-ci communique, dans les meilleurs délais et au plus tard dans les quinze jours de la transmission, le dossier au ministre intéressé et au ministre chargé de la consommation avec son avis motivé.

En cas de danger ou immédiat, le représentant de l’Etat dans le département prend les mesures d’urgence qui s’imposent. Il en réfère aussitôt au ministre intéressé et au ministre chargé de la consommation, qui se prononcent, par arrêté conjoint , dans un délai de quinze jours […] »

Enfin, l’article L.221-8 dispose :

« Les mesures prévues au présent titre ne peuvent être prises pour les produits et services soumis à des dispositions législatives particulières ou à des réglements communautaires ayant pour objet la protection de la santé ou de la sécurité des consommateurs, sauf, en cas d’urgence, celles prévues aux articles L.221-5 et L.221-6 ».

Au regard de ces dispositions, le Conseil d’Etat indique « que les dispositions précitées de l’article L.221-8 du code de la consommation, qui prévoient qu’en cas d’urgence les mesures prévues aux articles L.221-5 et L.221-6 peuvent être prises y compris pour des produits ou services soumis à des dispositions législatives particulières, ne donnent pas compétence au préfet pour suspendre l’exercice de sa profession pour un médecin, dès lors que les dispositions de l’article L.4113-14 du code de la santé publique permettent au préfet de prononcer cette suspension en cas d’urgence ; qu’ainsi, en jugeant que la décision litigieuse du préfet du Puy-de-Dôme avait pu légalement être prise en application des dispositions de l’article L.221-6 du code de la consommation, la cour administrative d’appel de Lyon a ommis une erreur de droit ; que l’article 2 de son arrêt doit, par suite, être annulé ».

Au plan procédural, lorsqu’une décision litigieuse a été prise sur un fondement erroné, le Conseil d’Etat peut procéder à une subtitution de base légale, à condition toutefois de ne pas priver le destinataire de ladite décision de garanties similaires, si ce n’est identiques.

Or, en l’espèce, les conditions de cette substitution n’étaient pas remplies dès lors que le Préfet n’a pas fait bénéficier le requérant des garanties prévues à l’article L.4113-14 du code de la santé publique, en prévoyant son audition dans un délai de trois jours et en limitant la durée de la suspension à une période de cinq mois. Il suit de là que le requérant est fondé à demander l’annulation de la décision du 28 août 2003.

Une fois de plus, on se trompe de case (code de la consommation en lieu et place du code de la santé publique) pour sanctionner des faits répréhensibles. Le médecin s’en sort. C’est de bonne guerre.

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