On Sunday, Santé Québec becomes responsible for delivering health services in the province. So far it has been caught up with spending reductions.
But setting the stage for a new battle, Dubé argued another option exists to improving services: negotiating more flexible contracts with Quebec’s powerful medical federations representing general practitioners and medical specialists.
To date, he said, they refuse to play ball, preferring to drag out talks.
“Santé Québec is not the only thing that will make a difference (in the quality of services),” Dubé told reporters at a news conference marking Sunday’s arrival of Santé Québec on the health landscape. “It’s one of the tools.
“That’s the reason I am putting a lot of pressure on the doctors unions. I am not talking about the doctors themselves. I’m talking about their union. Sometimes they are playing the calendar, playing out the clock (like in hockey). I want to make sure Quebecers understand that.”
The bill was adopted in the middle of the night, with Dubé holding a news conference at 4 a.m. where he boldly declared that it was Day 1 of Quebec’s health care transition.
In theory the spending reductions are supposed to be in administrative functions but the opposition parties have been attacking Dubé for days with more and more stories of how difficult the situation is in reality.
Québec solidaire MNA Vincent Marissal revealed this week that jobs are being abolished in several regional health networks including Chaudière-Appalaches, Laval and Montérégie-Est.
“Home care is being amputated, the number of workers in CHSLDs is being reduced, dialysis projects are cancelled and recruitment of personnel, including nurses, is suspended,” Liberal health critic André Fortin said Thursday.
Asked about the $1.5 billion at his Friday news conference, Dubé recognized eliminating such a large chunk of spending could affect services. He said Santé Quebec is making every effort it can to “minimize the impact.”
“If we do nothing, it (the deficit) could rise up to $1.5 billion,” he said.
Dubé rapidly steered the focus back on negotiations with Quebec’s two big doctors unions: the Fédération des médecins omnipraticiens du Québec (FMOQ) and the Fédération des médecins spécialistes du Québec (FMSQ). On the table is a total of $9 billion in wages.
In a surprise statement, Dubé argued Quebec needs more say on how that money is spent and work is organized.
“For the first time we want to assume control of these (spending) envelopes,” he said. “We have no say about who does what with this money. We have control of about five per cent. It’s ridiculous. Should we have control over 30 or 40 per cent of the envelope?”
He said in his mind it would be normal to pay more to a doctor who does house calls than one who works in a clinic. Quebec also questions why some specialists are paid more than others and some less for similar work.
But he said he’s fighting an uphill battle. Both federations have the means to employ legions of top lawyers who are good at dragging out talks.
“Everyone agrees with change except when it’s in their backyard,” he said. “There is a lot of resistance to change at the negotiation table.”
There was a swift response from the FMSQ, publishing a photo on X of its president Dr. Vincent Oliva, at work in an operating room at the CHUM.
“We don’t have time to respond to the remarks of the minister of health,” the FMSQ wrote.
Dubé insisted, however, that Santé Québec has other ideas for improving services even if the context is not great for it to make a splashy launch Sunday.
Opposition politicians were ready to comment on Santé Québec’s performance so far.
“Citizens more than ever are abandoned and the waiting lists are still excessively long,” interim Liberal leader Marc Tanguay said.
“I remember very well (former Liberal premier) Philippe Couillard saying at the time there is no austerity,” added Québec solidaire MNA Alexandre Leduc. “They said it’s just rigorous management. The reality is the same. They’re cutting.”
“It’s a major fail,” Parti Québécois MNA Pascal Bérubé said bluntly.