Gag Order to Force Adoption of Bill 10 : The FMSQ's Reaction
Not content with having endorsed the tabling of a Bill so badly thought out and written that as many amendments as initial sections, the Couillard government today decided to impose a gag order to force its adoption. It is rushing headlong, in spite of all the objections and warnings formulated by the healthcare network's actors as a whole. "With the equivalent of 10 working days of parliamentary committee work to study this enormous piece of legislation, the Minister of Health has already reached his quota ?" asked the President of the FMSQ, Dr Diane Francœur.
"Here we are, powerless, facing another reshuffling of structures, essentially for budgetary reasons. Today, we're given the same arguments to justify the adoption of Bill 10 at all speed. A reform of such a magnitude cannot be accomplished by muzzling everyone and by botching the work. Nevertheless, the past is always ahead of us," continued Dr Francœur.
The last major reorganization of structures took place in 2003, when Philippe Couillard was Minister of Health. The regional régies were going to disappear and we were promised the sun and the moon : there would be no more waiting in the ER; the patient would be at the heart of decision-making; things would be closer, more efficient; there would be better services, less bureaucracy; and, of course, the savings would be important. So, what happened ? The régies became the agences, the CSSSs appeared, the savings disappeared, and most of all : the patient never benefited from the big upheaval.
"Rather than sitting down with the various actors of the network and keeping an open mind in order to find concrete solutions to the problems of access for the benefit of patients, the Minister has chosen to show off by turning the structures upside down, just like his predecessors. His arguments are populist and his only aim is to seduce voters. People who work in the healthcare network and who are against this Bill cannot all be wrong ! The network is already in bad shape. This reform may just kill it off completely. Today, Gaétan Barrette makes the same promises to the population, while undoing what Philippe Couillard did," concludes Dr Francœur.
In his quest to rewrite everything, Minister Barrette is deleting the essential.
A look back at the principal criticisms and warnings formulated by the FMSQ regarding Bill 10
About modifying current structures
- The current reform proposes a centralization of structures and decision-making methods that goes against the present consensus of experts in the organization of healthcare services who recommend a greater decentralization.
About regional superstructures
- Merging all the institutions into a single regional entity results in the creation of a regional superstructure instead of increasing the autonomy and margin for manœuver of healthcare facilities;
- Questions are left unanswered, on the administration of these new institutions as well as on the organization of care and the provision of medical services;
- Some regional institutions will round up thousands of physicians, located in a many different institutions, sometimes separated by several hundred kilometres;
- Current legislative provisions were adopted many years ago within a framework of distinct local institutions, not one of regional superstructures;
- Arbitrary and excessive obligation are planned to force physicians to move from one to another facility;
- No local level representation is planned concerning departments, services and CMDPs.
About ministerial and government powers
- This Bill puts back into question the local organization of healthcare and concentrates an uncommon range of powers and responsibilities in the hands of a single person, the Minister of Health and Social Services;
- The extent of the ministerial appropriation of powers currently belonging to the agences.
- The Minister will be able draw up regulations that would establish the rules applicable to the organizational structure of institution management; also by regulation, he will be able to establish any other measure that a public institution would have to respect regarding organization and management of resources;
- The Bill grants the government the almost unlimited power of adopting regulations on any measure it deems necessary or useful to the application of the law or to the efficient realization of its objective;
- The Bill provides that the regulations adopted by the government would not be submitted to the obligation to publish nor to a delay prior to effective date as set out in the Regulations Act.
Finally, this Bill generates numerous questions on the future of medical practice without providing any answers.
The Fédération des médecins spécialistes du Québec represents close to 10,000 medical specialists certified in one of the 53 recognized medical specialties.