{"texte":{"uid":"PIONANR5L16B0813","legislature":16,"titre":"relative à l'instauration d'un nombre minimum de soignants par patient hospitalisé","titreLong":"proposition de loi relative à l’instauration d’un nombre minimum de soignants par patient hospitalisé","dateDepot":"2023-02-01","dossierRef":"DLR5L16N46650","auteurs":[],"cosignataires":[],"cosignatairesCount":0,"type":"Proposition de loi","anUrl":"https://www.assemblee-nationale.fr/16/propositions/pion0813.asp","dispositions":{"exposeMotifs":null,"articles":[{"num":"unique","extrait":"I. – Après le 4° de l’article L. 161-37 du code de la sécurité sociale, il est inséré un 4° bis ainsi rédigé : « 4° bis Établir, pour chaque spécialité et type d’activité de soin hospitalier et en tenant compte de la charge de soins associée, un ratio minimal de soignants, par lit ouvert ou par nombre de passages pour les activités ambulatoires, de nature à garantir la qualité et la sécurité des soins ; ». Ibis (nouveau). – Le chapitre IV du titre II du livre I er de la sixième partie du code de la santé publique est complété par des articles L. 6124-2 à L. 6124-5 ainsi rédigés : « Art. L. 6124-2. – Pour des raisons de sécurité, certaines activités de soins peuvent être soumises à des conditions de fonctionnement particulières requises pour l’accueil de patients. Celles-ci sont fixées par décret pour une période maximale de cinq ans. « Art. L. 6124-3. – En vue de garantir la qualité des soins et des conditions d’exercice, il est défini, pour chaque spécialité et type d’activité de soin hospitalier, un ratio minimal de soignants par lit ouvert ou par nombre de passages pour les activités ambulatoires. « Le ratio prévu au premier alinéa est établi par décret, pris après l’avis de la Haute Autorité de santé, pour une période maximale de cinq ans. Il tient compte de la charge de soins liée à l’activit é et peut distinguer les besoins spécifiques à la spécialisation et à la taille de l’établissement. « Art. L. 6124-4. – Dans les établissements assurant le service public hospitalier au sens du chapitre II du présent titre, l’organisation des soins propre aux services de l’établissement au regard de s ratios définis en application de l’article L. 6124-3 est soumise pour approbation aux commissions médicales et chargées des soins infirmiers, de rééducation et médico-techniques. « Art. L. 6124-5. – Dans les établissements assurant le service public hospitalier au sens du chapitre II du présent titre, lorsqu’il est constaté pour une unité de soins que les ratios définis à l’article L. 6124-2 ne peuvent être respectés pendant une durée supérieure à trois jours, le chef d’établissement en informe le directeur général de l’agence régiona le de santé territorialement compétent. » II et III. – (Supprimés) IV (nouveau). – A. – Le I entre en vigueur à une date fixée par décret, et au plus tard le 31 décembre 2024. B. – Le Ibis entre en vigueur le 1 er janvier 2027.","resume":"Établit des ratios minimaux de soignants par lit ou passage pour garantir la qualité et la sécurité des soins."}],"pdfUrl":"https://www.assemblee-nationale.fr/dyn/16/textes/l16b0813_proposition-loi.pdf","pdfPages":null},"dispositionsVersion":6,"provenance":"senat","provenanceFormule":", adoptée par le Sénat, relative à l’instauration d’un nombre minimum de soignants par patient hospitalisé"},"stade":{"cle":"intermediaire","etiquette":"Lecture intermédiaire","phrase":"Ce dossier est devenu la loi, promulguée le 29 janvier 2025, mais ce texte n'en est qu'une étape : la loi peut en différer.","garde":"Ce résumé décrit cette étape du texte. La loi promulguée peut en différer.","final":"PIONANR5L17TAP0027"},"linkedScrutins":[{"id":"VTANR5L17V600","titre":"l'ensemble de la proposition de loi, adoptée par le Sénat, relative à l'instauration d'un nombre minimum de soignants par patient