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In recent months, the CAQ government has undertaken aggressive reforms of Quebec's public sector, in the name of "flexibility", efficiency and the famous "competition". These terms have become a kind of mantra for ministers, guiding every bill and decree. However, their meaning remains hazy: for whom are we making things more flexible? Is it about reconciling work and family life, or about forcing workers to work at any time?
Without saying so openly, politicians use these terms in reference to "New Public Management" (NPM), an approach that emerged in the 1980s to justify reforms such as PL-15 in healthcare and PL-23 in education. Promoted by Margaret Thatcher, it aims to apply private-sector management models to public services.
The method gained in popularity with the proliferation of policies in favour of free enterprise, reduced workers' rights, deregulation and minimal state intervention in the economy - in other words, with neoliberalism.
NPM is based on two main ideas. Firstly, it integrates private-sector methods into the internal workings of the public sector, such as close monitoring of results, quantitative performance bonuses and the introduction of outsourcing.
Secondly, NPM pushes public services to act like private companies, integrating into the market and competing with each other. The key idea behind NPM is that the methods used in the private sector would be more "efficient" at organizing things.
As a result, NPM reforms are often seen as the first attack on the public sector in order to promote privatization. And with good reason: they serve to introduce the generally chaotic laws of the market into sectors that were previously relatively protected from them.
In so doing, they modify public organizations until the dividing line between private and public becomes so blurred that privatization becomes no more than a simple transfer of ownership. These reforms, usually pushed by external consulting firms such as McKinsey & Co, Deloitte and KPGM, make it easier to privatize education and healthcare.
But is the private sector really more efficient than the hated bureaucracy? While the latter certainly has its share of problems, several episodes in recent years demonstrate that the private sector is not the saviour so eagerly awaited by political and economic elites.
In 2020, when the coronavirus infiltrated CHSLDs, it infected over 15,000 elderly people and caused the death of around 5,000 of them. A year later, the figures reveal that, in general, the private sector has significantly higher mortality rates. The three worst, with mortality rates of 45% or more, were private CHSLDs.
In fact, the situation only improved in the second wave, after the government stepped in to alleviate the crisis in the private sector, by raising attendant salaries, providing subsidies and distributing personal protective equipment.
But maybe the private sector is cheaper than the public? Not according to the government's own data, which reveal, following a pilot project in three Montreal clinics in 2016, that surgeries performed in private clinics cost up to 150% more than in public facilities. These additional costs are pocketed by the owners of these companies, and are not used to improve services. All this, while the state and the public purse foot the bill.
In the end, the question to be asked is not the difference in flexibility and efficiency between the public and private sectors, but rather: who does this supposed flexibility and efficiency serve?
Citizens who want to benefit from an efficient, universal health and education system?
Governments, who can play with workers like a child with play dough, thereby reducing their costs?
Or the shareholders and big bosses of the private sector, who see the shift to the private sector as an "efficient" way of enriching themselves by taking even more out of workers' pockets?