The European Union Review 

Hôpital et Santé Publique en Droit Français: l’Incidence des Réformes de 1996

Marie-France Mialon - Université de Paris II (Pantheon-Assas), France

The reform of the French hospital system, which commenced in 1991, can be seen as moment of fundamental importance in the redefinition of overall healthcare system, a redefinition that had become essential owing to the financial burdens of the system, which had become particularly pressing in all industrialised countries. Our aim is to assess the conditions that required reform, the reform being aimed not at creating a new system, but rather at adjusting the existing system, introducing principles to curb prices, new principles in management, coordination criteria between public and private health providers, the overall target being the most efficient and effective service possible. In particular, the paper examines the innovations introduced in 1996, both on a district level, through introduction of the "Agence Régionale de l’Hospitalisation" (ARH) (District Hospitalisation Agency), to which the duties of planning and coordinating offer were ascribed, and at an institutional level, through empowering public health facilities with financial autonomy, as well as management responsibilities. In spite of these significant innovations, the reform process is still far from complete, with many of the targets not having, in fact, been met: therefore, a decisive commitment is still required to increase the system’s capacities and offer suitable quality services efficiently and effectively.