Quebec Health Agency Merger Sparks Concerns Over Public Health

Concerns have been raised regarding the Quebec government’s proposal to merge two key health agencies, aiming to streamline operations and reduce costs. The proposed legislation, known as Bill 7, was introduced by France-Élaine Duranceau, President of the Treasury Board, and could result in savings of $35 million by eliminating 220 full-time positions, including roughly 100 jobs within the healthcare sector.

The bill seeks to consolidate the Institut national de santé publique du Québec (INSPQ) and the Institut national d’excellence en santé et en services sociaux (INESSS) into a single entity. Additionally, it proposes transferring the operations of three medical biology laboratories from INSPQ to Santé Québec while reallocating organ and tissue donation coordination from Transplant Québec to Héma-Québec.

Experts Challenge Efficiency Claims

Despite the government’s rationale, experts in health policy are questioning the potential implications of the merger. Olivier Jacques, a health policy professor at Université de Montréal, has voiced skepticism about the government’s claims regarding efficiency and savings. He argues that the merger could jeopardize essential public health services, as each agency plays a vital role within its respective mandate.

“We have difficulty to see what is the intent of policymakers there,” Jacques told CBC News. “There’s not much money to save, and there’s not much efficiency gains to have.”

Jacques emphasizes that merging the agencies could lead to a detrimental impact on public health in Quebec. He likened the situation to the saying, “if it ain’t broke, don’t fix it,” suggesting that the existing systems do not require such drastic changes.

Government’s Response to Public Health Needs

Duranceau’s office has defended the merger, stating that it aims to address issues highlighted during the COVID-19 pandemic. The government claims that the pandemic exposed the limitations of a fragmented health model, which hampered effective responses. According to the statement, combining the expertise of both institutes will lead to a more coordinated approach, ensuring clarity in responsibilities and aligning with the health system’s current and future demands.

The office has acknowledged the concerns expressed by senior officials from INSPQ during parliamentary consultations and indicated that reviews of submitted briefs are underway to consider improvements to the bill.

Jacques, alongside his colleague Nathalie Clavel, an assistant professor specializing in health services management at Université de Montréal, presented their apprehensions before a parliamentary committee last week. They raised alarms about the potential fragmentation of critical services and the risk of diminishing preventative care.

Jacques warned that merging these organizations could lead to a loss of specialized knowledge and resources, particularly if research and laboratory functions are absorbed by Santé Québec. He pointed out that public health initiatives focus on long-term improvements, while the current merger might prioritize immediate curative care, thereby neglecting preventative strategies.

He expressed concerns about the likelihood of budgets being skewed towards curative functions, given that the two agencies will be combined under one budgetary umbrella. This shift could adversely affect funding for preventative healthcare, which is often overshadowed by acute health crises.

While Jacques maintains that the merger is a misguided approach, he suggests that if the government proceeds, maintaining separate budgets for preventative and curative functions would be essential to ensure a balanced focus on both areas of healthcare.

As the debate continues, the long-term impact of this merger on public health in Quebec remains to be seen. The concerns raised by experts reflect a broader apprehension about the direction of healthcare policy and the prioritization of public health initiatives in the province.