Tribune. Some 145 faculty presidents and deans recently sounded the alarm in a forum at the World : “The CHU, this” flagship “of our health system, is taking water, especially on the academic side”, published on June 4. They rightly underlined two points of concern: the Ségur de la santé forgot the university and even suppressed the opinion of the deans on the appointment of heads of service; the medical schools are stifled by the reform of medical studies, and the proposal to create 250 posts over five years, that is to say one per year and per faculty, totally misses the reality of the needs. This forum concludes by calling for “To plunge the university and the faculties back into the center of the system, like all countries with an ambition in the field”.
Precisely, it would be good to analyze what is happening in the health systems of other countries, which are totally different from the French model. In fact, most often, the hospital is a component of the university or the university itself chooses the hospitals with which it wishes to collaborate in the interest first of the students and then of research.
This is not at all the case in the French system where the hospital, regional hospital center (CHR), is obligatorily, and for all its services, in connection with the university. It is obvious that within a CHR all services are not equal. Some are local services that do not have a university dimension. To add to the complexity, the university cannot enter into contracts with hospitals other than the CHR without its assent. In most university hospital centers (CHU), it is not the university that is the master of the game, but the general manager of the CHU.
How to keep it simple?
We must reverse the roles and restore primacy to the university. That’s it “Do like everyone else” : it means going to the end of the autonomy of universities, especially in the field of health and letting the university enter into contracts with whomever it wants in its interest. This is particularly the case in the American system and in most European systems.
How to keep it simple? First by rewriting article 6 of the ordinance of 58 : “Agreements can be concluded by faculties or schools and by hospitals, acting jointly, with other hospitals or public or private organizations likely to be associated with the various missions. “ And by removing “And by hospitals, acting jointly”. The legislative provision becomes: “Agreements can be concluded by the faculties or schools with hospitals or public or private organizations likely to be associated with the various missions defined in the article”. Doing like everyone else is putting the university at the heart of the system.
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