Question 43792 — health professions

Summary

Mr. Philippe Latombe questions the Minister of Solidarity and Health on the cancellation of the decrees of the exclusive IBODE acts by the Council of State. Nearly four and a half years after the granting of exclusivity for the performance of certain acts by operating theater nurses (IBODE), the Council of State has just canceled in a decision of December 30, 2021, the successive texts organizing this system. Canceled on the grounds of “excess of power”, these decrees concerned various measures relating to acts of operating theater FDI, as well as the withdrawal of registration of CPD organizations or structures in the health professions. The referral was made in parallel by the FMF and the SML, as well as by the FHP-MCO, the UCDF and the Bloc. This decision also orders the Prime Minister “to adopt transitional measures to ensure the proper functioning of the surgical services until the number of holders of the state operating theater nurse diploma is sufficient and, at the very least, until December 31, 2025.” The Council of State also underlines the inadequacy of the transitional system which had been put in place and which did not make it possible to prevent the risk of undermining the proper functioning of operating theaters and the conditions of practice in operating theaters of IDEs, nor to protect professionals from legal risk. It therefore cancels the transitional measures in force and asks the Government to rewrite them within 4 months to ensure legal security for the exercise of IDEs and continuity of care in the operating room. The transitional measures were to allow the training by employers since 2015, the date of entry into force of the exclusive acts, of a large number of IBODEs favoring the full and complete application of procedures, in order to optimize the safety and quality of care for patients in the operating room. However, neither the FHP nor the private surgeons who are members of the UCDF have kept their commitments, as the Council of State recalls in its opinion. On the contrary, their objective seemed rather to have the decree repealed under the pretext of the lack of IBODE in the operating theaters, this savings strategy allowing to use non-IBODE qualified nursing staff, therefore at lower cost, and to imprison them in a professional status with no possibility of advancement. For its part, the Inter Blocs Collective proposes to establish work-study diploma training for operating theater IDEs as part of transitional measures. Its objective would not be to replace the traditional training already in place but to facilitate access to training in IBODE specialization for FDI eligible for MT, without putting employers in difficulty. This proposal responds to the injunction made to the Prime Minister by the Council of State and would fall within the framework of continuing training with the possibility of using the personal training account (CPF) (in accordance with the law of September 5, 2018 for the freedom to choose one's professional future). It is adapted to FDI depending on their experience in the operating room and personalized so that they can all ultimately benefit from comprehensive training covering at least the basic surgeries detailed in this proposal. The internships would be carried out in private or public structures. In a context where health policy over the last thirty years has been strongly criticized for having favored a strictly accounting approach to health in detriment to the interests of patients, he wishes to know how the Government plans to comply with the opinion of the Council of State.

Machine translation from French. The official text remains authoritative.

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