

{"id":39237,"date":"2019-02-01T15:54:07","date_gmt":"2019-02-01T14:54:07","guid":{"rendered":"https:\/\/gestions-hospitalieres.fr\/?p=39237"},"modified":"2019-02-20T17:05:10","modified_gmt":"2019-02-20T16:05:10","slug":"les-ordonnances-de-58","status":"publish","type":"post","link":"https:\/\/www.ricom-web8.com\/gestions\/les-ordonnances-de-58\/","title":{"rendered":"Les ordonnances de 58"},"content":{"rendered":"<span class=\"span-reading-time rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">Temps de lecture\u00a0: <\/span> <span class=\"rt-time\"> 2<\/span> <span class=\"rt-label rt-postfix\">minutes<\/span><\/span><p><strong>Didier Tabuteau<\/strong>, pr\u00e9sident de la section sociale du Conseil d\u2019\u00c9tat et professeur associ\u00e9 \u00e0 l\u2019universit\u00e9 Paris Descartes, est revenu sur l\u2019origine et l\u2019\u00e9laboration des ordonnances de 1958.<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/pAjAFulFhr4\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>Ces ordonnances viennent apr\u00e8s une s\u00e9rie de lois\u2009: celle du 7 ao\u00fbt 1851 sur les hospices et h\u00f4pitaux, celle du 15 juillet 1893 sur l\u2019assistance m\u00e9dicale gratuite\u2026<\/p>\n<p>L\u2019id\u00e9e que l\u2019h\u00f4pital doit s\u2019ouvrir \u00e0 tous, et pas uniquement aux pauvres, se d\u00e9veloppe dans les ann\u00e9es 1930. D\u00e8s 1939, un d\u00e9cret-loi relatif aux h\u00f4pitaux et hospices pr\u00e9voit une extension des personnes accueillies dans les h\u00f4pitaux.<\/p>\n<p>Robert Debr\u00e9 est charg\u00e9 en 1943-1944 par le comit\u00e9 m\u00e9dical de la R\u00e9sistance et le Comit\u00e9 national des m\u00e9decins fran\u00e7ais d\u2019\u00e9laborer un rapport sur l\u2019organisation de la profession m\u00e9dicale et la r\u00e9forme de l\u2019enseignement de la m\u00e9decine. Ce rapport, tr\u00e8s critique, pr\u00e9conisait notamment l\u2019acc\u00e8s \u00e0 l\u2019h\u00f4pital pour tous et pr\u00e9cisait que le corps enseignant devait \u00eatre d\u00e9di\u00e9 aux t\u00e2ches universitaires et hospitali\u00e8res. L\u2019objectif de Robert Debr\u00e9 \u00e9tait de sortir des salles communes, de l\u2019h\u00f4pital des pauvres et de construire l\u2019h\u00f4pital moderne.<\/p>\n<p>En 1955, Pierre Mend\u00e8s France r\u00e9unit de jeunes m\u00e9decins autour de Jean Dausset pour r\u00e9fl\u00e9chir sur une nouvelle organisation de la sant\u00e9\u2009: les th\u00e8ses pr\u00e9sent\u00e9es sont tr\u00e8s proches de celles d\u00e9fendues par Robert Debr\u00e9 en 1944. La construction du projet se fait autour d\u2019une alliance m\u00e9dico-administrative, avec la cr\u00e9ation en 1956 d\u2019un comit\u00e9 interminist\u00e9riel d\u2019\u00e9tude des probl\u00e8mes de l\u2019enseignement m\u00e9dical, de la structure hospitali\u00e8re et de l\u2019action sanitaire et sociale, avec \u00e0 sa t\u00eate Robert Debr\u00e9. De premiers projets de loi sont pr\u00e9sent\u00e9s en 1957 et 1958, ce qui permet d\u2019avoir, fin 1958, lorsque la V<sup>e<\/sup>\u00a0R\u00e9publique se met en place, des textes \u00e0 maturit\u00e9.<\/p>\n<p>C\u2019est dans ce contexte que l\u2019ordonnance du 11 d\u00e9cembre 1958 est prise. Celle-ci proclame que les h\u00f4pitaux sont ouverts \u00e0 tous et pr\u00e9voit que le statut g\u00e9n\u00e9ral du personnel des h\u00f4pitaux n\u2019est pas applicable aux m\u00e9decins. Elle annonce donc l\u2019ordonnance du 30 d\u00e9cembre 1958. Cette derni\u00e8re cr\u00e9e non seulement les CHU et la m\u00e9decine hospitalo-universitaire, mais aussi le service public hospitalier lui-m\u00eame.<\/p>\n<p>Une cons\u00e9quence fondamentale de ces ordonnances est la cr\u00e9ation du temps plein hospitalier. Le contexte international \u00e9tait porteur et, d\u00e8s 1953, l\u2019Assistance publique-H\u00f4pitaux de Paris avait exp\u00e9riment\u00e9 le temps plein m\u00e9dical. Cette cr\u00e9ation a toutefois d\u00fb faire face \u00e0 une forte opposition, les critiques portant tout aussi bien sur une fonctionnarisation de la m\u00e9decine que sur le co\u00fbt de la r\u00e9forme.<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n<p>Didier Tabuteau a conclu en notant qu\u2019au-del\u00e0 de cette r\u00e9forme elle-m\u00eame, de nombreux changements sont apport\u00e9s par les ordonnances de 1958\u00a0:<\/p>\n<ul>\n<li>l\u2019av\u00e8nement d\u2019un principe d\u2019\u00e9galit\u00e9 devant la protection de la sant\u00e9\u2009;<\/li>\n<li>la pr\u00e9\u00e9minence de la sp\u00e9cialit\u00e9 technique hospitali\u00e8re. Les ordonnances r\u00e9introduisaient la science au sein de l\u2019organisation m\u00e9dicale et hospitali\u00e8re\u2009; mais Jean Dausset et Robert Debr\u00e9 ont pu regretter que cette pr\u00e9\u00e9minence se fasse au d\u00e9triment de la pr\u00e9vention et de la m\u00e9decine g\u00e9n\u00e9rale\u2009;<\/li>\n<li>l\u2019\u00e9mergence des droits des malades. Le<i> Journal officiel<\/i> du 12 d\u00e9cembre 1958 publie \u00e0 la fois l\u2019ordonnance du 11\u00a0d\u00e9cembre 1958 relative aux h\u00f4pitaux et hospices publics et une circulaire du 5 d\u00e9cembre 1958 relative \u00e0 l\u2019humanisation des h\u00f4pitaux, circulaire promulgu\u00e9e dans le cadre des ordonnances de 1958.