(Quebec) The former president of the commission who scrutinized the health system has reservations about the choice of Minister Christian Dubé to make Health Quebec the sole employer of the network. Quebec must leave local bargaining power to organizations if it wants to operate a real decentralization, believes Michel Clair.
The author of the Clair report, which precisely recommended the creation of a “national agency” centered on operations, said he was surprised by the intention of the Legault government to make its future state corporation, Santé Québec, the sole employer in the health network and thereby merging union seniority. “That’s what surprised me the most,” Michel Clair told La Presse.
According to him, the government must allow Health Quebec to offer “a space for negotiation and adjustment of national collective agreements” to local organizations to avoid negative consequences of “wall-to-wall” type solutions. He cites as an example, a nurse close to retirement who would decide to settle in Magog and who would dislodge younger workers from the region.
“If everything is settled [according to the initial version of the bill], we will have a convention, a rule that will apply to 350,000 people, that cannot be,” he adds. Quebec must therefore in return allow local agreements between the union and the employer, in particular to “weight seniority with competence, according to the positions and the particularities of the different environments”, according to the former PQ minister.
If Minister Christian Dubé wants to make the health network “an employer of choice”, it goes without saying to allow organizations “to bring a local color to create a feeling of belonging and adjust the organizational culture”, estimates the ex-chairman of the Commission for the Study of Health and Social Services, which published its report in 2001.
Again on Tuesday, François Legault affirmed at the Blue Salon that Minister Christian Dubé “is putting a CEO in each establishment so that [the network is] decentralized”. The Prime Minister was responding to the grievances of the parliamentary leader of Québec solidaire, Gabriel Nadeau-Dubois, who criticizes the Legault government for “completing” Gaétan Barrette’s centralizing reform.
Michel Clair does not believe that the Dubé reform in its current form would decentralize powers despite the addition of hundreds of local managers – one for each facility, hospital or CLSC. “These managers if they are just in a vertical hierarchical structure their real boss, it will not be the population, it will be the person above”, he illustrated.
Bill 15 also abolishes the boards of directors of the CISSSs and CIUSSSs to create governing boards. Michel Clair believes that Quebec should also add another local body that would be accountable to the population, such as a monitoring committee by MRC or CLSC territory.
“True decentralization is boards of directors with specific legal persons, me, that would have been my preference. But, I look at the bill and I say to myself: yes it can be an approach, but here are the conditions if we want that at least there is a spirit of decentralization to recreate local cultures and to have transparency in local results. »