Question 15601 — hospital public service

Summary

Mr. Jérôme End draws the attention of the Minister of Health, Families, Autonomy and Persons with Disabilities to the compensation and statutory situation of directors of health, social and medico-social establishments (D3S) as part of the reform of the senior civil service initiated since Ordinance No. 2021-702 of June 2, 2021. The reform of the senior civil service initiated in 2023 led to starting January 1 2026, to a significant revaluation of the careers of hospital directors. The body of directors of health, social and medico-social establishments (D3S) remains to this day excluded from this revaluation, which gives rise to a profound incomprehension with regard to the missions entrusted to them in the service of the general interest. The National Management Center has also recognized that the responsibilities they exercise were comparable to those of hospital directors. Directors of health, social and medico-social establishments manage local hospitals, establishments for dependent elderly people and structures relating to disability or child protection. They manage large budgets, lead complex organizational transformations, ensure social dialogue and concretely implement public policies across the entire territory, as close as possible to the most vulnerable populations. At a time when issues linked to aging, mental health, inclusion and social cohesion occupy a central place in public debate and parliamentary work, it seems essential that the executives who carry out these policies, often in small structures and with resources constrained, benefit from recognition commensurate with their responsibilities. This is, beyond a statutory situation, an issue of fairness, coherence, but also attractiveness, the number of active members in the D3S corps decreasing from year to year and the share of those choosing to detach themselves to the DH corps continually progressing. He asks her what measures she plans to take to integrate the directors of health, social and medico-social establishments in the implementation of the reform of the senior civil service and to guarantee statutory and compensation equity between their body and that of hospital directors.

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