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Quebec health reform bill passes after government invokes closure

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After sitting through the night, early Saturday morning, members of the Quebec legislature finally passed Bill 15 to reform the health-care network, voting 75 to 27.

On Friday, Health Minister Christian Dubé said he was tired of it and in a hurry to move on, pointing out that his bill had already been the subject of over 200 hours of study in parliamentary committee.

At a press briefing on Saturday morning, Dubé welcomed the bill's passage, saying he's convinced it will have positive effects for hospital patients, something the opposition parties strongly doubted.

In particular, Dubé noted his reform would give Quebecers better access to specialist physicians.

Moreover, patients will be able to seek treatment anywhere, regardless of their postal code, and will be offered an alternative solution, either in another region or in the private network (free of charge), when wait times are deemed unreasonable.

"It's a great day, because it's Day 1 of the transition that's about to begin and that will transform our great health-care network," said Dubé.

He was also keen to reassure the network's employees, who will be undergoing "significant changes" in the coming months. He pledged to "clearly explain" these changes, in particular what will become of the Health Ministry.

Bill 15 creates a new agency called Santé Québec, which will be responsible for coordinating network operations. The Health Ministry, meantime, will concentrate on defining the major policies. Personnel transfers are to be expected.

Santé Québec will become the sole health-care employer, with regional health boards the CISSS and CIUSSS integrated into it. Union accreditations will be merged and a single seniority list will also be introduced, allowing staff to move from one region to another.

Bill 15 is part of the Legault government's drive to achieve greater "flexibility" for workers in the health-care network, most of whom are currently on strike until Dec. 14 as part of the renegotiation of their collective agreements.

"Now that Bill 15 has passed, I'll be able to get back out in the field, go to the hospitals and take care of our employees a little bit," said Dubé.

CAQ INVOKES CLOSURE

Opposition parties vehemently denounced the use of invoking closure to adopt this major health-care network reform. During the course of the evening on Friday, they were persistent, demanding Dubé explain every article or amendment he adopted.

Québec Solidaire (QS) parliamentary leader Gabriel Nadeau-Dubois was the last to oppose passage of the bill before the vote on Saturday morning.

"It's a bad idea for our democracy, for our health-care system, for Quebec to impose the biggest reform of public services in Quebec's history under closure. This government has chosen confrontation," he said.

The government had offered to extend the detailed study of Bill 15 to next week, an implicit "admission" that much work remained to be done, according to QS MNA Guillaume Cliche-Rivard.

The offer to extend was rejected, in part because it included a deadline. The government insisted on completing the work by Dec. 15 at the latest, even though not all 2,000 articles had been gone through with a fine-tooth comb.

"It was a long night. Right up to the last minute... there were still a number of errors raised... in the few articles we had time to deal with. It just goes to show that this bill is still highly perfectible," said Cliche-Rivard.

Throughout the process, the opposition criticized the health minister's inability to answer questions on major aspects of his reform, as well as on the amendments he himself tabled.

In the end, they agreed to adopt amendments en bloc, in exchange for improvements in the bill, notably on the autonomy of midwives, which explains the relatively short duration of invoking closure.

"The 400 articles we haven't had time to study... what effect will they have?" asked Joël Arseneau, health spokesperson for the Parti Québécois (PQ), at a press briefing on Saturday morning.

Liberal Party interim leader Marc Tanguay said Bill 15 will not improve patient services.

"It's a bad reform that won't solve the immense problems of access to care. Emergency rooms are overflowing in Quebec, everywhere, and we've seen people die even in emergency rooms, and there was a link with delays," Tanguay said.

This is the fifth time closure was invoked by the Legault government to force the passage of bills since it came to power in 2018. Parliamentary business has been adjourned until Jan. 30, 2024.

- This report by The Canadian Press was first published in French on Dec. 9, 2023.

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