The Minister of Health Christian Dubé would have done well to run to the Maisonneuve-Rosemont hospital last Monday to find a way to prevent the closure of the emergency room as well as the resignation of a hundred nurses overworked. imposed on them and the “toxic atmosphere” that reigns there.
Just last week, he expressed his displeasure at having to “put out fires and deal with emergencies”, when he would rather focus on actions with “structuring effects that will change things”. Prime Minister Legault, however, judged that the situation in Maisonneuve-Rosemont was sufficiently critical “for the minister to get involved”.
In reality, Mr. Dubé did not really need to travel to appoint a conciliator and order that part of the ambulances be diverted to other establishments in order to relieve one of the busiest emergency services in Quebec.
However, the importance of perception in politics cannot be overstated. Mr. Legault considered it essential that the minister demonstrate by his presence that the government was aware of the seriousness of the situation and intended to spare no effort to remedy it.
In the same way, a Minister responsible for Public Security makes a point of rushing to the scene of a flood in boots, even if the manipulation of a bag or two of sand under the eye of television cameras does nothing to improve the fate of the victims.
During the last election campaign, Mr. Dubé took up the idea of an agency separate from the department, which would be called Santé Québec. He promised, in the event of a victory for the Coalition avenir Québec, its establishment in the summer of 2023.
Its role would be to ensure the smooth running of daily activities in the establishments of the network, while the ministry would concentrate on defining the major orientations, planning, monitoring performance and budgets.
To hear it, one would think that this would make it possible to “decentralize and debureaucratize” the network and to “provide access to more humane and more effective care”. Taking up an old cliché, the Minister was delighted that we were finally able to “no longer make decisions in office towers, but on the ground”.
Philippe Couillard had already proposed such an entity, in a speech given to the Chamber of Commerce of Metropolitan Montreal in 2011, during a break in his political career.
“Is it really a good thing that the Minister of Health is the leader [suprême] of the health system itself, or shouldn’t he, as an elected official, be among those who evaluate the results of the system and ask questions in relation to the objectives that he, as a politician, will have determined ? he asked.
Perhaps he had in mind the example of Alberta Health Services, a quasi-independent Crown corporation of the Alberta government created in 2008. Once he became Premier, he did the exact opposite, leaving Gaétan Barrette assume more power over the network than any of its predecessors had.
The creation of Santé Québec would aim not only to lighten the management of the network, but also to “depoliticize” it. However, one may wonder to what extent health and politics can be dissociated, insofar as the government will continue to determine budgets and negotiate collective agreements.
Is it depoliticization or rather disempowerment? What may be suitable for income or transport is not necessarily suitable for an area such as health. For that matter, why not an Éducation Québec agency?
Managers of the health network are already largely held responsible for the ills that afflict them. “They don’t have a favorable popular rating, and that comes in handy for many,” wrote Friday in The duty the CEO of the Association of Senior Health and Social Services Executives, Carole Trempe.
Competence may be unevenly distributed among managers, but they make convenient scapegoats. It would be even easier to assign responsibility to an agency separate from the government, which could be regularly put on trial in parliamentary committee.
In 2014, the Couillard government ordered cuts of around $100 million to the defunct Montreal Health and Social Services Agency. When she undertook to fulfill this order, which would inevitably affect services, Mr. Couillard immediately got on his high horse. “Unacceptable,” he said. It is out of the question for us to accept any type of scenario from any public body. »
When a problem turns out to be unsolvable, why blame yourself when others can, right?