Since coming to power, and especially since the end of the COVID-19 pandemic, the Quebec government has been promising greater efficiency and patient service from Quebec's healthcare system. For over a year, Health Minister Christian Dubé has been hard at work. First to consult, then to make his proposals, and now to adjust and defend the reform. And things aren't going as planned.
First of all, the Minister has extended his consultation efforts, a highly commendable initiative. However, in the face of opposition from certain groups, he has had to add numerous amendments to his bill, delaying its consideration and adoption. In addition, six former Québec premiers publicly encouraged him to further modify certain aspects of the reform. Several of these ex-premiers had themselves cut their teeth as health ministers, trying to reform the complicated system. While some of their proposals make sense, a little more deference to their successors might have been expected.
In addition to political opposition, the Minister has to contend with an impressive corporatist force, embodied in labour unions and institutions wary of how change will affect their interests. In the face of this challenge, Minister Dubé is holding firm for the time being. He wants to avoid diluting the reform and turning the envisioned coordinating body – Santé Québec – into nothing more than a mishmash of unaccountable hospitals, facilities and programs. This situation is not surprising. Changing things calls into question an established, often clogged, order that some public players are prepared to defend fiercely.
Complicating matters further, the government’s negotiations with the public sector are not going very well, and a strike may be in the cards. As a result, healthcare reform has become a credibility issue for the government as a whole. That’s a lot of pressure for just one sector, however important it may be.
The general public still supports the reform, but it needs to be adopted quickly to avoid new pitfalls. Given the large number of amendments tabled, it is not certain that the whole bill can be adopted by Christmas. The law of entropy dictates that more delay inevitably leads to more disarray. It would be a pity if the desire to do things too well ended up eclipsing all the good that the proposed changes could bring.
For a government that has backed down on occasion, this is a crucial test. A test worthy of Minister Dubé's qualities and ambitions for Québec.