[Regulation for contractual practice]

The use of contractualisation has greatly developed over the last years in the field of health care, with results that are often promising, but also with failures and sometime virulent criticism. Thus it has become more and more necessary to regulate contractual practices. In the framework of its mission of general administration, that is to say, protection of the general interest, it falls to the Ministry of Health to put in place this regulation. Several tools are available. Certain, such as standard contracts and master agreements, although useful, do not remain specific and ad hoc. On the other hand, the politics of contractualisation, fitting well in the general politics of Health Care, form, without doubt, the most globalised tool, since they allow contractualisation to be replaced in the management of the total health case system, and thus to be seen as a potential contribution in the framework of performance improvement. The conditions for success are not, however, automatically united. One must ensure that the mechanisms exist which bring about regulatory tools, and which ensure that the participants use correctly the framework defined by the Ministry of Health.