What is the connection between the computer fiasco of the Société de l’assurance automobile du Québec (SAAQ) and the will of Christian Dubé, Minister of Health and Social Affairs, to hire private sector shock managers for the health network? It is accountability, an essential guarantee of good governance.
First, the SAAQ. The first lesson to be learned from this computer fiasco is that computerizing the files of millions of citizens will always be a challenge for any government.
But Cybersecurity and Digital Minister Éric Caire has really done the minimum service. When the controversy erupted earlier this month, Mr Cairo did little to admit any responsibility.
“We asked the SAAQ if they were ready. The SAAQ told us: We are ready. So let’s let them go,” he told the National Assembly.
A few days later, the minister added a shift: “It’s a SAAQ project, designed by SAAQ and managed by SAAQ, so it’s up to them to explain what’s going on and what they’re going to do in the fall, i.” asked for information and the ads we were shown were green. So I’m extremely surprised by the situation,” he said on March 8.
Back from spring break, Prime Minister François Legault went in the same direction: “What I would like in the coming days, the next few weeks, is to evaluate the work of the SAAQ Board and the SAAQ President, because there is obviously a serious lack of planning gave. »
In short, both the minister responsible for digital and the prime minister have found a way to take responsibility instead of taking their share.
Fortunately, Transport Minister Geneviève Guilbault had quickly returned from a mission to Europe to take practical action to reduce wait times at SAAQ. But we cannot say that the government in general has been very proactive on this matter. It felt more like we were trying to find who to blame.
What brings us to health.
During last year’s election campaign, Health Minister Christian Dubé promised to create an agency called Santé Québec to coordinate the day-to-day running of the health system. The Department of Health and Human Services would continue to plan and measure the performance of the network.
However, opposition parties in Quebec are more likely to say they fear this will serve to absolve the minister of responsibility and allow him to blame the agency if the soup gets too hot.
Nothing tells us from the start that creating another box in the complex organizational chart of this sector will improve healthcare management in Quebec. But we will give the runner a chance, the minister is convinced of that. Also last week he promised to “shake” the pillars of the temple with his forthcoming bill.
However, we just saw at SAAQ how an independent agency can serve as a scapegoat in times of crisis. It was easy for the government to blame the company and its independent board for the IT fiasco in an attempt to evade any form of accountability.
By the way, the computer file of the SAAQ is very small compared to the computerization of the medical record. The SAAQ only requires a few data: name, address, license number, registration number. It’s not much more complicated than the White Pages that Bell Telephone used to publish. Now imagine the complexity of the medical record, which can contain hundreds of pages of data, not to mention the confidentiality issues.
And now Mr. Dubé adds a problem. He wants his new health agency to be run by “top guns” whom he would poach from the private sector with salaries that would be competitive with those in the private sector.
Since the fear of “health two classes” has been around for so long, here are the health system leaders who will have two class pay.
There can hardly be anything more demotivating for today’s healthcare network managers. Granted, they have their flaws, but they’re the ones that’ve kept the network at bay for years. And they are now being told that at the highest levels they will be replaced by “top guns” paid with “top money” of course.
And if we think this is how we can increase accountability, we are clearly on the wrong track.
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