hospitalisé (première lecture).","date":"2025-01-23","sortCode":"adopté","pour":138,"contre":3,"abstention":70}],"hasEnjeu":true,"hasDisp":true,"hasVotes":true,"hasOu":true,"themeLabels":{"sante-systeme":"Système de santé (hôpital, accès aux soins, assurance maladie)"},"themesTexte":["sante-systeme"],"nAmdtDeposes":45,"amdtIdx":{"dossierRef":"DLR5L16N46650","leg":17,"counts":{"total":45,"Irrecevable 40":3,"Rejeté":29,"Irrecevable":8,"Retiré":5},"stades":{"commission":19,"seance":26},"organes":[{"prefixe":"AN","label":"Séance publique"},{"prefixe":"CION-SOC","label":"Commission des affaires sociales"}],"textes":[{"ref":"PIONANR5L17BTC0697","n":26},{"ref":"PIONANR5L17B0104","n":19}],"byGroupe":[{"groupeId":"EPR","code":"EPR","couleur":"#7B4591","n":27,"adoptes":0},{"groupeId":"RN","code":"RN","couleur":"#313567","n":14,"adoptes":0},{"groupeId":"DR","code":"DR","couleur":"#8CB0DC","n":3,"adoptes":0},{"groupeId":"GDR","code":"GDR","couleur":"#830E21","n":1,"adoptes":0}],"divisions":[{"key":"art-unique","label":"ART. UNIQUE","n":35,"adoptes":0},{"key":"apres-art-unique","label":"APRÈS ART. UNIQUE","n":10,"adoptes":0}]},"amdtDivisions":{"art-unique":[{"u":"AMANR5L17PO838901BTC0697P0D1N000001","n":"1","no":"1","ex":"AN","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"M. Serge Muller","gc":"RN","gk":"#313567","t":"À l’alinéa 2, après le mot :\n« soignants »,\ninsérer les mots :\n« déterminé sur la base des données scientifiques validées par la…"},{"u":"AMANR5L17PO420120B0104P0D1N000002","n":"AS2","no":"2","ex":"CION-SOC","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"M. Matthieu Marchio","gc":"RN","gk":"#313567","t":"Après l’alinéa 8, insérer l’alinéa suivant :\n« Art. L. 6124-6. - Afin de répondre aux besoins des ratios définis au présent…"},{"u":"AMANR5L17PO838901BTC0697P0D1N000002","n":"2","no":"2","ex":"AN","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"Mme Christine Loir","gc":"RN","gk":"#313567","t":"À la seconde phrase de l’alinéa 6, après le mot :\n« activité »,\ninsérer les mots :\n« au surcroît d’activité, notamment lors de…"},{"u":"AMANR5L17PO420120B0104P0D1N000003","n":"AS3","no":"3","ex":"CION-SOC","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"M. Matthieu Marchio","gc":"RN","gk":"#313567","t":"Compléter cet article par l’alinéa suivant :\n« C. - Avant la mise en application des ratios mentionnés au chapitre IV du titre II…"},{"u":"AMANR5L17PO420120B0104P0D1N000004","n":"AS4","no":"4","ex":"CION-SOC","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591","t":"I. - Après la première occurrence du mot :\n« et »,\nrédiger ainsi la fin de l’alinéa 2 :\n« pour les activités aiguës de courte…"},{"u":"AMANR5L17PO420120B0104P0D1N000005","n":"AS5","no":"5","ex":"CION-SOC","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591","t":"À l’alinéa 10, substituer à l’année :\n« 2024 »\nl’année :\n« 2025 »."},{"u":"AMANR5L17PO838901BTC0697P0D1N000005","n":"5","no":"5","ex":"AN","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591","t":"I. - Supprimer les alinéas 1 et 2.\nII. - En conséquence, à la fin de l’alinéa 5, substituer aux mots :\n« , pour chaque spécialité…"},{"u":"AMANR5L17PO420120B0104P0D1N000006","n":"AS6","no":"6","ex":"CION-SOC","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591","t":"I. - À l’alinéa 2, substituer au mot :\n« soignants »\nles mots :\n« d’infirmiers diplômés d’État et d'aides-soignants hospitaliers…"},{"u":"AMANR5L17PO838901BTC0697P0D1N000006","n":"6","no":"6","ex":"AN","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591","t":"I. - À l’alinéa 2, substituer aux mots :\n« chaque type d’activité de soins hospitaliers et en tenant compte de la charge des…"},{"u":"AMANR5L17PO420120B0104P0D1N000007","n":"AS7","no":"7","ex":"CION-SOC","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591","t":"I. - À l’alinéa 2, substituer au mot :\n« soignants »\nles mots :\n« pour chaque catégorie de professionnels composant l'équipe…"},{"u":"AMANR5L17PO838901BTC0697P0D1N000007","n":"7","no":"7","ex":"AN","et":"Retiré","se":"Retiré avant publication","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591"},{"u":"AMANR5L17PO420120B0104P0D1N000008","n":"AS8","no":"8","ex":"CION-SOC","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591","t":"I. - Supprimer les alinéas 1 et 2.