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Private-public partnership: The challenges of a necessary restructuring Volume 95, issue 1, Janvier 2019

Author
Nightingale Hospitals Paris
11bis rue de la Porte Jaune
92380 Garches, France
* Correspondance

The French healthcare system and the mechanisms for meeting its costs—social security and complementary health insurers – have always left a place open for the private sector. Just like private healthcare providers, the public health service aims to respond to the health needs of the population. It cannot do so without establishing the necessary cooperation on a national scale.

In France in particular, the coexistence of public, private for-profit, and private not-for-profit sectors has to date not been accompanied by development of the kind of efficient cooperation that would enable an implementation of the healthcare paths prescribed by recent laws. Different logics, the result of distinct statutes, licensing regimes, and regulatory measures, have instead encouraged competition between public and private hospital sectors. It is illusory and surely counterproductive to plead for a public monopoly. Thus, the establishing of GHTs (Groupements Hospitaliers de Territoire, regional hospital consortia) has often served as an obstacle to the development of healthcare cooperation between public and private, worsening the isolation and compartmentalization of the actors concerned.

Rather than a virtuous cooperation that would benefit the healthcare path of patients, the real “systematic” tendency in a country where the private sector is often dominant as far as numbers of hospital beds is concerned, is that today, the public hospital sector seems set to undergo a forced adaptation, reduced to receiving those patients the private sector does not want.

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