No one disputes the patient’s distress. But many doubt the remedy that the Minister of Health is proposing, through his sprawling reform, to revive our health system. Christian Dubé is not at his first revolt. Since the tabling of Bill 15 last March, discontent has taken multiple forms. Still, the group shot of six former prime ministers is a different story.
Its symbolic charge not only shakes the foundations of the building, it affects the Prime Minister and undermines public confidence. Breaking a mold like that of health means launching headlong into the twelve labors of Hercules. Those who have encountered it have all more or less failed along the way, struck down by the bureaucratic hydra, the corporate Cerberus or the union lion, among other perils. We must salute the courage of the CAQ government to return to the arena in such a resolute manner.
The network needs urgent care, but also needs to be shaken up. A host of power games and unfair mechanisms must be undone. To untie the hands on the ground and bring the patient back to the center of concerns, Mr. Dubé wants to decentralize the beast by appointing directors in each of the hospitals, CHSLDs and other entities. But since in the end, Santé Québec will become the sole employer of the network’s 350,000 employees, it’s a bit of window dressing.
There is one word to describe the effect that this structure will have on the decentralized network that Minister Dubé dreams of, and it is “centralization”. This is also the opinion of the gang of six, who calculate that with advice everywhere and decision-makers nowhere, the risk of ending up with an emasculated counter-power is real.
It is difficult to find elements that work in the health network. Access to the first line has become a pure nightmare from which getting out seems more and more difficult, unless one resigns oneself to paying, which more and more Quebecers are doing, exasperated in fact.
It is a little better for secondary care, mainly given in hospitals. It is even more so where the most advanced care is practiced, that is to say in the famous research institutes and university hospital centers, for which the six former prime ministers have taken to the front. They are not wrong in arguing that these cutting-edge establishments — flagships of which we can be proud — excel and demonstrate a spirit of initiative which risks extinguishing if we deprive them of the oxygen provided by a full institutional autonomy. We are less certain of the solidity of their arguments surrounding the fate of powerful private foundations which have always, and under all political banners, had the attentive and eager ear of high levels. But the Caquistes are also right to want to put an end to management in isolation and cut the privileges of these elite players whose appetites have an impoverishing effect on the rest of the network.
The public, above all, needs to believe that the patient can still be saved. For everyone, it is undoubtedly good at this stage to recall the words of the alchemist Paracelsus: “Everything is poison, nothing is poison: it is the dose that makes the poison. » There is still time to adjust the dose.