Bill 10 - Act to modify the organization and governance of the health and social services network, in particular by abolishing the regional agencies - A reform that brings solutions but that includes major risks and requires a rigorous transition plan

QUÉBEC CITY, Oct. 27, 2014 /CNW Telbec/ - Today the Québec Ombudsman presented its brief on Bill 10 to the Committee on Health and Social Services. On the strength of the Québec Ombudsman's findings from the interventions it carries out, the Ombudsperson began by indicating that "access to quality, clearly defined, properly integrated services delivered equitably and at reasonable cost hinges on streamlining of structures, clarification of providers' responsibilities, greater accountability by leaders and clarification of the basket of services."

"However, Bill 10 presents major risks that must be properly identified and managed if this sweeping reform is to be viable," Raymonde Saint-Germain cautioned. In particular, she underscored the importance of adequate assessment of the following risks:

• The unwieldy management of the mega-institutions thus created;
• Managers' being out of touch with the reality of services and evaluation of service quality;
• Priority allocation of available budgets for the medical and hospital mission of the new regional institutions at the expense of the response to needs in terms of social services, many of which are already unmet;
• The insufficient leeway of CISSS presidents and executive directors;
• The cost and danger of slip-ups in the recovery of information assets in the absence of a rigorous strategic transfer and conversion plan;
• If there are no clear guidelines, more rapid erosion of the basket of services, notably to absorb unforeseen implementation costs.

Consequently, the Ombudsperson insisted on the absolute need for a solid transition plan for such a sweeping reform and that all involved know this plan. The parameters of such a plan must include in particular the phases of the change proposed, guarantees that user services will be maintained, expected savings after factoring in transition costs, and a realistic implementation schedule.

User participation and upholding of users' rights

With the passage of Bill 10, the number of institutions will decrease and, as a result, the number of users' committees. The Québec Ombudsman's opinion is that there must be more emphasis on the presence of users or user representatives on boards of directors. Consequently, it recommended that the number be maintained at two, one being familiar with health institutions and the other, with social services institutions.

The Québec Ombudsman therefore made ten recommendations concerning a transition plan and the requirements for a smooth transition, user participation and representation on boards of directors, fairness in the regional service offer, and regulation.

The Ombudsperson insisted on the overriding need—indeed, duty in the public interest—for  implementation of these proposed changes to be harmonized with the efforts required so that service provision is not only maintained, but improved in terms of accessibility, fairness and efficiency everywhere in Québec. "Citizens must not, under any circumstances, suffer harm because of these changes in the network's organization and governance," Raymonde Saint-Germain said in closing.

The brief is available at www.protecteurducitoyen.qc.ca.

SOURCE: Protecteur du citoyen

and requests for interviews: Carole-Anne Huot, [phone]/ [phone] [email protected]; Joanne Trudel, [phone]/ [phone] [email protected]; www.protecteurducitoyen.qc.ca