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The law on hospital reform and related to patients, healthcare and territories was enacted on 21 July 2009. Minimal modifications of the Constitutional Council have closed one of the longest debates in the history of the 5th Republic. We will not consider here the infighting that opposed some health professionals nor the efforts of other professionals to accomplish so remarkable a recognition of their mission as primary care providers.

It is the battles that we should forget and policymakers must now take advantage of the achievements of this text effectively to rebuild the health system.

We must retain from this law four cardinal virtues - the clear redefinition of responsibilities and tasks of each partner: in a system where access to care and continuity of care are increasingly precarious, the "job description" for each occupation is a life saver.

It will, in the future, consolidate and prioritize the skills to manage transfers and identify complementary areas, to make care more efficient - the definition of the level of care utilization: Procrastination and corporatism now have boundaries.

Citadels can be conquered and territories that had been claimed are now potentially redistributable. We can be assured that there is work ahead to refine the concept, open without bias to all operators (public and private), but it has a promising future - the breakdown of borders: to take the right steps, the liberal world can find a place in a hospital environment, that has become more transparent in its decisions and modes of operation. The fiefdoms are no longer appropriate. Alternative projects and new forms of support have found a place and recognition.

The artificial split between health and social care has ended.

The patient and the user will find that there are benefits to be seen from one end to the other of the system as a single individual rather than through successive statutes "user", then "patient," then "dependent", in perfect continuity with the Law of 4 March 2002 that changes a poorly adapted citizen to a participatory and responsible actor - the contract between the parties: a clear and transparent mode of operation, based on the analysis of a need, the recognition of the expertise of an actor and the combination of complementary offers.

Finally, it is possible to think outside the structures, outside "silos" (hospital, Liberal, private, public, care, social and health care, ...), to undertake and project, thinking "provides care and services" and to integrate complementarities and talents. We will stop here so that the positive list is not misrepresented to be an idealist rather simple. But the list of negatives already speaks volumes of those who believe in health. No pessimism intended here. And if there are areas for improvement, it would indeed be remarkable: the health system now debuts with an entrepreneurial approach.

Hopefully the actors, especially the professionals, seize this opportunity and become, beyond their professional expertise, entrepreneurs and solution providers of health services!

Download French PDF - Translations available on request.