MONTREAL – Will the Dubé reform “make the healthcare system more efficient”? To improve the minister’s ambitious bill, a wide range of interest groups will be heard before the parliamentary committee on Wednesday and Thursday. Further meetings are planned for the month of May.

Before the hearings began, Health Minister Christian Dubé told reporters he still aims to pass the law before the end of the current parliamentary session, which ends on June 9. However, he said he was “realistic” about the work to be done. About forty speakers will march before the Health Commission, then an in-depth study of the Articles will have to be conducted with the opposition.

Christian Dubé also welcomed the unanimous adoption of a motion calling on the parties to work together to improve the draft law. The minister tried to simplify the process by narrowing the 1,200 or so articles down to four main issues on which agreement can be reached.

He specifies that the law aims to separate the orientations of operations, improve clinical management, offer greater access to users and decentralize management to get closer to the field.

The Health Secretary introduced Bill 15 last month. The extensive document provides in particular for the establishment of a new state body called Santé Québec.

This new structure will be responsible for coordinating Quebec’s health network operations, while the department will retain its role in policy-making and budget allocation.

As the consultations approached, the minister reiterated his desire to take the time to listen to “all our partners, as well as the people on the ground”. He reiterated that his law could be “improved” and reached out to network players and the opposition to improve it.

On the opposition side, Vincent Marissal of Québec solidaire and Joël Arseneau of the Parti Québécois both raised concerns about the place given to the private sector in healthcare. We also try to ensure that the Secretary of Health remains accountable for the performance of the network and does not hide behind Santé Québec.

A pilot on the plane

On Wednesday, parliamentarians heard for the first time from Health and Welfare Commissioner (CSBE), Joanne Castonguay. She has analyzed many reforms in healthcare networks around the world. She emphasized that “there is a lot at stake in managing the transformation”. “It’s the continuous adjustments that matter,” she added.

She calls on the government to draw up a detailed plan for its transformation, to closely monitor its progress and results, and to constantly adapt as it does so. “Cultural evolution (of the network) takes a lot of time and a well thought out strategy,” she argued.

The commissioner commended several strategies Québec has adopted, including facilitating labor mobility and creating governing bodies that allow users to have their voices heard by managers.

Regarding decentralization, Ms. Castonguay fears that management of local operations will remain in the hands of Santé Québec as the facilities lose their distinct legal identities. They can therefore no longer enter into independent service contracts unless the state body delegates powers to local managers.

Other testimonials

The Quebec Auditor General and former Minister Me Michel Clair, who chaired the Health Services and Social Services Study Commission in the early 2000s, are also scheduled to be heard on Wednesday.

So are the Association of Senior Health and Social Services Executives, the Association of Managers of Health and Social Services Establishments, and the Federation of Medical Residents of Quebec.

On Thursday it will be the Patient Director and Scientific Co-Director of the Center of Excellence on Partnership with Patients and the Public, Vincent Dumez, then the Association of Councils of Physicians, Dentists and Pharmacists of Quebec, followed by the Council for the Health Protection and the provincial Merging of user committees that will speak.

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