Loi Bachelot, un comité d’évaluation pour la mise en oeuvre du titre I

FlickR - République Française - Jaume d'UrgellVoici, pour une fois, un décret d’application de la loi HPST qu’il n’était pas si difficile de prendre. En effet, le Titre I de la loi HPST porte sur la modernisation des établissements de santé. Son dernier article, l’article 35, prévoit la création d’un comité de suivi de la réforme de la gouvernance des établissements publics de santé, placé auprès du ministre chargé de la santé. Sa composition et ses missions sont définies par voie réglementaire. Il remet un rapport au Parlement deux ans après la promulgation de la loi HPST, soit le 22 juillet 2011 au plus tard.

C’est le décret n°2010-114 du 3 février 2010 qui a pourvu à cette tâche.

Le comité est chargé :

  • d’évaluer la mise en oeuvre de la réforme de la gouvernance hospitalière et d’en dresser un bilan portant notamment sur la mise en oeuvre des conseils de surveillance et des directoires ainsi que sur la mise en oeuvre des pôles et de la contractualisation interne ;
  • d’évaluer et de faire le bilan de la réorganisation des procédures de suivi et d’amélioration de la qualité des établissements de santé ;
  • d’évaluer la mise en oeuvre des mesures ayant pour objet de favoriser les coopérations entre les établissements de santé.

Pour ce faire, il « prend en compte » le point de vue des acteurs hospitaliers et celui des usagers. Il examine également le rôle joué par les ARS. Bilans et évaluations donnent lieu à des recommandations adressées au ministre chargé de la santé.

La composition a été voulue à la fois souple et représentative, sous l’oeil du Parlement. Ainsi le comité comprend un député et un sénateur, un représentant des associations d’usagers (pourquoi pas le charismatique Christian Saout ?), six représentants des personnels médicaux et non médicaux et des personnels de direction des établissements de santé (on pense au Centre national de gestion), et enfin trois personnalités qualifiées choisies en raison de leur connaissance du système de santé (sans doute des sommités, comme il se doit).

Le comité se réunit à la demande de son président, au moins trois fois par an. Il est regrettable que ses séances ne soient pas publiques. Toute personne dont le concours peut paraître utile peut être invitée à participer aux travaux du comité, à l’initiative du président. Deux fois par an, le secrétaire des ministères sociaux et les directeurs d’administration centrale de ces mêmes ministères informent le président du comité de l’action qu’ils mènent pour mettre en oeuvre la loi HPST.

Sont naturellement astreints à une obligation de discrétion à l’égard des informations présentant un caractère confidentiel tous les membres du comité, qu’ils soient membres habituels ou occasionnels. S’abstenir d’y siéger pendant un an, sans motif légitime, équivaut à une démission. La fonction de membre n’est pas rétribuée mais elle donne droit à un défraiement.

L’article 5 du décret est original en ce qu’il dit grosso modo : « le présent décret s’auto-détruira dès la remise du rapport bi-annuel prévu à l’article 1er. » C’est un procédé que l’on n’a pas l’habitude de voir. Le décret ne sera donc pas abrogé, il cessera simplement de recevoir application, ce qu’on peut regretter puisqu’il s’agit d’une mesure qui contribuera à nuire à la lisibilité de la norme. Il aurait mieux valu prévoir l’abrogation d’un texte qui deviendra inappliqué plutôt que de le laisser perdurer inutilement dans l’ordre juridique interne.

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