2023-04-19 18:07:54
(Quebec ) Although he wants to make the managers of the health network accountable, Minister Christian Dubé must clarify the “counterpart of accountability” and establish their real room for manoeuvre, believes the Health and Well-being Commissioner. be.
Commissioner Joanne Castonguay opened the ball for parliamentary consultations on Minister Dubé’s Bill 15, which aims to make the health and social services network more efficient.
Although very much in favor of the creation of Santé Québec – a brand new Crown corporation that will coordinate all of the Department’s operational aspects –, Ms.me Castonguay issued certain reservations regarding the future autonomy of health establishments.
“The decentralization of responsibility and accountability to local decision-makers comes up a lot in the government discourse surrounding the bill,” noted the Commissioner. However, despite Minister Dubé’s intention “to decentralize decision-making to establishments, the bill does not confer the ‘operational’ component on establishments, but rather on Santé Québec,” she points out.
Moreover, the legislative text does not specify the “counterpart of accountability”, ie the leeway available to local decision-makers. In its reform, the Legault government also wants to bring back hundreds of local managers – one for each facility, hospital or CLSC.
It is questionable to what extent local managers will have the necessary autonomy to achieve the objectives that will be required of them from the central authorities.
Joanne Castonguay, Health and Welfare Commissioner
Fear for the centralization of contracts
Furthermore, M.me Castonguay expressed concern that the centralization of operations in Santé Québec would have negative effects on the awarding and management of contracts in the public network. “If we centralize as we do for contracts with Services Québec, then we lose sight of the objectives [qu’on recherche]this is what we have observed a lot in the context of the pandemic”, she illustrated.
In this sense, Bill 15 should provide for the possibility that Health Quebec may delegate certain powers to the CEOs of establishments, “otherwise the autonomy required to allow establishments to exercise real local management risks varying according to changes policies”.
“Titanic” work, says Dubé
Several criticisms have been voiced since the tabling of the bill at the end of March regarding the proposed decentralization and the minister’s accountability. The opposition accuses Minister Christian Dubé of wanting to rid himself of responsibility for what is happening in the network by creating Santé Québec, whose CEO will be accountable.
PHOTO JACQUES BOISSINOT, CANADIAN PRESS ARCHIVES
Minister of Health Christian Dubé
“I think we’re going to talk a lot regarding decentralization,” said the minister on his arrival for consultations. “Decentralization, we will have the chance to explain it to Quebecers, it also means being able to go close to the field, to be able to get closer to them to find out what they want”, he assured. Mr. Dubé assured that his bill can be improved and that he is open to amending it.
“We are embarking on a titanic task”, launched the minister at the opening of the consultations. Bill 15 is a brick of some 300 pages which contains more than 1200 articles. All opposition parties offered their cooperation to the minister on Wednesday. Christian Dubé remains optimistic that the legislative text might be adopted by the end of the parliamentary session in June.
Forty groups will be heard in the parliamentary committee, which is held until May 19 with a two-week break for the study of credits.
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