Our health system is in serious trouble and justifies a strong intervention on the part of the government. Minister Dubé has embarked on a race against time with a bill that includes 340 pages and 1180 articles, hoping to obtain results in the short if not the medium term. In terms of structure, the two-headed monster that he proposes and which combines decision-making with operations in high places is not decentralized, which will necessarily have to be revised. In terms of operation, the three main priorities, which are to subdue the unions, bring medical specialists to heel and correct the shortage of nurses, are expected to be complex to manage. Historically, union power justifies its existence to counterbalance employer power.
In the health system, the pendulum has swung and the unions have acquired such power that they impose an agenda that is often difficult to reconcile with the ministerial agenda. The minister must therefore find a favorable niche for negotiation and above all avoid “a third world war”, to quote Gaétan Barrette, who sees no way out without confrontation. Medical specialists, under the reign of President Barrette, missed the opportunity to work in collaboration with family doctors and there was even a climate of tension. The Minister must encourage the two presidents of their respective federations to take the lead in working together to ensure access and the continuum of care, reduce waiting lists, free up emergency rooms and involve all physicians in the relevance program diagnostic and therapeutic procedures.
As for the shortage of nurses, the contribution of private agencies is essential to ensure the transition. It is true that they took excessive advantage of the situation, left to their own devices and tolerated by successive governments. However, the Minister must count on their cooperation and perhaps even design a healthy complementarity and support the public system rather than cannibalize it.
Minister Dubé proved to be the man for the job during the pandemic and he has a right to our trust to establish the health system on new foundations. As a good manager, he must bring people together, listen and trust people who have the knowledge and experience of the network. Finally, he must above all prevent the famous columns of the temple he intends to shake from being weakened further, as has happened too often in the past.
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