“Top guns”, there are already some in the public network, I have known some and I still know some! Let’s start by depoliticizing the appointments, identifying the “top guns” already in place, giving them objectively achievable mandates and giving them the essential conditions for success. Among the “top guns” are, like it or not, union representatives who know what is wrong and have real solutions to offer. Among the “top guns”, despite all the maneuvers too often put in place to “control” their work…there remain a few local commissioners for complaints and the quality of care and services who know the rights of users and who are capable not only to identify the shortcomings, but also the solutions.

Adding pieces of the puzzle to the huge organizational structure of health will only make the problems worse. None of your private “top guns” would be able to effectively run an organization with a bureaucracy taking over 50% of its resources. The emergency room is overflowing and the nurses are at their wit’s end. The solution is simple, Minister, invest heavily in frontline work and drastically reduce all that bureaucracy bogged down in paperwork.

This minister gives me full confidence in the future of a system that costs so much, and certainly needs professional managers at the helm. Our great schools of administration should be challenged to create the new model so much sought after in this sector. The parade of ministers-doctors-liberals was a little too personalized and had an air of yesteryear where the doctor and the village priest knew what was good for the people.

It is touchingly naive to think that a new structure can improve the way the network operates. The same CEOs, directors and assistants of all kinds remain in place in the CISSSs and there the Minister adds another level with his “top guns”. All these beautiful people will want to justify their reason for being. Even more data (figures) will be required and it is the network workers who will have to provide it, to the detriment of their work with people.

No, that doesn’t inspire any confidence in me. The network does not need an additional administrative structure, but rather autonomy for the establishments and direct funding for patient services. As with the education system, it seems that the messages that come from the field never reach the decision makers, even if they have been hammered for years. It is time to listen to the workers and to slim down the administrations.

I believe that a lot of tact is required to review the management structure of the health system, which really needs it: review the role and autonomy of doctors in the system, review the primacy of the door of entering hospitals through the emergency room, emphasizing home care… I have great respect for our Minister of Health, because of his management approach and his leadership skills, but I have apprehensions about the current message (“top guns” from private). There must be private and public ones, but let us be demanding and vigilant. There are a lot of things to review and the health machine must be able to keep up.

I have complete confidence in Mr. Dubé. How do you eat an elephant? One bite at a time. How do you change a culture that has become too rigid, that operates in silos? We make people accountable, we make them aware of the objectives, we refocus their efforts, we encourage the good ones and we get rid of the bad ones. It will come.

Based on my experience as an ex-banker, ex-CEGEP executive and ex-university teacher, I can say, without fear of being accused of exaggeration, that all such strategies (hiring managers successful for-profit companies to manage public bodies) have been unsuccessful. For what ? Simply because, while the management of private companies is all about shareholder return (period!), public organizations don’t share that goal. The pursuit of profit for the shareholder and the provision of services to the population are irreconcilably irreconcilable.

Oh how I have my doubts about that! Hopefully, the “top guns” in question will have the wisdom to consult with the “top guns” in healthcare. This idea of ​​Mr. Dubé does not surprise me. He comes from a business background, where he was surrounded by brilliant people in their respective fields, but whether that same success will apply to revolutionizing the healthcare system remains to be seen.