France

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Health systems in transition
France
2.5.4 Cross-border mobility of patients and health workers
France has entered into trans-border agreements for the use of hospital facilities
in the border regions of Belgium, Italy, Spain and Switzerland. France and
Belgium, which have the most extensive cross-border patient movements, have
implemented common protocols for emergency care as well as an agreement
established by four hospitals in neighbouring cities that allows patients from
both countries to receive care without preliminary authorization from either
health system. Wider patient mobility throughout the EU, the EEA and the rest
of the world is governed by European regulations and international agreements
(see section 2.9.6).
In terms of mobility of health workers, France is a net receiving country,
as emigration of French-trained professionals is low. French law distinguishes
professionals with European diplomas, who are entitled to the same rights as
French-trained professionals pursuant to European regulations, and those with
diplomas from outside the EU, who are subject to stricter standards. Doctors
with non-EU diplomas may be authorized to practise on a case-by-case basis,
while paramedical professionals trained outside of the EU must resume their
studies and obtain a French diploma (see section 4.2.2).
2.5.5 Health sector preparedness
Responsibility for the government’s response to exceptional health emergencies
(situations sanitaires exceptionnelles) falls largely under the Minister of
the Interior and the Ministry in charge of Health within the context of an
interministerial crisis unit (cellule interministérielle de crise). Four national
agencies have key roles: InVS, ANSM, ANSES and EPRUS (see section 2.3.4).
EPRUS, in particular, has a transverse role, falling under the shared oversight
of the General Directorate of Health and Health Emergencies Department
(Département des Urgences Sanitaires), with a director selected from the
prefectural corps attached to the Interior Ministry. EPRUS provides logistic
expertise and support in terms of materials, training and personnel, including
6000 voluntary reservists, mostly doctors and nurses.
At the regional level, health crisis preparation is undertaken pursuant to the
organization plan for the health system response to public health emergencies
(Organisation de la réponse du système de santé en situations sanitaires
exceptionnelles), which defines appropriate care pathways for various
emergency situations as well as coordination modalities among the actors,
including assignment and management of response measures and the training