BY: Dozens
of community and institutional leaders have expressed deep concerns about Bill 10
which proposes changes to the Health and Social Service Act via a sweeping reorganization
of the institutions and the governance of the health and social service network.
Supported
by a petition that has been signed by more than 9000 Quebecers
(www.bill10.com), more than three dozen groups, including school boards and
community associations, have joined together to demand that Health Minister
Gaétan Barrette make major modifications to the proposed legislation which they
say will have a negative impact on the vitality and identity of Quebec’s
English-speaking community.
In
summary, Bill 10 proposes to abolish Agencies, the planning and coordination
bodies in each region and eliminate 185 institutions by merging them on a
regional basis. If passed a single institution called a Centre intégré de santé
et de services sociaux (CISSS) would plan and manage the delivery of all health
and social services in each region, including one that would cover the island
of Laval.
Community
leaders worry that if adopted as currently drafted, Bill10 would abolish the
English-speaking community's hospitals and nursing homes such as the Jewish
Rehabilitation Hospital in Laval, as stand-alone institutions. As well, it
would eliminate community volunteers from the governance of our health and
social service system; fatally compromise the bilingual status of our
institutions; and exclude these community institutions from the critical role
they play in the vitality of the communities they serve.
“Bill
10 goes too far, too fast,” warned former Liberal MNA Clifford Lincoln, noting
that “suddenly reducing the number of health and social service institutions
from 182 to 28 will have an undeniable impact on accountability, transparency,
volunteerism and citizen participation. And for Quebec’s English-speaking
community this means the loss of 23 out of 24 of its bilingual institutions and
boards, and their protection under law,” he said.
There
will be a total of 20 CISSSs in the 16 regions of the province. On the island
of Montreal, because of the size of the population, demographics, and the
number of institutions, there will be five CISSSs, one in the west island, a
second in the center, a third in the southeast, the fourth in the north, and
the fifth in the east island. The CISSS
in the southeast will assume some of the responsibilities of the former Agency.
The
Cree and Inuit territories in the far north are not touched by these changes.
In addition there will be four super-regional institutions, all in Montreal;
The McGill University Health Center (MUHC), the Centre hospitalier de l’Université de Montréal
(CHUM), the Centre hospitalier universitaire Sainte-Justine, and the Institut
de cardiologie de Montréal.
While
there will be no more institutions directly identified with the
English-speaking community, except for the MUHC, the Bill continues provisions to
guarantee access to services in English, though these require some additional
precision.
“If
the Charter of the French Language saw fit to create exceptions that allow the
protection of the English-speaking community’s institutions, the Health Care
Act can and must do the same,” added Sara Saber-Freedman, President of the
Board of the MAB-Mackay Rehabilitation Centre in Montreal. “Bill 10 must be
amended in order not to abolish institutions -- and especially not those that
are designated to provide bilingual services.”
“The
goals of the government can be achieved without eliminating this unique and
irreplaceable community heritage,” added Saber-Freedman, noting that some
important modifications to Bill 10 are essential to ensure that the legislation
does not compromise a 30-year consensus that is crucial to the vitality of
Quebec’s English-speaking minority.”
The
Health and Social Services Committee of the National Assembly held several
weeks of hearings on Bill 10. The large majority of briefs were critical of
Bill 10 for one or more of the following reasons;
- The new CISSSs will be too large and distant from those who use their services;
- The range of medical and social mandates a CISSS must manage is too varied to be successful;
- Social service mandates will be get short shrift next to the medical mandates within the same organization;
- Too much control is placed in the hands of one person, the minister;
- The reduction of the number of board seats, and the process by which board members will be appointed, will substantially restrict access to these seats to members of the community;
- The pace of implementation of such a vast reorganization is too rapid. Bill 10 has not been adopted yet, and it is supposed to be implemented for April 1, 2015;
An important issue not yet resolved has to do with the assets of the existing institutions that have owning corporations. Bill 10 transfers those assets to the CISSSs, but the minister has said the assets will stay with owning corporations. This is particularly important in hospitals and other institutions where large amounts of public and private donations have been invested.
At the time of this writing the study of Bill 10 continues, and may continue into the New Year. If you are concerned by Bill 10 and want to express your concerns, go to www.Bill10.com and add your name to the on-line petition.
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