Health network managers support Minister Christian Dubé’s reform. But they want to be sure they are consulted when the time comes to implement changes locally.
“We welcome the Minister’s wish and we are with him, but “scalded cat fears cold water”, summarizes Danielle Girard, president of the Association of Managers of Health and Social Services Establishments (AGESSS).
AGESSS represents 10,000 managers and middle managers. The latter manage teams locally, but are not at the top of the hierarchical pyramid of the network.
The last reform left them with a bitter taste and they are afraid of everything “To be dictated to”, specifies Mme Girard, who calls for “autonomy” for its members. Network managers also fear that the reform will not yield results, she continues. “The fear is: will this reform work this time? »
AGESSS is one of the groups that will be heard in parliamentary committee on Bill 15 as of this Wednesday. This voluminous bill of more than 1,000 articles lays the foundations for a vast reform of the health care system. This reform provides in particular for the splitting of the Ministry of Health into two parts and the creation of an agency — Santé Québec — which will manage the day-to-day operations of the network.
3,000 more administrative staff
Since its introduction, the bill has been widely criticized for its centralizing overtones. “We need administrative staff to fill out paperwork instead of making real decisions,” laments Anne Plourde, researcher at the Institute for Socioeconomic Research and Information (IRIS). “It’s the style of management that has caused the problems that are driving the reform and we are being told to go even further in the wrong direction.”
IRIS also recalls that the Health Plan, launched in 2022, provided for the hiring, in the short term, of 3,000 additional administrative staff in the network. The government says it needs it to “reduce the time spent by nursing staff on administrative tasks”. However, for IRIS, which is due to publish a study on the subject on Thursday, this is a sign that too much energy is devoted to “rendering of accounts” and not enough to local decision-making.
Again on Tuesday, Minister Christian Dubé was questioned in parliament on the centralizing claims of his bill.
During the question period, the solidarity deputy Vincent Marissal notably deplored the absence, in the plan, of “boards of directors with specific legal persons”, like what the former minister advocated. PQ member Michel Clair, who will also be heard at the commission on Wednesday.
” We [veut] local management”, defended the minister on Tuesday by promising “management close to the field”.
Mr. Dubé claims that his reform is decentralizing because it provides for the creation of new director positions in each installation and establishment in the network (hospitals, CHSLDs, CLSCs, etc.).
In addition to AGESS and Mr. Clair, the parliamentary committee will hear on Wednesday the Commissioner for Health and Welfare, the Auditor General of Quebec, the Association of Senior Health and Social Services Executives and the Federation of Medical Residents .