Federal, cantonal and communal responsibilities: locating the decision

Three levels with distinct powers

The Confederation, cantons and communes are not interchangeable administrations. Cantons have their own political and judicial institutions. Communal autonomy operates within the relevant cantonal framework. Subsidiarity seeks to assign a task to the level able to perform it appropriately; it does not remove the need to identify the specific basis of each responsibility.

This distinction prevents two common mistakes: directing a demand exclusively to the Federal Council when implementation belongs to a canton, or assuming that a commune can change a requirement set by federal law. The place where a service is received does not, by itself, establish who can change the rule.

The example of hospital services

Compulsory health insurance operates under a federal framework. Within it, cantons draw up hospital plans and lists of institutions authorised to provide the relevant services. Ownership of a building is therefore distinct from awarding a service mandate. Institutions outside the canton can also help meet needs.

Fribourg’s presentation illustrates the stages: assessing needs, examining applications and awarding mandates. A dispute over access to a medical specialty needs to examine planned services, travel and the capacity of selected institutions. Counting hospitals alone does not answer that question.

The mandate must in turn be distinguished from clinical decisions and team organisation. A parliament approving funding does not determine every work rota. Conversely, a management decision cannot close a gap in the financing framework. Different responsibilities can contribute to the same problem without being equivalent.

A spending authorisation is not a competence

A budget vote authorises resources within a defined framework. It does not automatically create a power the authority does not possess. Conversely, a responsibility can exist without sufficient resources to exercise it. Confusing the two suggests that announcing an amount immediately creates a service.

Cooperation also needs examination through its agreements: who participates, what obligations are shared and which body answers for decisions? The proximity of a shared service does not identify its budget authority. The PCP argues that public documents should make those commitments intelligible. Cooperation should improve capacity without distancing decisions from democratic scrutiny.

Addressing the decision that can change the service

A public proposal becomes more precise when it names its object: changing legislation, awarding a mandate, authorising expenditure, adapting a connection or revising a procedure. It can then distinguish the deciding authority from other actors whose agreement or contribution is needed.

For the PCP, this is part of democratic accountability. Cooperation between levels should not allow each to pass a difficulty to the next. A proposal should make each authority’s commitments understandable and identify conditions dependent on further decisions.

Proximity and equal access

Different local arrangements can meet comparable needs. Distance, language and population characteristics often justify adaptation. A different territory does not, however, justify persistent inability to obtain an essential service.

The PCP supports common guarantees backed by solidarity, with local discretion over delivery. The political question then becomes concrete: which rights are secured everywhere, and what resources make them usable? Assigning a responsibility is only the beginning of the answer.