(Quebec) Christian Dubé on Wednesday tabled his vast reform aimed at making the mammoth of the health network more efficient by creating a brand new state corporation, Santé Québec, which will coordinate the operational component. The Minister of Health goes further: he wants to force medical specialists to do more and free the network from the “union shackles”.
Minister Dubé tabled Bill 15 on Wednesday aimed at making the health and social services system more efficient. The legislative text of some 300 pages includes more than a thousand articles that fundamentally modify the Act respecting health and social services.
Bill 15 creates Santé Québec, an agency that will coordinate all the operational aspects of the imposing Ministry of Health and Social Services (MSSS). The ministry will be able to concentrate on defining the major orientations and its planning role.
This is a recommendation from the Clair report, which dates back more than 20 years and which no government wanted to implement. In the House on Wednesday, Prime Minister François Legault boasted of having the “guts” necessary to carry out major reforms.
He was referring to the words of former Health Minister Gaétan Barrette, who told La Presse this week that former Prime Minister Philippe Couillard had “shocked” at the discontent of the unions. Mr. Barrette, who applauded the information that had filtered through on the Dubé reform, also predicted a “Third World War” in the coming months.
“Quebecers have made it clear that the status quo is not acceptable. There will be no war, we will work together and we will succeed, “said Minister Dubé upon his arrival at the Blue Room on Wednesday. He will hold a press conference this afternoon in Quebec.
Santé Québec will have its president, vice-presidents and a board of directors, like Hydro-Québec. Prime Minister Legault had also used the “Hydro-Santé” image to illustrate the aims of Minister Dubé. The agency will be subject to the Act respecting the governance of state-owned enterprises.
Once in place, the 34 directors general of the CISSSs and CIUSSSs will report directly to Santé Québec and no longer to local boards of directors or to the Deputy Minister in charge of the Ministry of Health and Social Services.
The pandemic has revealed serious shortcomings in the governance of the health network. Investigation reports from health and welfare commissioner Joanne Castonguay and deputy health minister Dominique Savoie recommended the department focus on planning. Santé Québec will have the mandate to develop a national program on the quality of services.
Minister Dubé also wants to hire several hundred managers, including middle managers, so that each health establishment, CLSC and hospital, has an accountable director. Former Liberal minister Gaétan Barrette himself admitted that he had abolished too many middle managers in his reform, which forced the departure of nearly 1,300 managers in 2015.
In the Girard budget, Quebec reserved 60 million over two years for the creation of the Health Quebec agency. A portion of these amounts will be used to fill these new management positions.
The Dubé reform plans to free the network from the “union shackles” by merging the union seniority of employees across Quebec. The centralization of operations in the Santé Québec agency will have the effect of merging the local collective agreements. Instead of the current 136 bargaining tables with the unions, the law will reduce them to just four national tables.
“What we want is cooperation from the unions. Everyone should agree […] with the fact that we must change the organization of work, we must decentralize. Me, I hope it’s going to be fine, “launched François Legault on Wednesday, going to the Blue Salon.
In his reform, Christian Dubé wants to force medical specialists to take more care of patients throughout the territory, including in neglected regions and hospitals.
As with family doctors, specialists will be subject to coverage obligations to improve access to care. They will have to offer better availability in emergencies and accept unfavorable schedules, as La Presse revealed on Monday.
