Quebec health minister tables 150 new amendments to reform bill

Already racing against time to pass the voluminous bill on reform of the healthcare network, parliamentarians saw Minister Christian Dubé add to his tally with the tabling of some 150 amendments on Tuesday morning.

The new package of amendments submitted to the elected representatives responds to a number of concerns raised during specific consultations.

In particular, the minister responded to criticisms made by user representatives. The future national users' committee will no longer be formed by Santé Québec, but will instead be made up of members elected by users.

This committee will have a mandate to make recommendations and produce reports to Santé Québec's senior management.

Despite these changes, Paul G. Brunet, President of the Conseil pour la protection des malades, still deplores the absence of user committee representatives on Santé Québec's institutional councils and board of directors.

He also deplored the fact that user committees will not have the power to evaluate user satisfaction. Instead, establishments will be responsible for self-evaluation.

"I get the impression we're being taken for fools, and I find that sad because I don't think we are," said Brunet.

Another concern about accountability had been raised by the Auditor General of Quebec (AGQ). She wanted to have the sole mandate of auditing Santé Québec's books, and this was granted. The AGQ will also be able to examine the books of all private health service providers if the majority of their revenue comes from public funds.

Under the same theme of checks and balances, complaints commissioners in health-care institutions will be required by law to have "the resources necessary to carry out their mandate."

EXCEPTIONAL MEDICINES

A look at the package of amendments shows that the minister has also heeded the call from the Councils of Physicians, Dentists and Pharmacists (CMDP) on the subject of exceptional drugs.

In the first version of PL-15, it was no longer possible for doctors to obtain special authorization from their hospital's pharmacology committee to administer a drug that had not been recognized by the Institut national d'excellence en santé et en services sociaux, even though scientific knowledge had evolved and its therapeutic value had been demonstrated.

An amendment has been tabled to introduce an exception allowing a drug to be used "for reasons of particular medical necessity."

Authorization could be granted "if the seriousness of the user's particular condition is such that taking the drug cannot be delayed without causing short-term complications that could lead to an irreversible deterioration in the user's condition or to death."

TIME TRIAL

On Monday, when the Commission de la santé et des services sociaux resumed its work in Quebec City, the minister threatened that the bill would be adopted under a gag order.

Asked by the opposition to commit to not resorting to this option, Dubé refused to do so, saying that discussions would have to end at a certain point so that the changes could be implemented on the ground.

The minister is keen to ensure that his reform of the health-care network, which is intended to give rise to a new government corporation, the Santé Québec agency, is adopted before the end of the parliamentary session in December.

In its current form, the future "Act to make the health and social services system more efficient" contains nearly 1,200 sections to be analyzed and debated by members of the national assembly.

Detailed study of Bill 15 is scheduled to continue until Thursday. 

This report by The Canadian Press was first published in French on Aug. 22, 2023.

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