(Quebec) In an extremely rare outing, six former prime ministers criticize Christian Dubé’s reform with one voice. They even spoke directly to François Legault, dissatisfied with the amendments presented Tuesday by the Minister of Health.
The Prime Minister’s Office confirmed it received a letter signed by six former prime ministers mid-afternoon Tuesday, shortly after Minister Dubé presented a series of amendments to further adjust his Bill 15, which aims to make the health and social services network more efficient.
At the center of his proposals: give more powers to future governing boards which will replace the boards of directors and clarify the entire process of granting donations to foundations. This exit by Christian Dubé is not unrelated to pressure from former prime ministers, first reported by Radio-Canada. Mr. Dubé also confirmed on Tuesday that he had “discussions” with some of them.
“A prime minister told me: “go as far as possible […] by not distorting your bill.” Then, it resonated with me because these prime ministers I spoke to are quite respectful of the work of a minister. They are able to say: ‘Listen, we’ll give you the message, but we don’t need to know what you’re going to do tomorrow morning,’” Mr. Dubé summed up in a press scrum on Tuesday.
However, a source close to the file confirmed to The Press that the missive was sent after having read the amendments proposed by the minister since these are not sufficient, according to them. The letter is dated October 24, 2023 and addressed only to the Prime Minister. It is signed by Pauline Marois, Lucien Bouchard, Jean Charest, Philippe Couillard, Daniel Johnson and Pierre-Marc Johnson.
As you know, we have never intervened together before today. But in the current circumstances, we believe it is our duty to share our concerns with you.
Excerpt from the letter
Former elected officials are opposed to hospitals and university institutes being “merged” into Santé Québec, the new state corporation created by the Dubé reform. According to them, this “will have a significant negative impact on these institutions which play an essential role in democratic society”.
It is emphasized that these institutions bring together “in the same organization care, research, teaching, technology evaluation and prevention”, that “their activities are inseparable and perfectly integrated” and that they “also each have their own history and their specificities.
Bill 15 creates Santé Québec, which will become the sole employer of the health and social services network. This new state corporation must supervise the entire operational aspect of the Ministry, which will be able to concentrate on defining the main orientations. The boards of directors of establishments will be replaced by establishment councils.
“The assimilation of the Montreal Heart Institute through its complete merger into Santé Québec, or even the dissociation of these pillars would break the spirit of the Montreal Heart Institute and reduce the major clinical impact of its discoveries,” cite former elected officials as an example. At the heart of their grievances: the loss of a distinct legal entity per establishment.
The merger at Santé Québec […] other university establishments would inevitably lead to a decline in their performance in the pursuit of their mission of excellence in health, to the detriment of patients and all of Quebec society.
Excerpt from the letter from six former prime ministers
Dubé partly brings back the boards of directors
Faced with these concerns, the Minister of Health tabled amendments on Tuesday which will bring the governing boards closer to the current boards of directors. He proposes that “the functions and powers” of the boards of directors relating to “teaching, research and innovation” be delegated to the governing boards and not to Santé Québec.
The name “establishment boards”, as initially provided for in the bill, would be replaced by “establishment boards of directors” in order to reflect their new functions, it was indicated. Files related to philanthropy would instead be entrusted to the presidents and CEOs with the support of a foundation linked to the establishment.
“What Santé Québec is going to do is that it will delegate to the different establishments, the CHUs, the CIUSSS, the whole question of research, the whole question of foundations, the whole question of innovation, so there has a delegation of powers,” assured Mr. Dubé.
I want to be very, very clear here, because perhaps a lot of things will be said in the coming weeks, but there is one thing that is clear: the children, they will continue to go to Sainte- Justine, people will continue to go to the CHUM. There is no one who will lose their identity.
Christian Dubé, Minister of Health
At a press briefing in Quebec, the minister explained that he had simmered on this compromise for a long time while he wanted to find a way between the coordination of establishments and the maintenance of their autonomy.
Christian Dubé still defended his choice to limit the powers of boards of directors by speaking of the need to put an end to management in silos. The creation of Santé Québec should promote better collaboration between establishments and institutions. Conversely, by nature, boards of directors have a duty to protect their establishment first before considering collaborating with other entities.
With The Canadian Press