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<h3>The various functions and vocations of the Ministry of Health and Social Services</h3>To mark my first day as President and CEO of the Private Health and Wellness Business Council (CEPSEM), I am devoting my second text to the healthcare system, hoping, with the coming texts, to allow everyone to better measure the extent of the actions taken by the government in place.The Minister of Health and Social Services, Christian Dubé, is currently working on setting up one of the important pillars in his overhaul of the health system, namely the creation of Santé Québec. A first step to properly situate this important change in our environment is to understand the multiple functions and vocations assumed by our Ministry of Health and Social Services (MSSS) and how they evolve over time.The MSSS oversees the application of more than thirty laws that have different functions. Essentially, until the creation of Santé Québec, the following functions or vocations could be identified: structural and organizational function, protection of the population function, insurer or payer function, and above all, a system regulation function.In terms of organization, of course, there is the Act respecting the Ministry of Health and Social Services (CQLR c. M-19.2), the first version of which dates back to 1936 with the creation of a health department. But with the increasing complexity of the health environment, other structures have been added, such as the Régie de l’assurance maladie du Québec (1978), the Institut national de santé publique (1998), Héma-Québec (1998), the Commissaire à la santé et au bien-être (2005) and the Institut national d’excellence en santé et services sociaux (2010).Another important function of the MSSS, in the context of a public healthcare regime, is that of insurer or payer. In this category, we find the Hospital Insurance Act (1970), which was a first step in the establishment of the public system. This law was subsequently followed by the Health Insurance Act (1970) and the Act respecting Prescription Drug Insurance (1997).The MSSS has the responsibility of ensuring the protection of certain classes of the population. Thus, it supervises laws such as the Youth Protection Act (1977), the Act respecting the exercise of the rights of disabled persons (1978), the Act to combat the mistreatment of seniors and any adult in a vulnerable situation (2017) and the Act respecting the protection of persons whose mental state presents a danger to themselves or to others (1997). It should be noted, however, that this last law is derived from one of the oldest health laws in Quebec: the Act respecting insane asylums in the province of Quebec (1885), whose framing, protection and insurance functions were split with the creation of the first Act respecting health services and social services (LSSS) (1971).This brings us to the function that will be of interest with regard to the creation of Santé Québec: the system regulation function where the MSSS does not assume a direct role in the provision of services but regulates the actors in the network.The first regulation functions date back to 1885 when the government assumed a certain level of specific oversight for insane asylums. This was followed by the oversight of hospitals (Private Hospitals Act of 1935, Hospitals Act of 1962, and the Public Assistance Act of 1921, revamped in 1964). This oversight began when the government started to assume part of the financial burden in the operation of hospitals with the establishment of the Canada Hospital Insurance and Diagnostic Services Act (1957). Following the adoption of the Canada Medical Care Act in 1966, the provinces continued to develop their healthcare networks with the introduction of various health insurance laws (in 1970 for Quebec). The LSSS underwent a major reform in 1991 and several adjustments that we will discuss in future texts until ultimately the law that creates Health Quebec. So far, with the LSSS as the backbone and several other satellite laws (essential services—1996, medical laboratories—2001, pre-hospital care—2002, access to medical services—2015), the role of the MSSS is primarily one of overseeing various quasi-governmental bodies endowed with more or less autonomous governance.With the creation of Santé Québec, we are witnessing a significant development of the function of employer of the MSSS.We will explore the evolution of this governance in the coming texts. Until then, if you have questions or need help on this topic, MEDIATOR is here to help you!

The impacts of the creation of Santé Québec—Part I

Close of businessman hand holding cube figure as symbol of innovation. 3D rendering

