As Health Minister Christian Dubé was about to release his bill on network efficiency at the end of March, his predecessor, Gaétan Barrette, predicted a “Third World War”. .
Luckily, it didn’t go for that.
It has now been five long days since various representatives of the network have been invited to vote on Bill 15 in the National Assembly and the fact is that fans of fierce confrontations have not had much to put themselves under the tooth.
It’s very good like that, by the way.
No one wanted, given the importance of this reform, that we are witnessing bickering rather than constructive discussions.
If the trend continues, this bill will continue to be seriously examined by elected officials, to then be improved. Because just about everyone – including Minister Dubé – agrees that the first draft of this legislation needs to be improved.
Let us recall two or three things about this bill before explaining how it can be improved.
First, it will allow the creation of Santé Québec. This new state corporation will have to coordinate the operations of the health system, a mandate that currently falls to the ministry. From now on, the latter will be able to focus on the priorities, objectives and orientations of the network.
With this new single employer, we should see the number of collective agreements for network employees melt like snow in the sun. Among the expected results: it will be easier to coordinate activities, among other things because the mobility of professionals will be facilitated. And we will necessarily operate less in silos. If it works, the patient will benefit.
Well, obviously, all this is not unanimous. You will not be surprised to know that certain unions – such as the Fédération des médecins omnipraticiens (FMOQ) and the Fédération interprofessionnelle de la santé (FIQ) – are not on the same wavelength as Christian Dubé on all aspects of legislation.
But there was no war, and that’s probably because there are three or four winning conditions right now.
Basically, the fear of the status quo is such that just about everyone seems to want the current reform – of which the bill is a centerpiece – to work.
Next, the idea of creating an agency for network operations is not new. It appeared in the report of the commission on health chaired by Michel Clair, written… more than 20 years ago.
Another asset can be summed up in two words: Christian Dubé. Unlike Gaétan Barrette, he prefers to leave his boxing gloves at home.
A good example of his talents as a diplomat: the way he gently ended a tougher exchange last week with Julie Bouchard of the FIQ. “Sometimes it’s good to agree on just what you don’t agree on,” he said calmly.
It is speakable, therefore. Even that he says he is ready to modify his bill taking into account the recommendations offered.
We will soon see to what extent the minister is prepared to water down his wine. Particularly in terms of “local management”, a concept to which he is attached, but which is not yet developed.
Many are concerned that the legislation does not go far enough in terms of decentralizing decision-making.
It is promised that there will henceforth be “accountable” local managers in each of the establishments, but the problem is that we do not know what their real power will be or what autonomy they will have.
In an interview with our journalist Fanny Lévesque last month, the Minister said that he was in favor of an idea launched by Michel Clair regarding local management: the creation of supervisory boards and a community alliance across Quebec. .
In particular, he would like “all directors, including those of family medicine groups and specialized medical centers”, to report to these councils on a regular basis, among other things in terms of performance.
The general idea would be to involve the community in the image of what the public security committees (CSP) currently found in each of the MRCs in the province, where four to seven elected municipal officials sit.
All that to say that there is still a lot of work to do before we can claim victory. We also know that the past is no guarantee of the future – battles could arise.
But in the context, the fact that we have already come a long way in a certain harmony is to the credit of all the participants in this collective effort. May they keep the plight of patients at the heart of their concerns until the end.