Case 315768

Mr. Patrick A requested the annulment of the decision of 8 February 2008 by which the National Council of the Order of Doctors declined to authorize him as a certified specialist in the field of plastic and reconstructive surgery. Mr. A had been practicing baldness surgery for 28 years as a general practitioner, and had numerous testimonials attesting to his skills. He was also a published author in the field of baldness surgery. Critically, however, he could not provide any evidence of medical training in the field, whether through undertaking relevant courses or practical experiences in teaching hospitals.

Article 1 of the decree of 19 March 2004 relating to the conditions in which doctors can obtain qualifications to specialize specified that doctors would be considered qualified when they possessed either a diploma of specialized study or a diploma of complementary specialized study. If a doctor possessed neither, their experience and training would be considered. Under Article 3 of the decree, in the absence of formal qualifications, a doctor must establish that he or she has undertaken relevant training or possessed experience that demonstrates a competence equivalent to that certified by obtaining a diploma of study.

The Court held that the Council was right in withholding its authorization. Mr. A did not meet the qualifications as clearly set forth by the Council. According to article 1110-1 of the public health code, the fundamental right to the protection of health must be protected by every means possible to the benefit of everyone.  Professionals, healthcare services and centers, health insurance organizations and all other organizations participating in the health care sector contribute to the provision of equal access to healthcare, and must work towards assuring the continuity of care and the best sanitation possible. The refusal to recognize the qualifications put forward by Mr. A would not impede him from practicing medicine and did not violate the principles established in the aforementioned article.  Thus the refusal was not contrary to the interest of his patients.

“The French Supreme administrative Court, according to article L.1110-1 of the Code of Public health stating that “The fundamental right to health has to be put into practice by every means available to the benefit of anyone. […] The professionals contribute, together with users, to developing the prevention, the equal access to sanitary care according to everyone’s health condition, the continuity of health care, the best sanitary safety as possible”, considers that the refusal to grant the claimant the required qualification will not prevent him from exerting medicine nor from applying the mandatory ethic principles of medicine; considers that the plaintiff cannot pretend that this refusal would endanger patients’ interest nor would harm his subjective rights.”

« Considérant qu'aux termes de l'article L. 1110-1 du code la santé publique : Le droit fondamental à la protection de la santé doit être mis en oeuvre par tous moyens disponibles au bénéfice de toute personne. Les professionnels, les établissements et réseaux de santé, les organismes d'assurance maladie ou tous autres organismes participant à la prévention et aux soins, et les autorités sanitaires contribuent, avec les usagers, à développer la prévention, garantir l'égal accès de chaque personne aux soins nécessités par son état de santé et assurer la continuité des soins et la meilleure sécurité sanitaire possible ; que le refus de reconnaître la qualification sollicitée, s'il fait obstacle à ce que M. A puisse s'en prévaloir, avec les effets qui sont attachés à cette décision, ne saurait avoir pour conséquence ni d'empêcher M. A d'exercer la médecine, ni de méconnaître les principes posés à l'article précité ; que M. A ne peut pas davantage faire valoir utilement que ce refus serait contraire à l'intérêt des patients, tel qu'il résulte de ces dispositions, ni qu'il porterait atteinte à l'existence de droits qu'il estime acquis à raison de son expérience ; »