Quebec’s College of Physicians warns of political interference under Bill 7

The Collège des médecins du Québec says Bill 7 risks opening the door to political interference that could weaken the scientific independence of public-health bodies.

The organization is calling for changes to the bill and warns Quebec could face problems seen elsewhere if the legislation proceeds as written.

College president Dr. Mauril Gaudreault outlined the concerns in a letter sent Monday to the secretary of the Commission des institutions regarding the “Act to reduce bureaucracy, increase state efficiency and strengthen the accountability of senior public servants.”

The bill would merge the Institut national d’excellence en santé et en services sociaux and the Institut national de santé publique du Québec into a single entity, the Institut québécois de santé et de services sociaux.

It would also transfer the operation of national laboratories from the INSPQ to Santé Québec.

The College says it understands the aim of centralizing expertise to improve government efficiency, but it fears public-health bodies will not be able to maintain scientific and decision-making independence if Bill 7 is adopted in its current form.

“Such independence is essential to guarantee the credibility of scientific advice and avoid any political or economic influence. We are concerned that the merger would weaken surveillance, prevention, protection and health promotion in our system, including in areas such as chronic disease, infectious disease and potential pandemics, especially since public-health functions are not explicitly stated in the bill,” Gaudreault wrote.

He urged the government to revise the legislation to clearly set out the mission and functions of public-health organizations to ensure their autonomy and effectiveness “particularly in surveillance, prevention, protection and health promotion.”

The International Association of National Public Health Institutes, of which the INSPQ is a member, has also emphasized the importance of financial autonomy for public-health institutes and the need to protect scientific processes from political interference, while maintaining collaboration with the Health Ministry.

U.S. cited as warning sign

Gaudreault pointed to the United States as an example of what Quebec should avoid.

A recent reorganization there has led to major funding cuts to the Centers for Disease Control, the Food and Drug Administration and the National Institutes of Health. Essential programs were reduced, “worsening health inequities,” he said.

“These measures, imposed in the name of efficiency, weakened the ability of U.S. authorities to respond to health crises and politicized decisions that should have been based strictly on science.

The College believes Quebec must avoid a path that could lead to similar problems,” Gaudreault warned.

He added that the COVID-19 pandemic highlighted the need to strengthen public-health science.

With bureaucracy-reduction efforts underway, the College says Quebec has an opportunity to build a stronger public-health infrastructure, similar to CDC-style models in other countries, including Canada.

Organ donation responsibilities

Bill 7 also proposes dissolving Transplant Québec and transferring its responsibilities to Héma-Québec. The College expressed concern, stressing that preserving expertise is essential to protect the public and ensure continuity and quality of care for people awaiting transplants.

“The transfer should include measures to retain Transplant Québec’s specialized teams, whose expertise is widely recognized. The organization has deep knowledge of every part of the organ-donation process and understands the complexity of hospital-based intervention, while Héma-Québec operates mainly in a community context,” Gaudreault wrote.

Héma-Québec took part in consultations on Bill 7 that began last week and continue Tuesday.

In a Nov. 26 statement, the agency said concerns raised by Transplant Québec and medical teams were legitimate.

The Crown corporation said it is considering integrating Transplant Québec as a subsidiary, which “would not result in any short-term changes to operations or organizational management.”

– This report by La Presse Canadienne was translated by CityNews