2023-04-19 04:00:00
Christian Dubé today begins a marathon of consultations regarding his vast reform of the health network. Among the first groups heard, the managers of hospitals, CHSLDs and other facilities will demand resources and increased autonomy in exchange for their new accountability decreed by Quebec.
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The Minister of Health will hear 40 groups in parliamentary committee by May 23. Unions, professional orders and researchers will come to dissect his 1,180-article bill, a legislative overhaul on a scale rarely seen in Quebec.
Christian Dubé proposes to modify 37 laws, in addition to repealing that of Minister Gaétan Barrette who had abolished, in 2015, the health agencies to merge them into CISSS and CIUSSS.
At the heart of the concerns, the players in the network do not agree on whether Bill 15 will further centralize powers within the new single agency, named Santé Québec, or will delegate more responsibilities to the managers who will be appointed to the head of each hospital, CHSLD and other facilities.
Centralization or decentralization?
For the main union of nurses, Santé Québec is continuing in the vein of the Barrette reform.
“Have the mergers of establishments improved the working conditions of the healthcare professionals? Will the next announced merger yield better results? This is what we want, but if the past is a guarantee of the future, we may have reason to doubt it,” says the Fédération interprofessionnelle de la santé du Québec (FIQ), in a recent communication to his members.
As for the Association of Senior Health and Social Services Executives, the CEO welcomes the Minister’s wishes, but recognizes that several questions remain unanswered.
Autonomy
“I think we have to give the runner a chance to find out where we’re going with that,” says Carole Trempe.
Local managers are also advocating for change. “The status quo, for us, was not viable,” says Danielle Girard, CEO of the Association of Managers of Health and Social Services Establishments.
But both demand the appropriate means to achieve the objectives that will be dictated by Quebec. After all, the minister says managers will now be held accountable for results on the ground.
“When you are accountable and responsible, it is understood that it takes resources to deliver,” says Carole Trempe.
Danielle Girard agrees, but remains cautious. “What we hear from the minister is that he wants things to work better and that we have the resources. We salute that. Now, we have had many reforms where there have been many disappointments among our members. So a scalded cat fears cold water,” she points out.
Private placement agencies
Minister Dubé will be able to begin his consultations with a victory in his pocket: the National Assembly adopted his bill on Tuesday to gradually stop using private personnel placement agencies.
This is one of the elements of its plan to reform the network. A few weeks earlier, Quebec had adopted another bill to facilitate data sharing in the network.
“So the second piece of the puzzle is starting to fit, which I find very encouraging for the future,” commented the minister in the corridor of parliament.
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