Committee studying Quebec's health-care reform bill

Will the Quebec health-care reform bill succeed in "making the health system more efficient?"

A host of stakeholders are taking part in a parliamentary committee on Wednesday and Thursday, in an effort to improve the ambitious bill, with more sessions planned for May.

Before the hearings began, Health Minister Christian Dubé told reporters that his goal was still to pass the legislation before the current parliamentary session ends June 9. However, he said he was “realistic” about the work that needs to be done. Some 40 speakers will appear before the health commission, and then the opposition will conduct a detailed study of the articles.

Dubé also welcomed the unanimous adoption of a motion calling on the parties to work together to improve the bill. The minister sought to simplify the process by reducing the 1,200 or so sections to four main themes on which to agree.

He said the legislation aims to separate policy from operations, improve clinical governance, provide better user access, and decentralize management to be closer to the ground.

Dubé tabled Bill 15 last month. The lengthy document includes the creation of a new provincial agency called Santé Québec.

This new structure will be responsible for coordinating Quebec health network operations, while the ministry will retain its role in setting directions and allocating budgets.

In the run-up to the consultations, the minister insisted he's willing to take the time to hear from "all our partners, as well as the people in the field."

He repeated that his bill "can be improved" and reached out to network stakeholders and the opposition to improve it.

On the opposition side, Vincent Marissal of Québec Solidaire and Joël Arseneau of the Parti Québécois both raised concerns about the place given to the private sector in health care. They are also seeking to ensure that the health minister remains accountable for the network's performance and that he doesn't hide behind Santé Québec.

A PILOT IN THE PLANE

On Wednesday, the parliamentarians first heard from Joanne Castonguay, Commissioner for Health and Welfare (CSBE), who analyzed numerous health network reforms worldwide. She stressed that there's a lot at stake in how the transformation is managed.

"It is the continuous adjustments that matter," she added.

She called on the government to plan its transformation in detail, closely monitor progress and results, and adapt constantly along the way. She argued that cultural evolution (of the network) requires a lot of time and a deliberate strategy.

The commissioner praised several strategies employed by Quebec, including facilitating labour mobility and the creation of governing boards that will allow users to have a voice alongside managers.

Concerning decentralization, Castonguay said she's concerned that the management of local operations will remain in the hands of Santé Québec since the institutions will lose their distinct legal identity. They will no longer be able to enter into service agreements independently unless the agency delegates powers to local managers.

OTHER TESTIMONY

The Auditor General of Quebec and former minister, Michel Clair, who chaired the Study Commission on Health and Social Services in the early 2000s, is also scheduled to be heard Wednesday.

Also set to appear are the Association of Senior Managers in Health and Social Services, Association Managers of Health and Social Services Institutions and the Federation of Quebec Resident Physicians.

On Thursday, Vincent Dumez, director of patients and co-scientific director at the Centre of Excellence on Partnership with Patients and the Public, and the Association of Councils of Physicians, Dentists and Pharmacists of Quebec, followed by the Council for the Protection of Patients and the Provincial Grouping of Users' Committees will speak.

This report by The Canadian Press was first published on April 19, 2023. 

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