[Developing a national health policy: a realistic ambition]

The current national health policy in France is almost impossible to pin down and define, spread as it is across thirty or so schemes and a hundred or so targets set by a law adopted in 2004. Yet the current legislation defines the national health policy as a standard reference for public policies developed and implemented by the Ministry of Health and associated bodies. In addition, the current policy involves little consultation and is not systematically monitored and evaluated. Developing an interdepartmental health policy combining several intervention strategies and using different regulation tools may seem like an impossible task. It may also seem somewhat imprudent when it claims to define priorities and strategies. In order to overcome these difficulties and inherent contradictions, we need to develop a policy based on three key elements (a strategy, plans and policies, and policy decentralization and devolution). However, it is not enough to merely develop a framework; it is also important to define the steering and oversight plan, the consultation process and a monitoring and evaluation system. The foundations of a policy based on these principles have already been laid. The authorities simply need to continue along the lines of recent policy developments, including the creation of regional agencies (ARS), the creation of a national steering committee, and the various public health plans developed over the last 20 years.