<\/li>\n<\/ul>\n<script>function PlayerjsAsync(){} if(window[\"Playerjs\"]){PlayerjsAsync();}<\/script>","protected":false},"excerpt":{"rendered":"<p><span class=\"span-reading-time rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">Temps de lecture\u00a0: <\/span> <span class=\"rt-time\"> 2<\/span> <span class=\"rt-label rt-postfix\">minutes<\/span><\/span>Didier Tabuteau, pr\u00e9sident de la section sociale du Conseil d\u2019\u00c9tat et professeur associ\u00e9 \u00e0 l\u2019universit\u00e9 Paris Descartes, est revenu sur l\u2019origine et l\u2019\u00e9laboration des ordonnances de 1958. Ces ordonnances viennent apr\u00e8s une s\u00e9rie de lois\u2009: celle du 7 ao\u00fbt 1851 sur les hospices et h\u00f4pitaux, celle du 15 juillet 1893 sur l\u2019assistance m\u00e9dicale gratuite\u2026 L\u2019id\u00e9e que l\u2019h\u00f4pital doit s\u2019ouvrir \u00e0 tous, et pas uniquement aux pauvres, se d\u00e9veloppe dans les&hellip; <\/p>\n","protected":false},"author":23133,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[6793,2],"tags":[7053,5135,43,6626,7143,7144,2326,1872,5198],"class_list":["post-39237","post","type-post","status-publish","format-standard","hentry","category-compte-rendu","category-gestions-hospitalieres","tag-7053","tag-assises","tag-chu","tag-etudes-medicales","tag-genomique","tag-innovations-medicales","tag-intelligence-artificielle","tag-numerique","tag-poitiers"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.8.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Les ordonnances de 58 - Gestions hospitali\u00e8res<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ricom-web8.com\/gestions\/les-ordonnances-de-58\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Les ordonnances de 58 - Gestions hospitali\u00e8res\" \/>\n<meta property=\"og:description\" content=\"Temps de lecture\u00a0:  2 minutesDidier Tabuteau, pr\u00e9sident de la section sociale du Conseil d\u2019\u00c9tat et professeur associ\u00e9 \u00e0 l\u2019universit\u00e9 Paris Descartes, est revenu sur l\u2019origine et l\u2019\u00e9laboration des ordonnances de 1958. Ces ordonnances viennent apr\u00e8s une s\u00e9rie de lois\u2009: celle du 7 ao\u00fbt 1851 sur les hospices et h\u00f4pitaux, celle du 15 juillet 1893 sur l\u2019assistance m\u00e9dicale gratuite\u2026 L\u2019id\u00e9e que l\u2019h\u00f4pital doit s\u2019ouvrir \u00e0 tous, et pas uniquement aux pauvres, se d\u00e9veloppe dans les&hellip;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ricom-web8.com\/gestions\/les-ordonnances-de-58\/\" \/>\n<meta property=\"og:site_name\" content=\"Gestions hospitali\u00e8res\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/gestionshospitalieres\/\" \/>\n<meta property=\"article:published_time\" content=\"2019-02-01T14:54:07+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2019-02-20T16:05:10+00:00\" \/>\n<meta name=\"author\" content=\"Gestions hospitali\u00e8res\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@revue_GH\" \/>\n<meta name=\"twitter:site\" content=\"@revue_GH\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"Gestions hospitali\u00e8res\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.ricom-web8.com\/gestions\/les-ordonnances-de-58\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.ricom-web8.com\/gestions\/les-ordonnances-de-58\/\"},\"author\":{\"name\":\"Gestions hospitali\u00e8res\",\"@id\":\"https:\/\/www.ricom-web8.com\/gestions\/#\/schema\/person\/3ba9fe913190dfe9507feb621e902c1f\"},\"headline\":\"Les ordonnances de 58\",\"datePublished\":\"2019-02-01T14:54:07+00:00\",\"dateModified\":\"2019-02-20T16:05:10+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.ricom-web8.com\/gestions\/les-ordonnances-de-58\/\"},\"wordCount\":620,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/www.ricom-web8.com\/gestions\/#organization\"},\"keywords\":[\"2018\",\"Assises\",\"CHU\",\"\u00e9tudes m\u00e9dicales\",\"g\u00e9nomique\",\"innovations m\u00e9dicales\",\"intelligence artificielle\",\"num\u00e9rique\",\"Poitiers\"],\"articleSection\":[\"compte-rendu\",\"Gestions Hospitali\u00e8res\"],\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/www.ricom-web8.com\/gestions\/les-ordonnances-de-58\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.ricom-web8.com\/gestions\/les-ordonnances-de-58\/\",\"url\":\"https:\/\/www.ricom-web8.com\/gestions\/les-ordonnances-de-58\/\",\"name\":\"Les ordonnances de 58 - 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