Recently, H+K hosted a virtual event where three experts from the firm’s Health + Wellness team dissected Quebec’s Minister of Health, Christian Dubé’s bill creating the Agence Santé Québec.
Former Minister of Health and Social Services, Dr. Yves Bolduc, former Ontario Deputy Minister of Health, Dr. Bob Bell, and former health policy advisor to the Coalition Avenir Québec (CAQ), Jean-François Landry, spoke about the clinical, organizational, and political aspects of this important reform, which has generated a strong reaction in Quebec and among national organizations that conduct business within the province. The discussion was moderated by former member of the National Assembly for Lévis, François Paradis.
Here are four highlights from the discussion:
1. Bill 15 will profoundly change the clinical and administrative governance of the health network
In particular, the new CEO of Santé Québec will have a great deal of power and will be accountable to the Minister of Health and to the members of a government-appointed Board of Directors. Santé Québec will become the employer of all employees in the health care network in a new, more centralized structure that will include only four major national unions. The creation of a medical director position would also reduce the power of influence of physicians within the health network. The mandate of the new medical director will undoubtedly involve many complexities, as managing physicians can be a challenge within complex organizations. This is especially true when they retain their self-employed status. In the end, decision making will be concentrated in the hands of very few stakeholders.
2. A long implantation marked by a transition period
Various branches of the Ministry of Health and Social Services will be transferred, in whole or in part, to the new agency. The new organization chart of the health network, including that of Santé Québec, is not yet available. At this time, many civil servants still do not know if they will remain in the ministry or be transferred to the agency. This vast game of musical chairs will create internal challenges of communication, management of responsibilities and governance. In addition, the implementation of Santé Québec will certainly slow down ongoing projects and reforms. The Quebec government has planned to invest a preliminary sum of $60 million to implement Santé Québec. Does this include the implementation of a computer system at Santé Québec that is compatible with the one currently used at the Ministry? This information is not available at this time, but one thing is certain: the coordination of information between health care institutions, Santé Québec and the Ministry is likely to be a major issue.
3. A minister who will remain a target
Despite the presence of a CEO at the head of Santé Québec, the Minister of Health will continue to be the target of journalists, opinion leaders, unions, professional associations and opposition parties. The Minister will still have to be accountable in the public arena and lead the Ministry of Health and Social Services. He will also have to make representations to the Minister of Finance and the President of the Treasury Board to obtain the budgets necessary for the proper functioning of Santé Québec.
4. An adaptation to be foreseen in representations
In addition to the office of the Minister of Health, the Ministry itself and the health care institutions, Santé Québec will be added to the list of organizations that stakeholders must meet with. It remains to be seen how senior management at Santé Québec will respond to requests for meetings from stakeholders and what direction the Minister of Health will give. One thing is clear: stakeholders will have to adapt their communication tools and strategic approach, in addition to mastering the new structure of the Quebec health network and the organizational culture of Health Quebec.
Our public affairs team specialized in Health + Wellness will be monitoring the situation to help our clients navigate this new environment. If you have any questions, please do not hesitate to contact us.