Control of hospitals and nursing homes in France: The 2016 reform may indirectly improve a dysfunctional system

Abstract

In France, the supervisory bodies require hospitals and nursing homes to undergo various control procedures. A stack of legislation and control measures has piled up, with no provision for their interconnection being included in any of the legislation. The purpose of the article is to point to the prospects for better control opened up by the legislation modernising the health system adopted on 26 January 2016. The reform will neither directly change the partitioning between the supervisory bodies preventing the sharing of information and the harmonisation of the practices in terms of control, nor change the internal partitioning within the supervisory body. But in hospitals, the reform will improve the interconnection of control of quality/control inspections/control of strategy using a common medical project and pooling certain cross-cutting functions, and implementing the control of quality for the new local hospital groupings as a whole. In nursing homes, the generalisation of multi-year aims and means contracts would allow a better interconnection of the control of strategy and the control of quality since it provides managers with the means of constructing projects for the evolution of their establishments over a period of time, and accompanies changes in the socio-medical offer to improve the provision of care. These changes would allow a more credible, coherent, useful, and equitable control.