Question 14683 — health establishments

Summary

Mr. Vincent Trébuchet draws the attention of the Minister of Health, Families, Autonomy and People with Disabilities to the critical situation of pharmacies for indoor use (PUI) within local hospitals, particularly in rural and mountainous areas such as Ardèche. In these establishments, the operation of the PUI very often relies on an extremely small pharmaceutical workforce, sometimes limited to a single pharmacist. Therefore, the departure, prolonged absence or inability to replace this professional may lead, in the very short term, to the closure of the PUI and the immediate calling into question of the very activity of the establishment. In certain territories, this fragility translates concretely into a direct threat to the maintenance of a local hospital offer, which is nevertheless essential for the continuity of care, securing the drug circuit and patient care. This situation is aggravated by the conditions of practice set by the public health code for pharmacists practicing in PUI. Indeed, article R. 5126-2 reserves this exercise for holders of specific specialized study diplomas, while the existing exemption systems remain too narrow to respond to structural difficulties. encountered by small, isolated establishments. However, in many local hospitals, the pharmaceutical activities carried out present neither the same degree of technicality nor the same level of risk as in establishments supporting heavy activities, which questions the truly proportionate nature of a uniform application of the same requirements to all structures, regardless of their size, their activity and of their territorial environment. The solutions currently used are, in practice, not up to par. The use of replacements does not ensure lasting and satisfactory continuity. Pooling or inter-establishment cooperation, when it exists, in fact comes up against geographical distance, the persistent shortage of available professionals and organizational constraints which prevent often to fully meet the quality and safety requirements expected by the Regional Health Agencies (ARS). In this context and while a mission has recently been launched to examine developments concerning PUIs, he asks whether the Government intends to evolve the framework applicable to PUIs of local hospitals located in rural areas, in order to take into account the reality of their activities, their recruitment constraints and very concrete risks of disruption in healthcare provision.

Machine translation from French. The official text remains authoritative.

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