\nII. - Après le mot :\n« défini »,\nrédiger ainsi la fin de l’alinéa 5 :\n« par pôles d’activité…"},{"u":"AMANR5L17PO838901BTC0697P0D1N000008","n":"8","no":"8","ex":"AN","st":"Retiré","et":"Discuté","se":"Retiré","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591","t":"I. - À l’alinéa 2, substituer aux mots :\n« de soignants »\nles mots :\n« pour chaque catégorie de professionnels composant l'équipe…"},{"u":"AMANR5L17PO420120B0104P0D1N000009","n":"AS9","no":"9","ex":"CION-SOC","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591","t":"À l’alinéa 8, substituer au mot :\n« trois »\nle mot :\n« sept »."},{"u":"AMANR5L17PO838901BTC0697P0D1N000009","n":"9","no":"9","ex":"AN","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591","t":"À l’alinéa 8, substituer aux mots :\n« supérieure à trois jours »\nles mots :\n« déterminée par décret en fonction de l’écart…"},{"u":"AMANR5L17PO420120B0104P0D1N000010","n":"AS10","no":"10","ex":"CION-SOC","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591","t":"À l’alinéa 8, substituer aux mots:\n« supérieure à trois jours »\nles mots :\n« déterminée par décret en fonction de l’écart…"},{"u":"AMANR5L17PO838901BTC0697P0D1N000010","n":"10","no":"10","ex":"AN","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591","t":"À l’alinéa 8, substituer au mot :\n« trois »\nle mot :\n« sept »."},{"u":"AMANR5L17PO838901BTC0697P0D1N000011","n":"11","no":"11","ex":"AN","et":"Retiré","se":"Retiré avant publication","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591"},{"u":"AMANR5L17PO838901BTC0697P0D1N000012","n":"12","no":"12","ex":"AN","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591","t":"Rédiger ainsi l’alinéa 11 :\n« B. - Le I bis entre en vigueur après une expérimentation d’une durée de deux ans visant à évaluer…"},{"u":"AMANR5L17PO838901BTC0697P0D1N000013","n":"13","no":"13","ex":"AN","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"Mme Annie Vidal","gc":"EPR","gk":"#7B4591","t":"Compléter l’alinéa 11 par les mots :\n« après remise d’un rapport au Parlement évaluant, d’une part, les besoins de formation au…"},{"u":"AMANR5L17PO838901BTC0697P0D1N000014","n":"14","no":"14","ex":"AN","st":"Rejeté","et":"Discuté","se":"Rejeté","an":"M. 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Emmanuel Macron","phase":"Promulgation de la loi"}]},"procedure":"Proposition de loi ordinaire","redepot":null,"civById":{"PA333285":"M."},"grpById":{"PA333285":{"id":"PO800496","code":"SOC","libelle":"Socialistes et apparentés (membre de l’intergroupe NUPES)","couleur":"#DF84B5"}},"mainAuthor":null,"enjeu":{"resume":"Le texte, adopté par le Sénat à l'initiative du sénateur Bernard Jomier, instaure un ratio minimal de soignants (infirmiers, aides-soignants) par lit ouvert ou par nombre de passages, dans les établissements du service public hospitalier. Ce ratio est fixé par décret, après avis de la Haute Autorité de santé, pour une durée maximale de cinq ans, en tenant compte de la charge de soins et des spécificités de chaque spécialité. Il entre en vigueur au 1er janvier 2027, délai destiné à permettre le recrutement et la formation de personnel supplémentaire. Adopté conforme par l'Assemblée nationale le 23 janvier 2025 sur le rapport de Guillaume Garot (Socialistes), le texte a été promulgué le 29 janvier 2025 (loi n° 2025-74). Il a recueilli un large soutien mais une