THE top guns are still sitting on ejection seats, whether it’s Hydro-Québec, the Regroupement des bliss et amblyopes du Québec or the future Health Quebec agency. All the ministers, who say they have to be accountable last, prefer to pass the puck when they can’t put it in goal.
The goal, this time, is to change the culture of the world of health. Culture is to an organization what personality is to an individual. An individual does not change personality by changing house. An organization does not change its culture by changing its structure. Especially since in the case of health, about 40% of ministry employees will be able to change homes by going to try out that of the new state-owned company, from which they can return if they wish. Free trial right and musical chair combined.
The new ones top guns ejectables from Santé Québec will entrust their disposable directors with the responsibility of doing what the ministers have never succeeded in doing: consolidate the collective agreements they have signed and stem the medical practice which they themselves have liberated and handsomely paid by treating doctors as free contractors with income guaranteed by the State on simple billing.
If this model were to be very successful, it would have to be transferred to other state corporations. They would then have to manage their main professionals without being able to control their salary. Their top guns would probably complain that their guns are only squirt guns or guns firecracker.
Fortunately for them, the top guns will have plenty of leeway and leeway to achieve population health objectives framed by ministerial orientations, defined by their agency and financed by budgets over which the Treasury Board retains control. Let’s translate: just enough rope to hang them, in good conscience as an elected official.
Will the candidates rush to the gate of the agency or prefer the security of the ministry?
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