The future Santé Québec agency will make it possible to avoid tragedies like the one experienced by the widow of former Prime Minister Robert Bourassa, who was deprived of palliative care for three days before her death, maintains the Minister of Health Christian Dubé, who spoke with The duty a few days before his return to the National Assembly.
Minister Dubé will table in the coming weeks the bill creating Santé Québec, an entity “separate” from the Ministry of Health and responsible for coordinating the activities of the network in the field.
“How come Mme Bourassa was treated like that? This is unacceptable. What happened to M.me Bourassa, what happened with our employees on the issue of the famous toasts… We have major work to do in terms of work climate and culture,” says Dubé.
The Minister believes that governance in the health system must be reviewed. According to him, the new agency will make the “network more efficient and more human”. Santé Québec is one of the centerpieces of its reform, presented in March 2022. “There are people who will say that it is still a mix of structures, he admits. No, there is an evolution of the structure. »
Santé Québec will be made up of a “small team”, he specifies. Its president and chief executive officer (CEO) and the members of its board of directors will be appointed by the government. The agency will not be a true “Hydro-Québec for health”. “It’s the minister who will say ‘here is your budget’,” says Christian Dubé, who is careful not to reveal the details of the bill, as it has not yet been tabled in Parliament.
Once the agency is in place, “the department [de la Santé] will remain a bit like the Ministry of Natural Resources, a ministry that measures objectives, orientations, ”he continues. Some 400 civil servants, working in the ministry’s information technology and infrastructure teams, will be transferred to the agency. “That’s pretty much all we do regarding the structure,” says Christian Dubé. But it has a major impact. »
The 35 CEOs of CIUSSSs and CISSSs will no longer report, as is currently the case, to Deputy Minister Dominique Savoie, but to the CEO of Santé Québec. It is the latter who will manage the crisis in the emergency room on a daily basis, for example. “Mme Savoie has 15 assistant deputy ministers who report to her on very complex subjects. It’s big. »
“I remain responsible”
In a report made public in June, Dominique Savoie recommended that the minister set up a new entity like Santé Québec in order to transfer certain responsibilities to it.
But why create a centralized structure if you want to decentralize the network and offer greater autonomy to institutions? The Minister sees no contradiction in this. He repeats that the vaccination campaign in Quebec was a success because one person coordinated it nationally—Daniel Paré—and each region was able to adapt its offer according to its reality.
Christian Dubé ensures that the establishment of an agency is not intended to relieve the Minister of Health of responsibility vis-à-vis the problems of the network. “I remain responsible, but I structure differently. »
Would he have gone to the emergency room at Maisonneuve-Rosemont Hospital if the agency had existed? “We had an illegal strike last week,” he said. In a case like that, yes, I would have gone. I would have gone to see the CEO of Santé Québec and I would have asked him: “What are you doing with Maisonneuve-Rosemont?” According to him, the bill should “clearly state what responsibilities the minister retains, what powers the minister retains, what investigative powers, and so on. »
All 35 CIUSSSs and CISSSs will remain intact. Asked about the relevance of reducing this number of establishments, the Minister replied: “The principle of a region with population responsibility and assigned to a team is very good. I just find, maybe, that we have a lot of teams. »
Christian Dubé wants to make Santé Québec a political legacy. “The greatest benefit I want to leave — one day I will retire — is to have made this permanent. That even if the next Minister of Health leaves, even if the government changes, that there is stability in health. Organizations and companies that work well are those that have stability. That’s what I want. According to him, the agency could be “operational by mid-2024”.