Open letter by former premiers slams Quebec's proposed health-care reform

Six former Quebec premiers are joining forces to refute the Coalition Avenir Québec (CAQ) government's bid to overhaul the province's health-care system.

In the letter, published in French media, former premiers Philippe Couillard (Quebec Liberal Party), Jean Charest (Quebec Liberal Party), Lucien Bouchard (Parti Québécois), Pauline Marois (Parti Québécois), Daniel Johnson (Quebec Liberal Party) and Pierre Marc Johnson (Parti Québécois) state: "We are speaking to you with one voice, motivated by the conviction that no issue is more important to Quebecers than access to quality health and social services."

However, Health Minister Christian Dubé is standing firm on his new health-care bill. 

Bill 15, An Act respecting health services and social services, proposes to make access to health care more efficient under the guidance of Santé Québec, a Crown corporation that would be responsible for coordinating the day-to-day operations of the health and social services networks.

The 300-page document comprises more than 1,100 articles that could modify over 30 laws.

"We believe that merging hospital centres and university institutes into a newly-created government corporation will have a significant negative impact on these institutions," the former premiers state. "While the aim of the reform is to make the health and social services system more efficient and integrated, there are exceptions that must be preserved in the interests of patients and the pursuit of these institutions' missions of excellence."

The six go on to remind the Quebec government that hospitals and university institutes "bring together care, research, teaching, technology assessment and prevention," emphasizing that these activities are inseparable.

They point to the Montreal Heart Institute, which they fear could "break its spirit" and "reduce the major clinical impact of its discoveries" should it fall under the Santé Québec banner.

"Merging the care of the Montreal Heart Institute and other university establishments into Santé Québec would inevitably lead to a decline of their performance in the pursuit of their mission of excellence in health care, to the detriment of patients and Quebec society as a whole," the former premiers lament.

They bemoan that loss of autonomy may also stunt the institutions' abilities to raise philanthropic funds, which are essential to cutting-edge care.

The former premiers end their letter by stating they understand the health-care system needs some sort of update to meet the demanding challenges of accessibility and quality of care -- but ask that the government avoid compromising the needs of Quebecers in its quest for reform.

DUBÉ STANDING FIRM

Minister Dubé says the government is moving ahead with Bill 15.

"All the establishments are staying there. It's just to make sure we have the right compromise between the coordination that we need and the way we do research and being supported by those big foundations," the minister said.

The opposition Liberals agree with the former premiers that the new bill would not make the health-care system more efficient.

"We have very specific university institutes, very specific institutes who need to be able to carry out their mandate in a way that was theirs, in a way that's not always just dictated from above," said Liberal health critic André Fortin.

"That's what we're asking Christian Dubé, that's what we're asking François Legault, that's what the six premiers are asking today, is stop what you're doing, take a breath and see how you can give them the independence that they need in order to carry out their full mandate and improve patient care."

Another concern is how the bill would affect funding for each hospital foundation, which many rely on.

"We have six university research centres that are extremely well known throughout the world. They innovate. If they don't have the capacity to raise money to develop their research projects and to apply their innovative methods through the care that they give Quebecers, we're going to lose something very precious," said the PQ health critic Joël Arseneau.

Dubé says all of that will remain the same.

"I'm keeping the foundation and their research exactly as they were; no change," he said.

Dubé has said he wants to pass the bill by the end of this session and has said he's not ruled out invoking closure, a procedural move that would end debate on the bill.