France

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Health systems in transition
France
Several health and social services that are not under the remit of the
ARSs come under the jurisdiction of the General Council (see section 1.3).
These include:
• health and social care institutions and services for elderly and disabled
people (nonmedical facilities come under the authority of the general
councils, who supervise and finance them through social assistance
budgets, while facilities combining social and medical services come
under the joint supervision of the state and the general councils);
• social welfare and work programmes supporting individuals with low
incomes, elderly and disabled people in institutions and financing of
home assistance;
• protection of children, particularly through the management of PMI
centres, which offer consultations and free health care;
• prevention of certain diseases, such as tuberculosis, sexually transmitted
diseases and cancer; and
• public health and hygiene (environmental health, sanitation, etc.), in
conjunction with municipalities.
2.5 Planning
2.5.1 Capacity / capital planning
Health services are provided by office-based physicians and hospitals. Officebased
physicians are self-employed. Ownership of hospitals is divided among
government (public hospitals); non-profit-making organizations that are
linked to the public sector and tend to be owned by foundations, religious
organizations or mutual-insurance associations; and private profit-making
hospitals, ownership of which is increasingly concentrated in large international
groups. Responsibility for planning health system resources and capacity is
shared by the Ministry in charge of Health and the 26 ARSs. The goal of this
partial devolution of the planning function is to enable regional authorities to
meet the health needs of the population more appropriately.
Hospitals
Other corporate actors, such as the hospital federations (see section 2.3.6)
and public representatives, also participate in the planning process and may
play an important role during consultations. The regulatory framework for
hospitals applies equally to public, private non-profit-making and private
profit-making providers.