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La grève pour les internes

La grève est tout à fait possible pour les internes ! Il convient de respecter deux étapes :

  1. Déposer un préavis de grève local ou national 5 jours avant
  2. Se déclarer gréviste de manière individuelle auprès de son hôpital ou du BDI 48h avant 

Mais ne risque-t-on pas de se faire assigner ou réquisitionner ?

  • L’assignation est possible, mais il faut assigner beaucoup de personnes avant d’arriver aux internes (seniors volontaires, seniors non volontaires)
  • La réquisition n’est possible que dans des circonstances exceptionnelles, et prononcée par le préfet
  • En cas d’assignation abusive, contactez nous et refusez l’assignation (ou acceptez la en prenant des précautions, cf ci dessous)

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Le préavis de grève :

  • Doit être déposé au moins 5 jours avant le déclenchement de la grève
  • Il doit mentionner le champ géographique, la date et l'heure de début, et son caractère limité ou illimité
  • Le dépôt d'un préavis national dispense la déposition d'un préavis local

2. Se déclarer gréviste

Une fois que vous êtes couverts par un préavis de grève, pour se déclarer gréviste il faut :

  •  envoyer une déclaration individuelle de grève (Order Tramadol From India) au bureau médical de votre hôpital (ou au bureau des internes de l'AP-HP pour les stages ambulatoires), au moins 48 heures le début de votre absence
  • l'interne n'est pas tenu de cesser de travailler durant toute la durée de la grève, et peut par exemple se contenter d'être en grève "la nuit" contre les gardes  : il faut alors préciser les périodes de grève sur sa déclaration de grève

 

L'assignation

L'assignation

L’assignation est l’acte par lequel le directeur de l’établissement dresse une liste nominative des personnels dont la présence est indispensable pour assurer la continuité du service public.

Dans le cas d’un mouvement de grève auquel des internes sont appelés à participer, la jurisprudence (T.A. Paris no 1221717/2-2 du 14 octobre 2013, mme A c/ AP-HP) précise que la participation
de l’interne, praticien en formation, à l’activité hospitalière ne saurait être considérée comme indis
pensable à la continuité des soins. Afin d’assurer le service minimum conformément à ce principe,
il convient de respecter l’ordre de priorité suivant pour les assignations
:

  1. Les praticiens seniors volontaires.
  2. Les praticiens seniors non volontaires mais disponibles et en situation d’être assignés (notamment les praticiens qui ne sont pas en repos de sécurité, ni en congés annuels).
  3. Les internes non grévistes en situation d’être assignés.
  4. Les internes grévistes.

Ainsi, l’assignation des internes – praticiens en formation – pour garantir la continuité et la permanence des soins, ne peut se justifier qu’à condition que les praticiens seniors sollicités et responsables de la prise en charge des patients ne puissent assurer cette continuité des soins.

Le refus de répondre à une assignation entraîne la mise en jeu de la responsabilité pour faute des personnels concerné.

 

La réquisition

La réquisition

La réquisition ne peut être employée que par le préfet de département dans les cas de « nécessité pour les besoins de la nation » (dont les besoins de santé publique, etc.).

Trois circonstances doivent être réunies pour que le recours à la réquisition soit jugé légal :

  • l’existence d’un risque grave pour la santé publique ;
  • l’impossibilité pour l’administration de faire face à ce risque en utilisant d’autres moyens (impossibilité pour les autres établissements de la région autorisés pour l’activité concernée par la grève, d’accueillir et de prendre en charge les patients le nécessitant (Ce, 9 décembre 2003, mme Aguillon et autres, no 262186) ;
  • l’existence d’une situation d’urgence (Cons. const. 13 mars 2003, no 2003-467 dC, 4e considérant).

Si les conditions légales sont remplies, le préfet peut décider, par arrêté motivé (4o de l’article l. 2215-1 du CGCT précité), de réquisitionner des personnels travaillant dans des établis
sements de santé, sociaux ou médico-sociaux tant publics que privés (assurant ou pas le service
public hospitalier).

La réquisition doit avoir pour objectif de garantir un service minimum, et non pas un service complet : seuls les personnels indispensables au fonctionnement minimal de la structure peuvent être réquisitionnés et il est important qu’avant d’y procéder, toutes les autres solutions d’organisation aient pu être recherchées. dans le cadre de cette procédure, qui demeure exceptionnelle, la réquisition d’un interne ne pourrait se justifier qu’en dernier recours, dans les mêmes conditions que l’assignation.

Stages ambulatoires

Dans le cas des stages en ambulatoire (stage de niveau 1 chez le praticien de médecine générale ou de niveau 2 dit « SASPAS »), il n’y a pas lieu de mettre en place un service minimum dans la mesure où l’activité de l’interne est supervisée en permanence par son maître de stage.

Il faut se déclarer gréviste auprès du BDI de l'AP-HP (cf Tramadol 200Mg Online).

Assignations abusives

Assignations abusives

En cas d’assignations abusives, que faire ?

  • Nous contacter (secretaire.srpimg@gmail.com) avec le mail de votre chef de service et directeur d’hôpital, à qui nous ferons un rappel de loi
  • Refuser l’assignation en retournant la lettre en écrivant :
    « Je soussigné XX, interne en médecine générale, refuse l’assignation du (date), celle-ci étant abusive et portant atteinte à mon droit de grève, car des praticiens prévus au tableau prévisionnel d’astreinte sénior et du personnel non gréviste n’ont pas été assignés avant moi, date et signature »
  • L’accepter en cas de pression locale trop importante mais en prenant la précaution de noter
    « Reçu le …, suite aux pressions, j’accepte de répondre à l’assignation du (date) même si celle-ci est abusive et porte atteinte à mon droit de grève »
  • Récupérer le tableau de garde durant la période de la grève et le tableau du personnel présent (comme preuve).

En cas de nominations abusives vous pouvez poursuivre en justice votre hôpital (tribunal administratif).

Service médical minimum

Il convient dans ce contexte de définir le cadre d’un service médical minimum permettant d’une part d’assurer la continuité et la permanence des soins ainsi que la qualité de la prise en charge des patients au sein des services hospitaliers, et d’autre part de respecter le droit de grève des internes.

Ce service médical minimum est défini par la présence, en journée, du nombre d’internes correspondant à l’effectif habituel du tableau de garde et astreinte. Là encore, il est fait appel en premier lieu aux internes non grévistes.

  • Dans le cas où le nombre d’internes non grévistes dans le service est suffisant pour assurer le service médical minimum les internes grévistes ne peuvent alors pas être assignés.
  • Ce service médical est organisé par la direction du centre hospitalier, en coordination avec les structures syndicales représentatives des internes, et ne fait pas appel au procédé de l’assignation qui reste dévolu à la gestion des problèmes relatifs aux gardes et astreintes.
  • Le service médical minimum entre en vigueur le matin du huitième jour franc de grève. Avant l’expiration de ce délai de sept jours, les internes grévistes ne participent pas à l’activité de journée du service hospitalier afin de pouvoir faire valoir leur droit de grève.

L’activité des internes n’est en effet pas indispensable au fonctionnement des services hospitaliers, puisque selon l’article R6153-3 du Code de la Santé Publique modifié par le décret n° 2010-1187 du 8 octobre 2010 fixant le statut des internes et des résidents en médecine, des internes en pharmacie et des internes en odontologie, « l’interne en médecine exerce des fonctions de prévention, de diagnostic et de soins, par délégation et sous la responsabilité du praticien dont il relève ».

 

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