Chapter VI: Internal organisation.

Under conditions laid down by regulation, the director of a public health establishment may, on a proposal from the head of the department, after obtaining the opinion of the chairman of the establishment's medical commission, admit doctors, midwives and odontologists practising on a freelance basis, other than statutory practitioners practising within the framework of the provisions of article L. 6154-1, and doctors, midwives and odontologists practising on a voluntary basis to take part in carrying out the tasks mentioned in articles L. 6111-1 and L. 6112-1. Self-employed medical auxiliaries may also participate in the establishment's activities when care is provided in the homes of patients who are users of the public establishment concerned. The fees of these healthcare professionals are paid by the public health establishment, which may apply special conditions of remuneration, other than payment on a fee-for-service basis, for self-employed medical auxiliaries involved in home hospitalisation. By way of exception to the provisions of article L. 162-2 of the Social Security Code, the public health institution pays the fees concerned at the rates provided for in 1° of I of article L. 162-14-1 of the same code, less, where applicable, a fee.

The healthcare professionals mentioned in the first paragraph participate in the institution's tasks under a contract signed with the healthcare institution, which sets out the terms and conditions of their participation and ensures compliance with the guarantees mentioned in article L. 6112-3 of this code. These contracts, with the exception of those concluded with doctors, midwives and odontologists practising on a voluntary basis, are approved by the Director General of the Regional Health Agency. Contracts concluded with doctors, midwives and odontologists practising on a voluntary basis do not replace permanent posts left vacant.

Self-employed doctors, midwives and odontologists admitted, under the conditions provided for in the first two paragraphs of this article, to take part in carrying out the tasks of the local hospitals mentioned in article L. 6111-3-1 may be compensated for this in accordance with the procedures provided for by regulation. This compensation is in addition to the fees mentioned in the first paragraph of this article.