forte abstention du bloc central et du Rassemblement national.","dynamique":"Adopté le 23 janvier 2025 : 138 voix pour, 3 contre, 70 abstentions. Six groupes ont voté pour et cinq se sont abstenus.","arguments":{"pour":[{"qui":"Guillaume Garot (Socialistes)","texte":"Rapporteur, il défend le texte comme une dépense d'investissement, susceptible de raccourcir les séjours hospitaliers et de réduire les maladies nosocomiales, et appelle à une adoption sans modification.","source":"https://lcp.fr/actualites/hopital-les-deputes-adoptent-un-texte-visant-a-instaurer-un-nombre-minimum-de-soignants"},{"qui":"Yannick Neuder (ministre de la Santé)","texte":"Au nom du gouvernement, il soutient le texte : « Je n’ai pas pour habitude d’abandonner une idée lorsqu’elle me semble aller dans le bon sens, et c’est le cas de ce texte, qui doit améliorer à la fois la sécurité des patients et l’attractivité du métier de soignant à l’hôpital. »","source":"Compte rendu de la 2e séance du 23 janvier 2025 (Assemblée nationale)","url":"https://www.assemblee-nationale.fr/dyn/17/comptes-rendus/seance/CRSANR5L17S2025O1N080#3605508"},{"qui":"Laurent Panifous (LIOT)","texte":"Il estime que l'adoption de ce texte enverrait un signal clair pour restaurer l'attractivité des métiers du soin à l'hôpital.","source":"https://www.assemblee-nationale.fr/dyn/17/comptes-rendus/seance/session-ordinaire-de-2024-2025/deuxieme-seance-du-jeudi-23-janvier-2025","url":"https://www.assemblee-nationale.fr/dyn/17/comptes-rendus/seance/CRSANR5L17S2025O1N080#3605087","ancrePrecision":"orateur"}],"contre":[],"reserves":[{"qui":"Annie Vidal (Ensemble pour la République)","texte":"Elle juge le texte difficilement opérant en l'état (son article unique couvre toutes les spécialités alors que le délai des travaux de la Haute Autorité de santé était déjà dépassé) et redoute des fermetures de lits faute de personnel disponible ; son groupe, ses amendements rejetés, s'abstient.","source":"https://lcp.fr/actualites/hopital-les-deputes-adoptent-un-texte-visant-a-instaurer-un-nombre-minimum-de-soignants"},{"qui":"Jean Moulliere (Horizons)","texte":"Il qualifie le texte de « fausse bonne idée » dont les limites techniques empêchent de le soutenir en l'état, citant l'exemple allemand où des ratios rigides ont conduit à des fermetures de lits dans une majorité d'hôpitaux.","source":"Compte rendu de la 2e séance du 23 janvier 2025 (Assemblée nationale)","url":"https://www.assemblee-nationale.fr/dyn/17/comptes-rendus/seance/CRSANR5L17S2025O1N080#3605077"},{"qui":"Serge Muller (Rassemblement national)","texte":"Ancien aide-soignant, il reconnaît l'ampleur de la crise des effectifs mais estime que les ratios doivent être déterminés sur des bases scientifiques solides et en concertation avec les professionnels, et demande des moyens financiers supplémentaires ; son groupe s'abstient.","source":"https://www.assemblee-nationale.fr/dyn/17/comptes-rendus/seance/session-ordinaire-de-2024-2025/deuxieme-seance-du-jeudi-23-janvier-2025","url":"https://www.assemblee-nationale.fr/dyn/17/comptes-rendus/seance/CRSANR5L17S2025O1N080#3605274","ancrePrecision":"orateur"}]},"sources":[{"label":"Dossier législatif (Assemblée nationale)","url":"https://www.assemblee-nationale.fr/dyn/17/dossiers/instauration_nombre_minimum_soignants_par_patient_hospitalise"},{"label":"Compte rendu de la deuxième séance du 23 janvier 2025 (Assemblée nationale)","url":"https://www.assemblee-nationale.fr/dyn/17/comptes-rendus/seance/session-ordinaire-de-2024-2025/deuxieme-seance-du-jeudi-23-janvier-2025"},{"label":"Rapport n° 281 (Sénat)","url":"https://www.senat.fr/rap/l22-281/l22-281_mono.html"},{"label":"LOI n° 2025-74 du 29 janvier 2025 (Légifrance)","url":"https://www.legifrance.gouv.fr/jorf/id/JORFTEXT000051058565"},{"label":"Hôpital : adoption définitive de la proposition de loi (Public Sénat)","url":"https://www.publicsenat.fr/actualites/sante/hopital-adoption-definitive-de-la-proposition-de-loi-pour-un-nombre-minimal-de-soignants-par-patients"}],"v":2,"source":"cure-verifie"},"explain":{"scrutinId":"VTANR5L17V600","version":2,"titre":"l'ensemble de la proposition de loi, adoptée par le Sénat, relative à l'instauration d'un nombre minimum de soignants par patient hospitalisé (première lecture).","synthese":"**L'Assemblée nationale** a adopté, le 23 janvier 2025, une **proposition de loi** visant à instaurer un **nombre minimum de soignants par patient hospitalisé**. Le texte, adopté par le Sénat, a reçu un large soutien avec 138 députés favorables, 3 contre et 70 abstentions. **LFI-NFP, SOC, ECOS et GDR** se sont prononcés en faveur du texte, tandis que **RN, EPR, DEM et HOR** ont choisi l’abstention. Le vote reflète un clivage entre les groupes qui soutiennent une amélioration des conditions de soins et ceux qui n’ont pas participé au scrutin.","perFamille":{"ECOS":"a voté pour","GDR":"a voté pour","LFI-NFP":"a voté pour","SOC":"a voté pour","DEM":"s'est abstenu·e","EPR":"s'est abstenu·e","HOR":"s'est abstenu·e","RN":"s'est abstenu·e"},"source":"ollama/qwen3:14b"},"objMoyens":null,"recoExperts":null,"eli":{"numeroLoi":"2025-74","eli":"https://www.legifrance.gouv.fr/eli/loi/2025/1/29/TSSS2303466L/jo/texte"},"promulgation":{"date":"2025-01-29","titre":"relative à l’instauration d’un nombre minimum de soignants par patient hospitalisé","numJO":"25","dateJO":"2025-01-30","url":"https://www.legifrance.gouv.fr/WAspad/UnTexteDeJorf?numjo=TSSS2303466L"},"commissionAmdt":{"nTotal":19,"nAdopte":0,"commissions":["Affaires sociales"],"leg":17},"rapportsDossier":[{"u":"RAPPANR5L17B0697","commission":"Commission des affaires sociales","date":"2024-12-04","num":"697","leg":17,"type":"permanent","rapporteurs":[{"id":"PA333285","label":"Guillaume Garot"}]}],"censures":null,"voteRef":{"id":"VTANR5L17V600","titre":"l'ensemble de la proposition de loi, adoptée par le Sénat, relative à l'instauration d'un nombre minimum de soignants par patient hospitalisé (première lecture).","date":"2025-01-23","sortCode":"adopté","pour":138,"contre":3,"abstention":70},"voteAggregat":{"PO845401":{"pour":0,"contre":0,"abstention":30,"nonVotant":0,"absent":94,"positionMajoritaire":"abstention","nombreMembres":124},"PO845407":{"pour":0,"contre":1,"abstention":26,"nonVotant":4,"absent":63,"positionMajoritaire":"abstention","nombreMembres":94},"PO845413":{"pour":35,"contre":0,"abstention":0,"nonVotant":0,"absent":36,"positionMajoritaire":"pour","nombreMembres":71},"PO845419":{"pour":62,"contre":0,"abstention":0,"nonVotant":0,"absent":4,"positionMajoritaire":"pour","nombreMembres":66},"PO845425":{"pour":2,"contre":0,"abstention":0,"nonVotant":2,"absent":43,"positionMajoritaire":"pour","nombreMembres":47},"PO845439":{"pour":27,"contre":0,"abstention":0,"nonVotant":0,"absent":11,"positionMajoritaire":"pour","nombreMembres":38},"PO845454":{"pour":1,"contre":0,"abstention":6,"nonVotant":0,"absent":29,"positionMajoritaire":"abstention","nombreMembres":36},"PO845470":{"pour":1,"contre":2,"abstention":7,"nonVotant":1,"absent":23,"positionMajoritaire":"abstention","nombreMembres":34},"PO845485":{"pour":4,"contre":0,"abstention":0,"nonVotant":0,"absent":19,"positionMajoritaire":"pour","nombreMembres":23},"PO845514":{"pour":6,"contre":0,"abstention":0,"nonVotant":0,"absent":11,"positionMajoritaire":"pour","nombreMembres":17},"PO847173":{"pour":0,"contre":0,"abstention":1,"nonVotant":0,"absent":15,"positionMajoritaire":"abstention","nombreMembres":16},"PO840056":{"pour":0,"contre":0,"abstention":0,"nonVotant":0,"absent":10,"positionMajoritaire":"pour","nombreMembres":10}},"voteGroupes":[{"id":"PO800490","code":"LFI","libelle":"La France insoumise - 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