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The creation of the Agence Santé Québec, structured like a large corporation and headed by leaders of major hotels and private medical services, is raising serious concerns. According to Anne Plourde, researcher at the Institut de recherche d'informations socio-économiques (IRIS), the agency's stated objective of increasing the "efficiency" of Quebec's healthcare network will enable further capitulation from the provincial CAQ government to the Quebecois and Canadian oligarchy.
In 2022, the CAQ government presented the Agence Santé Québec project, aimed at creating a centralized network to manage all municipal and regional institutions. It will also subsidize "private providers" to offer "health and social services," as set out in article 23 of the reform.
On April 29, Health Minister Christian Dubé announced the appointment of the new agency's Board of Directors. At its head, he appointed Geneviève Biron, former CEO of Biron Groupe Santé, a chain of private medical laboratories.
Then, on May 23, he appointed Christiane Germain, co-founding president of the Groupe Germain hotel chain and founding member of the CAQ, to the Board.
In light of the government's statements and recent appointments, Anne Plourde reiterates that the CAQ is not doing anything new. Drawing inspiration from the private sector and importing its management methods is exactly what all Quebec governments have done in recent decades:
"If we look at the consequences of previous reforms, we can try to predict what will happen as a result of the current reform because, contrary to what one might think, this current reform is in complete continuity with previous ones."
"I'm thinking of the Couillard reform of the early 2000s and the Barrette reform of 2015," she clarifies. "These two reforms led to the centralization of management, mergers of establishments, increased use of management methods specific to the private sector, such as the so-called new public management, and increased privatization of services."
"If we analyze the bill and the current government's statements, what we can see is that the current reform is heading in exactly the same direction," she adds.
Anne Plourde also points out that not only is this reform far from an innovation, but that there is no evidence that it will actually improve the state of the network or make it more efficient. If anything, the data indicates the opposite.
The private sector has long been a major player in Quebec's healthcare sector, and the data to assess the effectiveness of McKinsey-style management is available:
"When you analyze the different models that exist in Quebec and their ability to improve access to health services, to relieve overcrowding in public hospitals, to reduce costs, to offer quality services, it's a dismal failure. The data is very clear, both here and internationally."
It's hard, then, to believe that the government's real objective is to improve the efficiency of healthcare services. The appointment of Christiane Germain and Martine Biron, as well as the general organization of the new agency, suggests that this reform will be aimed more at pleasing the oligarchs who are friends of the CAQ government, which is itself headed by a former CEO.
Anne Plourde adds that "what we risk seeing happen is an accentuation of the problems we're trying to solve with this reform. [...] So, in my opinion, the problems of deteriorating working conditions, service quality, and access to services that we've been seeing in the healthcare network for quite some time now are likely to get worse."