” This is a good thing. A very, very good thing.” The former president and director general of the Montreal Health and Social Services Agency, David Levine, welcomes the arrival of Health Quebec and the new law on health efficiency. The College of Physicians says it is in favor of specialists assuming a “collective responsibility” to better care for patients throughout the territory, subject to knowing all its details. However, health unions denounce not having been consulted.
“That’s what the network needs and what managers need,” says David Levine upfront. In the new law, Quebec will, among other things, merge the union seniority of employees across the province, force medical specialists to practice in the regions and put an end to regional boards of directors.
“Right now it’s the minister’s office that makes all the decisions based on the policy. It is much better that it is centralized somewhere else where decisions are not made for political reasons, but are made for the well-being of the people,” he says.
The government will end regional boards of directors and appoint general managers in all major establishments. These directors will report directly to Santé Québec, rather than to local boards of directors or to the deputy minister in charge of the Ministry of Health and Social Services.
However, the success of the new law will depend on “if the people of the ministry are ready to let Health Quebec, another separate body, take responsibility for 50 to 55% of the budget”, estimates Mr. Levine. “I hope they’ll have the guts to do it,” he said.
In addition, the director of Santé Québec will have to be chosen carefully, he argues. “It doesn’t have to be a CEO of an automobile manufacturing company or a lumber mill. It has to be a CEO who has worked in the service to people field and where his employees and his customers are very important,” he says.
One thing is certain, there will be “resistance in the network” in particular on the part of the unions, he notes. “But I think the government, being at the beginning of its mandate, may be able and have the courage to implement the necessary things. »
The College of Physicians says it is in favor of the idea of requiring medical specialists to assume “collective responsibility” in order to better care for patients throughout the territory, including in regions and hospitals that are currently neglected. He decides subject to knowing all the details of the bill expected this week.
“I agree with what I hear if it is in this sense to ensure that the medical community is more responsible for providing the services to the population it has to serve in its region” , said its president, Dr. Mauril Gaudreault.
As La Presse revealed on Monday, Quebec intends to enshrine this “population responsibility” with new obligations prescribed for specialists: respond more effectively to consultation requests made by family doctors, provide on-call duty at the hospital and accept sharing. unfavorable hours (after 4 p.m., for example).
According to Dr. Gaudreault, several doctors he met during his recent tour of hospitals “agree with the fact that the medical community must organize itself better to be more responsible, all together. There is a relative attack on professional autonomy when you do that, but you have to go in that direction. The same must be done to ensure that the task is shared between all the doctors in the same region.”
In Quebec, it is pointed out that family physicians are subject to patient care obligations, whereas specialists are not. The latter must now be, in order to improve access to care, it is explained.
“Family physicians in the various regions have established beautiful ways of doing things in relation to this social responsibility of providing care to the population. And if Mr. Dubé wants to do the same with medical specialists, well, I’m sure I’ll approve of that and support that,” said Dr. Gaudreault.
The lack of consultation surrounding Santé Québec and the new health efficiency law frustrates health unions. “These are things that were not discussed at the bargaining table. This government negotiates in the public square, ”exclaims Réjean Leclerc, president of the FSSS-CSN. “I find it peculiar to enshrine this directly in a law before even discussing it with the people concerned. »
“The government is inconsistent. He says with the edge of his mouth that he wants to decentralize, then his actions say the opposite. They want to centralize things even more,” Leclerc says. Eventually, network employees will have a single employer, Santé Québec, rather than the 34 local employers, which will allow the collective agreements to be merged. “It takes flexibility away from local managers and it further centralizes management that was already very centralized,” laments Mr. Leclerc.
For the president of the Confederation of National Trade Unions-CSN, Caroline Senneville, many questions remain unanswered. “We met the minister last Friday who gave us the outline of the bill, but it was only the outline, because the National Assembly must be aware first of the content of the law,” says- She.
In addition, Ms. Senneville wonders about the “added value” of these new measures. “Is national seniority, for example, going to make it so that there are regions where it’s going to be even more difficult to retain employees? she asks herself.
She also fears that these new changes will be seen as “another burden” on workers. “All is not well in the healthcare system and you have to make sure that the changes are made at the right speed,” she says.
Several unions, including the Fédération interprofessionnelle de la santé du Québec (FIQ), the Association of specialists in internal medicine of Québec (ASMIQ) and the Federation of medical residents of Québec (FMRQ), have said they want to wait to see the project and to analyze it before commenting.