The project to overhaul the health system appears gigantic, at least in its current presentation, but Minister Christian Dubé is open to discussion.
It has now been two decades since consultants from the prestigious firm McKinsey, a strategic and operational management consulting firm, reported in what has become a “bestseller” (In Search of Excellence, Thomas Peters, Robert Waterman, 1982) the results of their investigation to discover the secrets of the best companies. Among other things, they noted that the structure of a company, whatever its size, constitutes a tiny part of its efficiency and that it benefits from being simple and light. Simple.
The Santé Québec agency introduced by Mr. Dubé is in fact presented as an intermediate structure, which must be simple in its constitution as well as in its function, which is to ensure the link between the decision-making department and the operational network. Unlike the unidirectional up and down mode (top-down) that we have known so far, this agency must be equipped with a two-way belt in a continuum of exchange, sharing and accountability. Lightweight. Still according to the authors, the size of a company is in itself a major element of complexity.
The health care system, which has been described as a monster and more recently a mammoth, includes health, social services and public health. In fact, it is the equivalent of three departments under the same management. The latest ministerial draft has given more space to social services under the responsibility of Minister Lionel Carmant. It would also be necessary to create a space for public health, whose essential role we have just discovered. In fact, it would even deserve the status of a ministry which would be the first model made to measure with a simplified and lean structure.
So Mr. Dubé will be able to focus on operations, where it is happening and where it counts, and the major challenges deserve that he devotes the maximum of his efforts to it. Supported by a revitalized and much more functional structure, he must, as a good manager, bring people together, listen and trust the people who have the knowledge and experience of the network and who must manage the day-to-day complexity of health care.