(Quebec) The ex-president of the commission who scrutinized the health system has reservations about Minister Christian Dubé’s choice to make Health Quebec the sole employer of the network. Quebec must leave local bargaining power to organizations if it wants to operate a real decentralization, believes Michel Clair.
The author of the Clair report, which precisely recommended the creation of a “national agency” centered on operations, said he was surprised by the intention of the Legault government to make its future state corporation, Santé Québec, the sole employer in the health network and thereby merging union seniority. “That’s what surprised me the most,” Michel Clair told The Press.
According to him, the government must allow Health Quebec to offer “a space for negotiation and adjustment of national collective agreements” to local organizations to avoid the negative consequences of “wall-to-wall” type solutions. He cites as an example, a nurse close to retirement who decided to settle in Magog and who would dislodge younger workers from the region.
“If everything is settled [selon la version initiale du projet de loi], we are going to have a convention, a rule which will apply to 350,000 people, that cannot be, ”he adds. Quebec must therefore in return allow local agreements between the union and the employer, in particular to “weight seniority with competence, according to the positions and the particularities of the different environments”, according to the former PQ minister.
If Minister Christian Dubé wants to make the health network “an employer of choice”, it goes without saying to allow organizations “to bring a local color to create a feeling of belonging and adjust the organizational culture”, considers the ex-chairman of the Commission for the Study of Health and Social Services, which published its report in 2001.
Decentralization?
Again on Tuesday, François Legault affirmed at the Blue Salon that Minister Christian Dubé “is putting a CEO in each establishment to [que le réseau soit] decentralized”. The Prime Minister was responding to the grievances of the parliamentary leader of Québec solidaire, Gabriel Nadeau-Dubois, who accuses the Legault government of “complete” the centralizing reform of Gaétan Barrette.
Michel Clair does not believe that the Dubé reform in its current form would decentralize powers despite the addition of hundreds of local managers – one for each facility, hospital or CLSC. “These directors, if they are just in a vertical hierarchical structure, their real boss, it will not be the population, it will be the person above”, he illustrated.
Bill 15 also abolishes the boards of directors of the CISSSs and CIUSSSs to create governing boards. Michel Clair believes that Quebec should also add another local body that would be accountable to the population, such as a monitoring committee by MRC or CLSC territory.
“Real decentralization, these are boards of directors with specific legal persons, me, that would have been my preference. But I look at the bill and I say to myself: yes, that could be an approach, but here are the conditions if we want at least there to be a spirit of decentralization to recreate local cultures and have transparency in local results. »