Everything comes at the right time to who knows how to wait, must have said to himself the deputy for Saint-Jérôme, Youri Chassin, giving jointly with the Minister of Health, Christian Dubé, the kick-off for the construction of the two private mini-hospitals. promised by the Coalition avenir Québec during the last election campaign.
Long before entering politics in 2018, the former director of research at the Montreal Economic Institute had promoted the privatization of public services, whether it be the SAQ, Hydro-Québec or CPEs.
As soon as his candidacy for Saint-Jérôme was announced, Gaétan Barrette, then in charge of Health, was quick to conclude on Twitter that “François Legault wants to privatize the network, but does not say so”. The PQ deputy for Sanguinet, Alain Therrien, who already seemed to concede victory to the CAQ, had declared: “There will be a Youri Chassin tint in the next government, we cannot deny it. »
Mr. Chassin had every reason to believe that Mr. Legault was willing to let the private sector occupy a more important place in the delivery of health services. To facilitate the merger with the Action Démocratique du Québec (ADQ), he had agreed to take up the idea of a pilot project to test the public-private mix in health.
Once he became prime minister, however, he thought it best to put the idea aside, and those who feared seeing Mr. Chassin become the apostle of privatizations within a Legault government breathed a sigh of relief.
At the start of his second term, the situation is no longer the same. The Prime Minister had to realize that the CAQ had been very presumptuous in promising to get the network back on its feet quickly, even with a minister whose merits he constantly praises.
Admittedly, the pandemic has considerably added to the difficulty, but the catch-up it has imposed, combined with the shortage of labor and the stinginess of Ottawa, makes recourse to the private sector, which is already very widespread, even more easier to sell to a population that is desperate to receive the care to which it is entitled.
At first glance, mini-hospitals, probably more user-friendly than gigantic, impersonal and often dilapidated establishments, where you just have to present your health insurance card, are obviously attractive when you no longer know which saint to devote yourself to.
All that glitters, however, is not gold, as the saying goes. There is no proof that the health network will gain in efficiency. Several studies — relatively old, it is true — tend to show that the private sector is not necessarily more efficient, nor less costly.
Those who will invest in mini-hospitals will not do so out of charity. They will legitimately want to make a profit that will justify this investment, which will encourage them to favor the lightest cases and the youngest patients.
In 2016, the Couillard government launched a pilot project, extended in 2019 by the Legault government, which aimed to compare the costs of day surgery between the public network and three private clinics, where 75,000 operations were performed. were made at a cost of $71 million.
We still do not know the conclusions that have been drawn. Last fall, a spokeswoman for the Ministry of Health and Social Services told a journalist (also a doctor) from the independent media Pivot: “The comparative results include confidential data from private clinics, which cannot be shared . It’s very convenient.
While the labor shortage poses insoluble problems for managers of the public network, to the point of having to legislate to repatriate nurses who have found refuge in private employment agencies, the government gives the green light to the construction of establishments, also private, which will certainly offer them working conditions that they will find it difficult to refuse.
There is a serious risk of entering a vicious circle, where the attraction of the private sector will further aggravate the situation of the public network, which will have the effect of accelerating the exodus towards the private sector and so on.
When he was Minister of Health, François Legault had tried in vain to convince the government to which he belonged of the need to increase taxes to ensure better financing of the public network. Going private was not the answer, he said. It is true that his thinking has evolved on several levels over the past twenty years.