"Doing Better, Doing Differently": A Patient?Focused Governance for the Quebec Health Network

MONTRÉAL, Sept. 17, 2014 /CNW Telbec/ - The governance of the health system in Quebec should be based on ten user-focused Service Regions responsible for coordinating and supervising the health-care establishments within their region.

The reforms carried out in recent years failed to yield the expected results. The coordination and availability of services to patients will be achieved through a decentralized system made up of autonomous organizations operating with a tight and effective governance. The overall supervision of the network remains the responsibility of the Ministère de la Santé et des services sociaux (MSSS), which sets policies, budgets and structures of the system. However, the Ministère must not manage the network; it must govern it effectively.

This proposal comes from a Working Group set up by the Institute for Governance (IGOPP), which publishes today a report proposing a simplified, more effective governance for the health network in Quebec.

The Working Group, which includes experts from the health and governance sectors and is chaired by Mr. Gaston Bédard, Chairman of the board of the Centre hospitalier universitaire de Québec (CHUQ), reviewed the experiences of other jurisdictions in America. The Working Group proposes a new governance architecture for the Quebec health system, one which ensures that all stakeholders play a clear role.

"The Minister of Health must assume leadership of the change" says the Working Group. The objectives and priorities of the MSSS would be implemented by the 10 Service Regions, each one governed by a board of directors accountable to the Ministère. Each Service Region, led by a team of managers and professionals, will put forth a comprehensive plan and a budget to the MSSS, which is responsible for their approval. The Service Region must act in the public interest and in compliance with the health and welfare policy of the Quebec government.

A budget, with emphasis on the patient, is allocated to each Region, which must deliver expected results. In this context, physicians play a key role. Medical resources must be aligned, through contractual agreements, with the priorities and challenges of each region.

With a clear responsibility and the resources entrusted to it by the Ministère, the Service Regions will have the authority to allocate human, material and financial resources among the various health establishments on its territory. These health services purveyors will remain separate entities, without a board of directors, headed by a Director General and accountable to the management of their Service Region.

The health establishments will enjoy true autonomy within a strategic governance system to ensure an ongoing dialogue between the management of the establishment and the management of the Service Region.

The Service Regions should be informed by the Régie de l'assurance maladie du Québec (RAMQ) of the amounts paid to physicians in their respective region.

The Working Group strongly believes that a health system which places the patient at the centre of its operations will have to supply health professionals and management professionals with timely and relevant information about clinical and financial performance.

The IGOPP's report is available at www.igopp.org

List of the members of the Working Group*:

Yvan Allaire, Executive Chair of the Board of Directors
Institute for Governance (IGOPP)

Gaston Bédard, Chair of the Board of Directors,
New CHU of Quebec City (merger of CHUQ and CHAUQ)

Sonia Bélanger, Director General
CSSS du Sud‑Ouest‑Verdun

Isabelle Brault, Chair of the Board of Directors
CSSS de Dorval‑Lachine‑Lasalle and  assistant professor at the Faculté des sciences infirmières of Université de Montréal.

Ronald Dahms, Chair of the Board of Directors
Institut de réadaptation Gingras-Lindsay-de-Montréal and president of Optimum Talent.

Dr Pierre Gfeller, Director General
Hôpital Sacré-Coeur de Montréal

Richard Legault, Chair of the Board of Directors
CSSS de l'Ouest-de-l 'Île

Michel Nadeau, Executive Director
Institute for Governance (IGOPP).

* These persons participated in the work of the Group in a personal capacity and not as representatives of their respective organizations.

About IGOPP:

Created in 2005 by two academic institutions (HEC Montréal and Concordia University – The John Molson School of Business) and the Stephen Jarislowsky Foundation, the Institute for governance (IGOPP) has become a centre for excellence about governance of public and private organizations. Through research, training programs, policy papers and participation in public debates, IGOPP has become a key reference on all issues of governance in the private and public sectors.

SOURCE: Institute for governance of private and public organizations (IGOPP)

or to request an interview, please contact: Majida Lamnini, Institute for Governance (IGOPP), [phone], Ext. 104, [email protected]