If the new Santé Québec agency is to have any hope of succeeding, it should be based in Montreal — away from the talons of the Health Ministry.
Fasten your seatbelts, Quebec is in for some major changes on the health care front.
Health Minister Christian Dubé has vowed to “shake the columns of the temple” with his health reform. Premier François Legault says it will require him to tap into his last reserves of courage.
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Sounds like they’re preparing for a battle. In a certain sense, they are.
My career has given me the chance to witness many of the health care reforms that have come and gone over the years. I was literally given a front-row seat when former Liberal health minister Marc-Yvan Côté held a meeting in the round that had all of the trappings of a religious revival. Great optics. Zero results.
I worked with Jean Rochon on the professional regulatory side of his mammoth report. He went on to become health minister and … nothing changed.
The Michel Clair report, the Gaétan Barrette reform … on and on smart people have been given big mandates to only wind up shuffling the deck chairs on the Titanic.
Legault knows that at the beginning of this new majority mandate, he has a once in a lifetime chance to apply his years of experience in government to bring about real change.
Legault started out wanting to target the unions. His new approach will of course include a serious reorganization. We’ll go from over 130 bargaining tables to just four. But he no longer seems to be portraying the unions as the villains of the piece, and that’s a good thing.
One of the most important changes is that for over 300,000 health care workers, there will only be one employer: the new Santé Québec agency.
Today, a nurse with 20 years experience would be told that they’re at the bottom of the list if they changed hospitals. Now they’ll bring their seniority with them.
Having seen so many flops over the years, Quebecers can be forgiven for being a bit skeptical. Will another change of structures provide any improved access to mental health services to avoid the types of tragedy that saw a police officer killed in Louiseville this week?
What will happen to the governing boards of hospitals, and their foundations, built up by different communities over generations?
Bill 96 has already hobbled recruitment and management in the English health care sector, compromising access. Legault also tried to remove the constitutional right to control and manage English school boards. His animus seems clear.
Éric Girard, the minister of anglophone relations, better get involved now and not wait for this to blow up. The drafters of the health reform bill won’t even think about these issues. Dubé has to.
Dubé has clearly learned that the cure for our ailing health system has to be more than a plaster.
Quebecers should give his reform the chance that it deserves, but it can’t drive even more wedges between this government and wary communities.
In addition to its potential deleterious effect on English-language institutions, two parts of the reform I find worrisome are its delayed implementation and the confusing continuing presence of the tentacular Health Ministry in Quebec City.
Announcing that key changes will only happen in several years is a huge problem. That part of the plan has to be revisited. It would provide an opportunity for the forces of inertia to contest and stall in the hopes of dragging things out until the next election.
The Health Ministry has become an inefficient, unwieldy beast. Eighteen associate deputy ministers! It won’t reform itself; Dubé has to do it.
If the agency is to have any hope of succeeding, it should be located in Montreal, away from the talons of the ministry that will bide its time and try to keep control. That would be a recipe for failure.
Tom Mulcair, a former leader of the federal NDP, served as minister of the environment in the Quebec Liberal government of Jean Charest.
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