Experts warn merger of two Quebec health agencies could worsen public health

Some experts are raising concerns about the Quebec government’s proposal to merge two major health agencies as part of a broader plan. Reduce bureaucracy and increase efficiency of the state.

Bill 7 tabled last month By Francois-Alain Duranceau, President of the Treasury Board, Designed to save $35 million, primarily by cutting 220 full-time positions, including about 100 in the health care system.

Bill will fuse Institut National de Santé Publique du Québec (INSPQ) and Institut National d’Excellence en Santé et en Services Socioux (INESSS) in a new institute.

it will move The activities of the three INSPQ medical biology laboratories are assigned to Sainte-Québec, while the functions of organ and tissue donation coordination, currently carried out by Transplant Québec, are assigned to Héma-Québec.

However, not everyone agrees with this plan.

Olivier Jacques, a professor specializing in health policy at the Université de Montréal, recently raised concerns with the government, saying he sees no clear line between potential savings and the cost of services because each agency does its own important work.

“We’re having a hard time seeing what the intentions of the policymakers there are,” Jacques told CBC News.

“There’s not a lot of money to be saved, and there’s not a lot of efficiency gains to be made and on the contrary, it could be a real issue for public health in the province in general.”

Quoting the old adage, he said, “If it ain’t broke, don’t fix it.”

Problems exposed during the pandemic

In a statement released this week, Duranceau’s office stressed that the merger would fix problems encountered during the COVID-19 pandemic.

“The pandemic exposed the limitations of a fragmented model in which a lack of coordination between the two institutions hampered the speed of response on the ground,” the statement said.

The statement said that by combining these areas of expertise the government can work more efficiently, clarify responsibilities and better meet the current and future needs of the health system.

It added, “The Government intends to fully preserve the missions of both organizations, which are highly complementary.”

It states that the government INSPQ “heard concerns” raised by senior officials during the parliamentary consultation and teams from affected ministries are reviewing the brief submitted “to assess whether follow-up is needed to improve the bill.”

Preventive care always loses, experts say

Jacques said he did not believe combining these agencies would create greater efficiency.

Neither does his colleague, Nathalie Clavel, an assistant professor who specializes in health services management at the Université de Montréal.

They both spoke to a parliamentary committee about the bill last week, raising a number of concerns with the bill – including fragmentation of key services and reductions in preventive care.

In a subsequent interview with CBC News, Jacques expressed concern about the potential loss of expertise and prevention, for example, with the research and INSPQ laboratories moving to Sainte-Québec.

He explained that public health is about improving the health of the population in the future, while health care problems are serious in the present.

He said, “I am really concerned that the budget will be allocated more to remedial tasks related to INESSS, to the detriment of the preventive, long-term oriented tasks of INSPQ.”

Because one agency is controlling the budget, short-term palliative care may ultimately receive larger amounts of money, he said, Add His research shows that when two budgets are in competition, preventive care always loses.

Despite the effectiveness of prevention, he said the public also prefers to see money directed toward immediate curative care of the crisis rather than prevention.

While he sees the merger as a mistakeHe explained, if the government does this then separate budgets should be maintained for at least two functions With this.

he also says There is no evidence that other governments have successfully conducted similar mergers.

“I don’t think fusion is a good idea,” he said. “These are two institutions with two very different visions and two very different missions.”