A SYMPTOM OF A DEEPER PROBLEM
It took mere weeks after Bill 10 was rammed through the National Assembly for the most dire predictions about the dangers of concentrating so much power in the hands of the health minister to come true.
A flurry of high- profile resignations have shaken Quebec’s largest hospital network, the Centre hospitalier de l’Université de Montréal, with four top board members and the chief executive citing the interference of Health Minister Gaétan Barrette in daily operations as the reason for their untimely departures.
At issue is Barrette’s apparent insistence that Dr. Patrick Harris be reappointed chief of surgery at the CHUM, even though the board had struck two hiring committees that had both recommended a replacement. Barrette has denied he made Harris’s nomination a condition of chief executive Jacques Turgeon’s continued tenure at the CHUM; Bill 10 is forcing every hospital director in Quebec to reapply for their jobs. But scathing resignation letters from Turgeon and the board members say otherwise.
Politically, Premier Philippe Couillard must rush to the defence of another embattled minister as the opposition ( predictably) calls for Barrette’s head. But the interference in the CHUM’s internal affairs gives credence to the warnings of Bill 10’ s harshest critics that abolishing layers of bureaucracy and initially centralizing control with the health minister could give rise to an abuse of authority. Because that’s what second- guessing the selection of a hospital department head amounts to.
Under the health reform, the minister is now responsible for appointing the members of the
Unable to stop physicians from speaking out, Barrette has been unfairly demonizing doctors as lazy and/ or greedy.
34 mega- boards that will replace the governing bodies of 182 hospitals, rehabilitation centres, long- term care homes and local health agencies. An impartial committee is supposed to be set up to vet candidacies in the future. In the meantime, Bill 10 will abolish about 1,300 of 6,000 managers’ jobs and force those who want to stay to compete for the remaining positions.
Putting jobs on the line was a blunt instrument that damped criticism of Bill 10’ s reforms from within the health care sector when the government wanted to proceed quickly. In most cases, senior hospital officials, presumably not wanting to endanger their future job prospects, have remained silent at a time when the system most needs to marshal its best minds to sort out the turmoil the reorganization has wrought.
It is worrisome that the potential exists for this kind of meddling elsewhere in the health system. But how many whistleblowers would come forward, given the stakes? Turgeon and the CHUM board members deserve credit for having had the courage to stand up to Barrette publicly, at the expense of their own jobs.
This is a disastrous time for the CHUM to be rudderless only a year after Turgeon was named to right the listing ship and a year before its new superhospital is set to open. But this is also a crucial moment for the future of the health system, as the government forges ahead with Bill 20, an equally contentious reform that would impose patient quotas on doctors or penalize them financially. Unable to stop physicians from speaking out, Barrette has been unfairly demonizing doctors as lazy and/ or greedy.
This would be an apt time for the government to hit pause and take another look at both its bulldozer approach and Bill 20 — before public confidence not only in the Couillard government, but also in Quebec’s health system, is eroded.