Dubé tables health-care reform bill to create Santé Québec agency

The François Legault government is planning on reinvigorating the province’s health network by creating an agency called Santé Québec.

Health Minister Christian Dubé introduced Bill 15 on Wednesday, an act to make the health and social services system more efficient.

This bill, which contains more than 1,100 articles, acknowledges that everyone has the right to receive “adequate, continuous, personalized and safe” health and social services.

“The purpose of it is to implement an effective system, by facilitating people’s access to safe and quality health and social services,” said Dubé at the tabling.

The bill establishes the Santé Québec agency, which would coordinate network operations and become the sole employer of health-care workers in the province, rather than the 34 that currently exist.

It would also create four collective agreements rather than 136, a service quality and complaints commissioner would be appointed and mobility of personnel encouraged.

The bill also aims to improve the organization of pre-hospital emergency services. It proposes that the Corporation d’urgences-santé be under the responsibility of Santé Québec rather than the Health Ministry.

“The most important resource that we have is human resources,” said Dubé. “That’s clear. And if we have happy resources we will have happy patients. So what we need to change is to say most of our employees have still in mind that once upon a time there was a culture of the patients, there was a feeling of being part of a team in one hospital, this has been lost.”

QS, health-care workers raise concerns

Québec solidaire’s Vincent Marissal raised concerns about the bill before it was even tabled Wednesday.

In a press conference at the National Assembly, Marissal said the health network is already “very shaken” and that Dubé was adding a “layer of uncertainty”.

“He comes in with his big shoes, like a cowboy, saying, ‘Get out of the way, it’s going to shake up.’ Frankly, it’s a bad way to operate,” Marissal said.

Some working in the health-care system are criticizing the centralized approach.

“Bill 15 just seems like another painting, lipstick on a pig and trying to show it off as it’s passible. It’s not,” said Naveed Hussain, a teacher and nurse at the MUHC. “What we’re doing right now is hiring more bureaucrats, creating an agency called Santé Québec and taking responsibility away from the Ministry of Health and putting it into this new organization and hiring bureaucrats that are going to be sitting in their offices in Quebec City, creating plans that they think will help our health-care system survive. It’s not the appropriate action that’s needed.”

Those concerns were echoed by Dr. Paul Saba, a family physician and health advocate.

“In the past we had local council of physicians for each hospital, and now that’s disappeared,” said Saba. “We used to have local boards for each hospital and each health care centre… Those have disappeared.

“My concern is that they’re going to be nominating people. These are going to be more bureaucrats who are going to answer to a central authority. So even though they talk about being concerned about the local needs, it sounds like it’s all going to be top down management.”

Part of $60M to fill management positions 

Quebec reserved $60 million over two years for the creation of the Santé Québec agency – part of that is to fill new management positions.

“I think improving working conditions and more flexibility for working conditions, working with the unions to create that – I think those are all positive,” said Saba. “I don’t think creating one single government agency to run everything is the way to go.”

The bill also differentiates salaries according to regions and shifts.

“The first thing we need to do is get back nurses and personnel in the system, the specialist and GPs are saying ‘we need people, we cannot operate full time our ER,’” said Dubé.

“The reason why this system is failing right now is that nurses are taxed to the extreme,” added Hussain. “We’re overloaded. We’re trying to stay afloat. Right now, we’re losing staff and it’s becoming harder and harder to maintain. And the idea of having health operators or managers coming in and saying, ‘well we’re going to cut here, we’re going to cut here, we’re going to make everything come together,’ it doesn’t work. We need w collaboration.”

Dubé says he wants to collaborate with the unions for this to succeed.

“If we are able to give them good conditions instead of going to private or to agencies, give us the confidence that we are working, they will be very proud,” the health minister said.