Gaétan Barrette tables bill to overhaul Quebec’s health care system

Health Minister Gaétan Barette tabled Bill 10 today, which the government says will cut down on bureaucracy and save the province roughly $220 million a year.

Health minister's Bill 10 would eliminate entire layer of bureaucracy, cut 1,300 management jobs

Health Minister Gaétan Barrette says it's time to reform the health care system so that "it works for the patient." (CBC)

The province is pushing forward with a massive reform of the health care system.

Health Minister Gaétan Barrette tabled Bill 10 today, which the government says will cut down on bureaucracy and save the province roughly $220 million a year.

Right now, the citizens of Quebec are not getting their money’s worth.- Gaétan Barrette, Health Minister

“Right now, the citizens of Quebec are not getting their money’s worth,” Barrette said during a news conference as he unveiled his plans.

Eliminate agencies, merge health care centres

If passed, Bill 10 would eliminate an entire layer of bureaucracy — namely, the province’s 18 regional health agencies.

Right now, the agencies act as middlemen between the minister and the province’s Health and Social Services Centres (known as CSSS).

Many CSSSs — which manage hospitals, clinics and long term care facilities — would also be merged.

Instead of the 182 that exist today, there would be 28 which would become integrated health centres (CISSS).

Bill 10 Recap:

  • the creation of integrated health and social services centres (CISSS)  with one CISSS in each of the province’s 16 health regions —  except for Montreal, which will have have 5 CISSSs;
  • the elimination of Quebec’s 18 health agencies
  • the elimination of 1,300 management positions
  • the merger of 182 health and social services centres (CSSS) into 28 integrated centres (CISSS)
  • The reduction of administrative boards from 200 to 28.
  • No changes for Montreal’s MUHC, CHUM, Sainte-Justine Hospital and Montreal Heart Institute

Barrette says these integrated centres will work to coordinate all the services a patient would need.

For example, Barrette said that under the current system, if a cancer patient needs to find a surgeon following a mammogram, “she is told by her family doctor, ‘Find yourself a surgeon.’ This is unacceptable.”

Barrette said that under Bill 10, doctors’ offices would coordinate everything through the new CISSS to get patients their appointments.

“We want to seize this opportunity to make, what we consider, the necessary change in the culture of our network in order to make sure once and for all the system will work for the patient. Period," Barrette said.

The government says the move would eliminate 1,300 managerial jobs, mainly through attrition and moving employees into other vacant positions in the system.

More ministerial power

With all health facilities being grouped under regional bodies, their individual boards would be eliminated and replaced by one regional board — appointed by the minister.

This would drop the number of boards from 200 to 28.

Bill 10 would also give the minister more power to intervene in the system when he thinks something is wrong.

The opposition is worried that will give the ministry too much power.

“We agree that we need an update of our health system and some new way to monitor this, but it should be targeted on the patient outcomes,” said Parti Québécois health critic Diane Lamarre.

Union leaders are also concerned.

“We think this is a terrible bill. It concentrates the power of what services are offered all over Quebec in the hands of the minister and friends of the minister because he will name the majority of independent members. That’s a lot of power in the hands of one person," said Jeff Begley, president of the FSSS-CSN which represents more than 130,000 workers in Quebec's health care and social services system.

Barrette said he’s not surprised there is some pushback to his plan.

“I expect that there are some pockets of resistance — it is quite normal. But the consultations I have done show me that people expect these changes and there are many people in the network who wanted them to happen earlier,” he said.

5 new centres for Montreal

Due to its higher population density, the island of Montreal will get five new health, rehabilitation and social services integrated centres (CISSS).

These five centres would share the management of hospitals, nursing homes, CLSCs and rehabilitation centres.

The McGill University Health Centre (MUHC), University of Montreal Health Centre (CHUM), Sainte-Justine Hospital and the Montreal Heart Institute will not be affected.

Barrette also said that all of Montreal’s anglophone facilities will get to keep their English status under the new structure.

“In no way do we want that link to be severed. We want those links to remain and I fully support the attachment — even emotional attachment — with their institution and I don't see why this should be altered in any way,” he said, adding that Bill 10 is just a part of the government's plan to cut $3 billion and balance the budget over the next two years.


To encourage thoughtful and respectful conversations, first and last names will appear with each submission to CBC/Radio-Canada's online communities (except in children and youth-oriented communities). Pseudonyms will no longer be permitted.

By submitting a comment, you accept that CBC has the right to reproduce and publish that comment in whole or in part, in any manner CBC chooses. Please note that CBC does not endorse the opinions expressed in comments. Comments on this story are moderated according to our Submission Guidelines. Comments are welcome while open. We reserve the right to close comments at any time.