As the launch of calls for tenders for mini-hospitals approaches, the Montreal Economic Institute (IEDM) is pressing Quebec to include operating rooms in the project, a subject on which the Legault government’s position remains ambiguous.
“The government seemed to back down on the presence of operating theaters as well as the possibility of hospitalizing patients beyond short periods,” notes the think tank in an analysis made public on Tuesday. The blocks, argues the MEI, are “essential” for mini-hospitals to be a success.
During the electoral campaign, the Coalition Avenir Québec committed to making more room for private health care. Last year, she announced that two private mini-hospitals would be built, in Quebec and Montreal.
The MEI is one of the groups impatiently awaiting the launch of the calls for tenders promised for winter 2024 to interested private partners.
These mini-hospitals — the first of their kind in Quebec — aim to relieve emergency and front-line congestion by treating minor health problems. The one in Quebec must specialize in pediatric care and the one in eastern Montreal, in geriatrics, according to calls for interest released by the government in recent months.
Unlike existing hospitals, they will not offer a full range of specialized care and would not have intensive care.
But a certain vagueness persists about their form and their vocation. In the call for interest launched in August to survey the private sector, the ministry left the door open on the presence — or not — of services offered 24 hours a day, 7 days a week. Same thing on the presence of operating theaters , notably.
Depending on the choices that are made, these private mini-hospitals will look more like large clinics or small hospitals.
No to fixed budgets
The MEI, which promotes greater openness to private health, believes that three conditions must be met for mini-hospitals to be a success: activity-based financing (instead of pre-established financing ), emergency rooms and new operating theaters.
Activity-based funding, as opposed to a fixed budget, “rewards establishments providing as much care as possible” instead of “penalizing” them, writes the author of her analysis, economist Emmanuelle B. Faubert.
“It is high time to focus on increased competition to generate innovative solutions and reduce endless waiting lists once and for all,” she emphasizes in conclusion.
The Minister of Health, Christian Dubé, entrusted the mini-hospitals file to MP Youri Chassin, who was director of research at the MEI before entering politics. On Monday, the latter declined the interview request from Duty on this subject.
In a written message, Minister Dubé’s office indicates that it will be a “new model which does not currently exist” and that the final clinical concept will be presented “soon”.
The first calls for interest to solicit possible partners were launched almost a year ago. Last year, Minister Dubé said he wanted mini-hospitals to be operational in 2025.