Experts warn merger of 2 Quebec health agencies could undermine public health

Some experts are sounding the alarm over the Quebec government’s proposal to merge two flagship health agencies as part of a broader plan to reduce bureaucracy and increase state efficiency.

Bill 7, tabled last month by Treasury Board President France-Élaine Duranceau, is designed to save $35 million, primarily by cutting 220 full-time positions, including about 100 in the health-care system.

The bill would fuse 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.

It would transfer the activities of the three INSPQ medical biology laboratories to Santé Québec, while assigning the functions of organ and tissue donation co-ordination currently exercised by Transplant Québec to Héma-Québec.

However, not everyone agrees with the plan. 

Olivier Jacques, a professor specializing in health policy at Université de Montréal, recently raised concerns with the government, saying he sees no clear line between potential savings and the cost to services as each agency serves its own important function.

“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 and, in contrast, it could be a real issue for public health in the province in general.”

Citing the old saying, he said, "if it ain’t broke, don’t fix it.”

In a statement issued this week, Duranceau’s office insists the merger will fix problems exposed during the COVID-19 pandemic.

“The pandemic revealed the limits of a fragmented model in which the lack of co-ordination between the two institutes hindered the speed of the response on the ground,” the statement says.

The statement says that by combining these areas of expertise, the government can work more efficiently, make responsibilities clearer and better meet the health system’s current and future needs.

“The government’s intention remains to fully preserve the missions of both organizations, which are highly complementary,” it says.

It added that the government has “heard the concerns” raised by INSPQ senior officials during parliamentary consultations and that teams across affected ministries are reviewing submitted briefs “to assess whether follow-up is warranted to improve the bill.”