Minister balances health cost and care

As a retired nurse administrator who managed healthcare institutions and facilitated the development of managers in health-care organization and management for more than two decades, I read with keen interest of the challenges and issues at the MUHC.

I do this with some knowledge of the evolution of the health-care system in Canada — including Quebec — and other jurisdictions, and without a linguistic or political prism.

A Comparison of the Canadian and Australian Healthcare Systems (Philippon and Brathwaite, 2008) provides an interesting reference. They note that since 2002, legislation in Quebec allows for the minister of health to appoint the board and executive directors of acutecare institutions, with roles spelled out in legislation or regulations. The CEO reports to the board and the minister. They also note that a return to central control is being done everywhere to rein in spiralling costs.

We had a decentralized system where hospitals spent and the ministry routinely covered deficits. We also had labour representation on boards. The ministry allocates budgets with parameters that must be followed to meet the targets.

The MUHC is a regional entity providing acute-care services within an integrated system. The need for cost control is dominant, but must be done with the competing need for quality patient care in mind. Very few of us know how complex this task is.

As we share information about this issue we should be careful to keep the facts in mind. We are all advisory to the minister.

However, ultimately, he has the responsibility for funding the public health-care system and must be the decisionmaker.

G.A. Hollingsworth, LaSalle