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“Rethinking the health system more democratically as possible in order to confront the crises of the Twenty-first century “

The caregivers of the intensive care unit at the clinique de l'estrée, to Healthy (Seine-Saint-Denis), 20 April 2020.

Forum. The reform failed pensions has highlighted the importance of debate before any change in systemic affecting our social model. As the national Council of Resistance (CNR) was made in 1943 about the social Security, a broad consensus of citizens about the pressing and urgent reform of our health care system is essential.

It is the ambition of the Institute for Health, a citizen’s initiative, non-political and independent, created in 2018, that aims to rethink the health system more democratically as possible in order to deal with a crisis of the XXIe century. Here are a few principles that have emerged from this collective reflection.

Rather than a model of health, focusing on the supply of health care, the new model should be focussed on the health needs of the population and of individuals. To allow this, the geographical unit of the steering will become the territory of health, gathers 120 000 to 150 000 people, including some living areas. It will then be necessary that the territory is a substitute to all other perimeter health have multiplied in recent years – groups of hospital territories, business communities and territorial health, public Assistance-Hospitals of Paris, etc –, thus leading to administrative simplification. It this will then become the scope of activity of all health professionals, whose missions integrate a territorial responsibility in health.

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This evolution induces and justifies a revision of the ordinances Debré in 1958 – which have created the university hospital centres and focused the organization of health care around the hospital. The ” Debré 2 “, the goal is to open the walls of the hospital, to terminate the full-time hospital systematic and accelerate the extension of the teaching and research outside of the hospital. It will then be able to break down the barriers-health will be organized only according to the city, the hospital and the medico-social, but according to the territory and the health needs of the people who live there.

Democracy, health and social

This approach can be done in the respect for the free choice of the articles of association employees, liberals, or combination of professional statutes which will be, if necessary, adapted legally to this territorial reality. Regardless of the status in question, new horizon territorial will need to be accompanied a greater diversification of the professional careers of all the caregivers. A powerful lever to find the attractiveness in all the health professions.

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