Updates

There has been a wave of “centralization” reforms across Canada since Alberta established a single province-wide health authority (Alberta Health Services) in 2008. Quebec is the latest province to announce such a reform with the plans to establish “Santé Quebec” with a proposed Bill 15. The broad aims of the reform are to reduce hospital overcrowding and surgical wait lists, and streamline/simplify the patient journey across the care continuum. This new provincial agency, as with other provincial authorities that have been established in Alberta, Saskatchewan, Nova Scotia, Newfoundland and Labrador, and Ontario, will replace the current regional authorities in Quebec that are responsible for day-to-day operations of the health system – Integrated health and social services centres (CISSS and CIUSSS). With the new agency, nurses and other health care workers who were employed by the regions will become employees of the provincial agency; this change streamlines collective bargaining and may increase mobility of workers across the province. However, critics point to the lack of a clear implementation plan and the limited evidence to suggest the intended objectives could be achieved with this restructuring.