Savoie Report: Quebec proposes new healthcare reform

Quebec plans to add at least a hundred new middle managers to the healthcare network, in addition to creating a unit responsible for managing national affairs.

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These are the two main recommendations of Deputy Minister Dominique Savoie’s report published on Wednesday. Health Minister Christian Dubé has already indicated that he intends to implement all of his recommendations.

The exercise commissioned by Mme Savoie aimed to provide a diagnosis of the network’s governance in the face of the pandemic’s failure.

Unsurprisingly, she is proposing the creation of middle management positions better equipped to run facilities, a shortage highlighted by the COVID-19 crisis when Quebec has sometimes been unable to know what happened on the spot. .

“I have doctors who tell me: It doesn’t make sense that I’m in a hospital. […] then I can’t look who is in charge of the hospital, that I have to go to the CISSS, then to the CIUSSS, to someone who is in charge of three, four facilities,” Minister Dubé illustrated during a press conference.

While some 1,300 executives were sacked following the Barrette reform in 2015, Minister Dubé is proposing to reinstate “one or two hundred” of them.

structural reform

What is more surprising, however, is that the Savoie report also proposes the creation of a new body which would be given certain responsibilities of a more national scope, currently held by the Ministry and the CISSS/CIUSSS.

Again, the lessons of the pandemic demonstrated the benefits of coordination between the CEOs of the CISSSs and CIUSSSs with the Ministry and the other key players in the network.

For example Mme Savoie notes that “major project management, building stock appointment responsibility, certain cross-divisional functions (HR, RF, RI, acquisitions) and good clinical practices” could be handled by this new entity.

This new proposal will be debated in the context of the forthcoming election campaign. “On this second recommendation, I will take a step back because there are many implications, but I want to tell you that it is much more up to my political party to come back to this very clearly in the coming weeks,” said Christian Dubé.

Fix the brace reform

In other words, Minister Dubé is proposing to make corrections to Minister Gaétan Barrette’s reform, which abolished health authorities, in order to centralize powers within a limited number of CISSSs and CIUSSSs.

An amazing decision by the minister, who had promised since taking office not to touch the structures of the health network.

If Quebec goes ahead, Deputy Minister Savoie reminds in her report that caution must be exercised to avoid “destabilizing structures like 2015”.

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