Opinion: Quebec’s health reform puts community connections at risk

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Bill 15 hands control to Quebec City bureaucrats who won’t benefit from the feedback we get from our users, their families and volunteers.

Author of the article:

Alan Maislin • Special to Montreal Gazette

Published Nov 07, 2023 • Last updated 51 minutes ago • 3 minute read

A 2021 photo shows flags flying at half-mast outside the Jewish General Hospital in Montreal in honour of those who died during the first year of the COVID-19 pandemic. — A 2021 photo shows flags at half-mast outside the Jewish General Hospital in honour of those who died during the first year of the COVID-19 pandemic. “Community involvement is our secret ingredient,” writes Alan Maislin, president of the board of directors of the CIUSSS West-Central Montreal. Photo by Allen McInnis /Montreal Gazette

It’s time to echo the sentiments of six former Quebec premiers by sounding the alarm about Bill 15.

Bill 15 will centralize control of our health and social services system under the new Santé Québec agency — or, more precisely, under its board of directors and its general director, to whom all 30 leaders of the province’s regional health authorities (CHUs, CIUSSSs and CISSSs) will report.

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At the CIUSSS West-Central Montreal, our board of directors will no longer exist.

And yet we owe our success to our culture and to the pillars upon which our CIUSSS is built — our board of directors, administration, corporations, foundations and volunteers. Our connection to our community is our lifeblood. We excel thanks to these pillars — but it is these pillars that Bill 15 is putting at risk.

Consider the following two examples.

After Hamas’ call for violent actions against Jews and Jewish establishments around the world on Oct. 13, CIUSSS West-Central Montreal took precautionary measures to protect staff and health care users by cancelling all non-essential services and activities. This decision, made after management consulted with police and with Federation CJA, was authorized by our board of directors.

On a more uplifting note, we launched our expanded command centre in late September to better manage patient flow.

The concept behind the command centre was developed by our CIUSSS management team and then tweaked by the board. We then secured startup funding from the Jewish General Hospital Foundation.

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In promoting Bill 15, the government of Quebec cites Alberta as its model for centralized health care. Yet, according to a study by the Fraser Institute, centralization has failed in Alberta where not surprisingly the government is now reviewing its approach. Also noteworthy is that neither Ontario nor British Columbia has opted for a centralized model.

By pursuing a failed model, the government of Quebec is handing control of our health care system to bureaucrats in Quebec City, who will not benefit from the feedback we receive on a daily basis from our users, their families and volunteers. Nor will they be inspired to innovate.

In addition, the foundations of our CIUSSS contribute close to $70 million annually to health care. And our donors will not offer financial support to what will be perceived as a government entity.

Rather than decimating our CIUSSS, the government should amend Bill 15 to allow us to maintain our board of directors with the power to set our strategic direction and take the lead in the selection of our general director. We are also asking that our foundations remain connected to our general director who, in turn, should retain authority over the allocation of donated funds.

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Our CIUSSS — particularly the Jewish General Hospital — is an international brand synonymous with clinical excellence, teaching, research and groundbreaking innovation. We train more than 3,300 students annually and oversee three recognized research institutes. We want this to continue and are asking for immediate official recognition as a university network, rather than in the next three years, as specified in Bill 15.

As well, research should remain outside the purview of Santé Québec and continue to be under the direction of our general director.

As I have said, community involvement is our secret ingredient. The constituent facilities of the CIUSSS were created and built by the community. MAB-Mackay, Father Dowd and Constance-Lethbridge, to name only a few, have deep roots in English-speaking Quebec. The Jewish General Hospital, Maimonides, Miriam Home and others have flourished, thanks in large part to support from the Jewish community. It is critical to emphasize that our community established these institutions decades ago to provide a continuum of care across people’s lifespan.

It is our hope that we can build on this foundation of community involvement in order to improve access to health care to the benefit of the Quebecers we serve.

Alan Maislin is president of the board of directors of the CIUSSS West-Central Montreal.