<h3>Bill 44 of the Minister of Economy, Innovation and Energy</h3>On February 7, Minister Pierre Fitzgibbon presented Bill 44—An Act to amend mainly the Act respecting the ministère de l’Économie et de l’Innovation with respect to research to the National Assembly of Quebec.The bill essentially aims to return government responsibilities for research and innovation to a ministry with an economic vocation. Indeed, the Ministry of Economy and Innovation (MEI) would resume responsibilities related to the Chief Scientist and the three Quebec research funds, namely Health, Nature and Technology and Society and Culture. The bill also provides for their merger into a single entity: the Quebec Research Fund.The government responsibility for innovation has, over the decades, traveled from one ministry to another, when it was not split among several. Indeed, the first political initiative in innovation was the presentation of “Bill 6—Scientific Research Council Act” by the Minister of Industry and Commerce, Gérard D. Lévesque in 1966. However, this bill died on the Order Paper following the call for elections.In 1983, with the Act to promote the advancement of science and technology in Quebec (L. Q. 1983, c. 23), the Science and Technology Council was permanently created and was under the aegis of the Ministry of Science and Technology. The three research funds of the time, the one for the training of researchers and research assistance (FCAR), the one for health and the last one on agriculture, fisheries and food were under the aegis of the Ministries of Education, Social Affairs and Agriculture, Fisheries and Food respectively. It was in 1999, with the creation of the ministère de la Recherche, de la Science et de la Technologie (L. Q. 1999, c.8) that all innovation bodies were grouped under the same ministry.In 2001, the funds were somewhat redefined, except for the health fund. The FCAR fund becomes partly the Nature and Technology Fund and partly the Society and Culture Fund, which also includes the Quebec Social Research Council.Innovation is transferred to a ministry with an economic vocation in 2003 with the creation of the ministère du Développement économique et régional et de la Recherche (L. Q. 2003, c-29), which subsequently became the ministère du Développement économique, de l’Innovation et de l’Exportation in 2006 (L. Q. 2006, c.8).In 2013, with the creation of the ministère de l’Enseignement supérieur, de la Recherche, de la Science et de la Technologie (L. Q. 2013, c. 28), innovation returns to a ministry with an educational vocation. And here we are in 2024 with Bill 44 proposing a new move!For a detailed analysis of the impact of Bill 44 and to be well equipped to follow parliamentary debates, do not hesitate to contact us!

The return of innovation to a ministry with an economic vocation

<h3>Projet de loi 44 du ministre de l’Économie, de l’Innovation et de l’Énergie</h3>Le 7 février dernier, le ministre Pierre Fitzgibbon présentant le Projet de loi 44 — Loi modifiant principalement la Loi sur le ministère de l’Économie et de l’Innovation en matière de recherche à l’Assemblée nationale du Québec.&nbsp;Le projet de loi vise essentiellement à retourner dans un ministère à vocation économique les responsabilités gouvernementales en matière de recherche et d’innovation. En effet, le ministère de l’Économie et de l’Innovation (MEI) reprendrait les responsabilités liées au Scientifique en chef et aux trois fonds de recherche du Québec, à savoir Santé, Nature et Technologie et Société et Culture. Le projet de loi prévoit de plus leur fusion en un seul : le Fonds de recherche du Québec.La responsabilité gouvernementale de l’innovation a, au cours des décennies, voyagé d’un ministère à l’autre, quand elle n’était pas éclatée au sein de plusieurs. En effet, la première démarche politique en matière d’innovation a été la présentation du « Bill 6 — Loi du Conseil de la recherche scientifique » par le ministre de l’Industrie et du Commerce, Gérard D. Lévesque en 1966. Toutefois, ce projet de loi est mort au feuilleton à la suite du déclenchement des élections.En 1983, avec la Loi favorisant le développement scientifique et technologique du Québec (L. Q. 1983, c.23), le Conseil de la science et de la technologie est créé de façon permanente et est sous l’égide du ministère de la Science et de la Technologie. Les trois fonds de recherche de l’époque, celui pour la formation de chercheurs et l’aide à la recherche (FCAR), celui de la santé et le dernier sur l’agriculture, les pêcheries et l’alimentation sont sous l’égide des ministères de l’Éducation, des Affaires sociales et de l’Agriculture, des Pêcheries et de l’Alimentation respectivement. C’est en 1999, avec la création du ministère de la Recherche, de la Science et de la Technologie (L. Q. 1999, c.8) que toutes les instances de l’innovation sont regroupées sous un même ministère.En 2001, les fonds sont quelques peu redéfinis, sauf pour celui de la santé. Le fonds FCAR devient en partie le Fonds Nature et Technologie et en partie le Fonds Société et Culture, qui lui englobe aussi le Conseil québécois de la recherche sociale.L’innovation est transférée dans un ministère à vocation économique en 2003 avec la création du ministère du Développement économique et régional et de la Recherche (L. Q. 2003, c-29), qui devient par la suite le ministère du Développement économique, de l’Innovation et de l’Exportation en 2006 (L. Q. 2006, c.8).En 2013, avec la création du ministère de l’Enseignement supérieur, de la Recherche, de la Science et de la Technologie (L. Q. 2013, c.28), l’innovation retourne dans un ministère à vocation éducationnel. Et nous voici en 2024 avec le projet de loi 44 qui propose un nouveau déménagement !Pour avoir une analyse détaillée de l’impact du projet de loi 44 et être bien outillé pour suivre les débats parlementaires, n’hésitez pas à communiquer avec nous !

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The impacts of the creation of Santé Québec—Part I

The return of innovation to a ministry with an economic v...

Le retour de l’innovation dans un ministère à vocation éc...