CAQ unveils Santé Québec, the new agency in charge of fixing the province's health-care system

François Legault's government is banking on a new provincial agency to fix its battered health-care system, and it's called Santé Québec.

The creation of Santé Québec is the foundational piece of Bill 15, which Health Minister Christian Dubé tabled at the National Assembly on Wednesday.

If it becomes law, Santé Québec would oversee all activities related to the public health-care system, including providing services and facilitating access.

The province's Health Ministry would provide broad guidelines, Dubé said, but Santé Québec would be the organization in charge. 

Santé Québec would also help organize elements of the private sector.

"It will be a separate entity with a small management team that will be responsible for operations, and developing the means to achieve results," the minister said.

The agency would also become the sole employer of the province's health-care employees and would supplant regional health agencies — known by their French acronyms CIUSSS and CISSS.

There are currently 34 regional health agencies in the province. This bill, if passed, would turn those regional health agencies into councils that answer to Santé Québec and monitor how effective services are. 

During a news conference Wednesday, Dubé described the bill of about 300 pages as "the fruit of colossal work" from the last few years.

"The status quo is not an option," the minister said, accompanied by Lionel Carmant, the province's junior health minister responsible for social services, and Sonia Bélanger, the minister responsible for seniors. 

During its first mandate, which saw the province endure several harsh waves of COVID-19, the CAQ government often blamed the health system's shortcomings on the previous Liberal government.

A few months into its second term, Bill 15 appears to be the CAQ's attempt at reforming that system it inherited in 2018.

If adopted, the law would not apply to the Naskapi, Inuit and Cree communities. 

What this means for patients and staff

According to Dubé, a more organized structure at the top will lead to reduced wait times in emergency rooms, put a dent in the backlog for surgeries and improve the overall patient experience.

With the current system, a CIUSSS or CISSS is in charge of hospitals, long-term care homes and other facilities within a given region. In many cases, that means the person in charge of a facility is not physically there.

"For me, that makes no sense," Dubé said.

With Bill 15, the CAQ wants each facility to have its own on-site directors. The law would also allow for regional directors — one for family medicine, the other for specialized medicine.

"We have to decentralize the decision-making process," Dubé said. "That's what's important. We have to be able to have a doctor or a nurse in a hospital in Saint-Jérôme bumping into their hospital director in the hallway."

The bill would also allow the seniority of health-care staff to be recognized across the province, not just within a certain region. That way, if a nurse from the Laurentians gets transferred to Montreal, she will preserve her seniority and the advantages that come along with it. 

Although the proposed legislation deals largely with how the health-care system is managed, there are elements that deal specifically with access to care.

The government wants the Quebec Federation of Medical Specialists (FMSQ) to do more and be available for more patients in different facilities in a given region, at different times of the day.

In a statement, the president of the FMSQ blasted the government, accusing it of being out of touch with reality.

"It is profoundly unacceptable to imply that medical specialists aren't present in hospitals after 4 p.m.," said Dr. Vincent Oliva.

Reform misses mark, unions say

The FMSQ isn't the only union unimpressed by the bill.

Robert Comeau, the president of the Alliance du personnel professionel et technique de la santé et des services sociaux (APTS), one of the largest health-care unions in the province with about 60,000 members, says Dubé's plan is flawed by the lack of consultation with workers who know the issues that plague the system better than anyone.

"Centralizing more and consulting less, it's a perfect recipe to worsen the situation," Comeau said.

The Fédération de la Santé du Québec, which is affiliated with the CSN union federation, agrees. Its representatives say the CAQ is trying to change a structure without tackling root problems.

Julie Bouchard, the president of the Fédération interprofessionnelle de la santé du Québec (FIQ), which represents 80,000 nurses, licensed practical nurses, respiratory therapists and clinical perfusionists, says recognizing staff seniority across the province "is not what will help the Quebec population have full access to the care they are entitled to."