Concerns have been raised by experts regarding a Quebec government plan to merge two prominent health agencies as part of an effort to streamline operations and enhance efficiency. The proposal, outlined in Bill 7 introduced by Treasury Board President France-Élaine Duranceau a month ago, aims to save $35 million by reducing 220 full-time positions, with around 100 of them in the healthcare sector.
The bill seeks to combine 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 new institute. Moreover, it plans to shift the operations of three INSPQ medical biology labs to Santé Québec and transfer organ and tissue donation coordination responsibilities from Transplant Québec to Héma-Québec.
Despite the government’s rationale for the merger, not all stakeholders are in agreement. Olivier Jacques, a health policy professor at Université de Montréal, has voiced reservations, questioning the potential trade-off between cost savings and service quality, emphasizing the distinct roles each agency plays.
Jacques highlighted the importance of maintaining the status quo if the existing system is functioning effectively, expressing skepticism about the projected benefits of the merger. He emphasized the critical functions fulfilled by both agencies and cautioned against any potential negative impact on public health in the province.
Challenges Unveiled Amid Pandemic
In response to criticisms, Duranceau’s office released a statement asserting that the merger is a response to shortcomings exposed during the COVID-19 crisis. The statement underlines the need for improved coordination between the two institutes to enhance response capabilities.
By consolidating expertise in a unified entity, the government aims to enhance operational efficiency, clarify responsibilities, and better address present and future healthcare demands.
The government is committed to preserving the core missions of both organizations, acknowledging the concerns raised by INSPQ senior officials during parliamentary consultations and promising to review submitted feedback for potential bill enhancements.
Expert Warns of Neglecting Preventive Care
Jacques and his colleague, Nathalie Clavel, also from Université de Montréal, presented their reservations about the merger to a parliamentary committee. Their concerns include service fragmentation and potential reductions in preventive healthcare services.
Jacques emphasized the risk of losing expertise and focus on prevention, especially with the transfer of research and INSPQ labs to Santé Québec. He stressed the distinction between preventive and curative healthcare, expressing apprehension over a shift in funding priorities towards short-term treatments at the expense of preventive measures.
Despite the recognition of prevention’s effectiveness, Jacques noted a tendency for immediate crisis intervention to receive more public support. He advocated for maintaining separate budgets for distinct functions to ensure the preservation of preventive healthcare efforts.
While acknowledging the government’s intentions, Jacques remained skeptical of the merger’s benefits, citing the divergent missions and perspectives of the two agencies as potential obstacles to successful integration.
