Bill 7: France-Élaine Duranceau remains firm on merger of INSPQ and INESSS

By merging INESSS and INSPQ into a single entity, as provided for in Bill 7, experts fear funding will go more toward care rather than public health prevention. The minister responsible for government administration and state efficiency, France-Élaine Duranceau, is defending her bill tooth and nail.

The “Act to reduce bureaucracy, increase government efficiency, and strengthen the accountability of senior public servants” aims to merge the National Institute of Excellence in Health and Social Services (INESSS) and the Quebec National Institute of Public Health (INSPQ) to create the new Quebec Institute of Health and Social Services (IQSSS).

On Tuesday, during special consultations on Bill 7, Duranceau assured that she was taking into account the risks highlighted by experts during the four days of public hearings. “Amendments are being drafted to incorporate several of these elements in order to preserve the organization’s mission,” she said.

“I remain convinced that it will not work to simply consolidate,” added Duranceau. “What we are eliminating are perhaps administrative positions that will be duplicated, but apart from that, the mission and expertise of the people who advise on health and work on public health prevention will remain.”

With Bill 7, Duranceau hopes to achieve savings of $35 million by 2029-30, notably by cutting 220 full-time equivalents (FTEs), including about 100 in the health-care system.

Louise Potvin, scientific director of the Université de Montréal’s Centre de recherche en santé publique (CReSP), raised certain risks associated with the planned merger. In particular, she pointed out that it would result in Quebec’s withdrawal from various public-health forums and that this would lead to Canada taking on more leadership in public health, without necessarily adapting to the reality in Quebec.

“In an organization that has both a mission to support care and a mission to support prevention, budgets, by force of circumstance and inertia, will go toward care and toward demands related to care, partly because the federal government has nothing to do with care, nothing to do with expertise in care, and because the federal government, with the Public Health Agency of Canada, continues to develop extremely specialized expertise in public health and makes it available to all provinces. In my opinion, this is a relatively significant danger or risk,” said Potvin.

Intention is not to ‘weaken the INSPQ,’ says Duranceau

Minister Duranceau assured that she would not touch the budget. “The intention is absolutely not to weaken the INSPQ, but to preserve its mission in its entirety. There is no question of reducing the budgets related to the INSPQ’s operations and mission. The idea is to consolidate. First, working together more effectively will lead to greater efficiency. We have seen the limitations of having organizations that operate in silos. Then, perhaps indirectly, yes, there will be administrative savings, but that’s about it,” explained the CAQ MNA.

Lara Gautier, who is an associate professor at the Université de Montréal’s School of Public Health and a regular researcher at CReSP, summarized her organization’s recommendations. The research centre wants the provisions relating to the dismantling of the INSPQ and its merger with the INESSS to be withdrawn.

“If this is not possible, establish a structure that maintains the institutional integrity of the INSPQ and, in order to maintain this integrity, which includes the integration of missions, and in a rapidly changing epidemiological context, this means, as a priority, ensuring that laboratories are included in the new structure and that public-health training and research components are retained rather than separated,” said Gautier.

Bill 7 also provides for the transfer of the operation of national laboratories to Santé Québec, previously under the responsibility of the INSPQ.

Gautier believes that Bill 7, as currently drafted, “jeopardizes a proven model that has positioned Quebec at the forefront of public health.”

–This report by La Presse Canadienne was translated by CityNews