{"id":9724,"date":"2025-04-23T09:57:00","date_gmt":"2025-04-23T13:57:00","guid":{"rendered":"https:\/\/www.fiqsante.qc.ca\/55-ans-de-reformes-en-sante\/"},"modified":"2025-09-23T10:40:26","modified_gmt":"2025-09-23T14:40:26","slug":"55-ans-de-reformes-en-sante","status":"publish","type":"post","link":"https:\/\/www.fiqsante.qc.ca\/en\/55-ans-de-reformes-en-sante\/","title":{"rendered":"55\u202fyears of health reforms"},"content":{"rendered":"

[vc_row][vc_column][vc_column_text css=””]<\/p>\n

55\u202fyears of health reforms<\/span><\/span><\/h1>\n

The health network has undergone several reforms in the last 55 years, reforms that have had major impacts on the work of healthcare professionals. With the Dub\u00e9 reform, we are <\/span>witnessing<\/span> the culmination of these major reforms, which are unravelling, law by law, the very foundations of the RSSS.\u00a0<\/span><\/span>\u00a0<\/span><\/p>\n

[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text css=””]<\/p>\n

Understanding past reforms to face today’s reform.\u00a0<\/span><\/span>\u00a0<\/span><\/h3>\n

[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column width=”1\/2″][vc_tta_accordion][vc_tta_section title=”1970 – Creation of the RAMQ ” tab_id=”1758635969347-ab824ee4-91ff”][vc_column_text css=””]1970<\/span><\/b> – <\/span>Creation of the RAMQ<\/span><\/b>\u00a0<\/span><\/p>\n

    \n
  • Universal access<\/span><\/li>\n
  • Adoption of the ARHSSS<\/li>\n
  • Creation of the MSSS and CLSCs\u00a0<\/span><\/li>\n<\/ul>\n

    It was the beginning of the public network which aimed to offer health care that is accessible to everyone. CLSCs were created to provide front-line care in communities.<\/span>\u00a0<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”1990 – C\u00f4t\u00e9 reform” tab_id=”1758635969352-3e1829bb-f9d0″][vc_column_text css=””]1990<\/span><\/b> – <\/span>C\u00f4t\u00e9 reform<\/span><\/b>\u00a0<\/span><\/p>\n

      \n
    • Regional boards<\/span><\/li>\n
    • Decentralization<\/li>\n
    • Participatory governance<\/li>\n
    • Labour shortage\u00a0<\/span><\/li>\n<\/ul>\n

      After the Rochon Commission, an attempt to modernize the health network began. The government wanted to decentralize the system and give more decision-making power to communities. Even then, they wanted to relieve overcrowding in emergency departments and the government cited the labour shortage as a major challenge.<\/span>\u00a0<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”1995 – Rochon reform ” tab_id=”1758636134633-ec1106eb-57b5″][vc_column_text css=””]1995 – Rochon reform<\/strong><\/p>\n

        \n
      • Outpatient shift<\/span><\/li>\n
      • Budget restrictions<\/li>\n
      • Massive retirements\u00a0<\/span><\/li>\n<\/ul>\n

        The organization of the network is now focused on reducing the length of hospital stays and bringing care and patients closer together. The money freed up by reducing hospital services is not being reinvested in local care, and the government claims that there are suddenly too many nurses in the network.<\/span>\u00a0<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”2003 – Couillard reform ” tab_id=”1758636185082-98654997-7555″][vc_column_text css=””]2003<\/span><\/b> – <\/span>Couillard reform<\/span><\/b>\u00a0<\/span><\/p>\n

          \n
        • Mergers (from 4,592 to 182 institutions)<\/span><\/li>\n
        • Austerity<\/li>\n
        • Privatization (FMG, SMC and public-private partnerships)\u00a0<\/span><\/li>\n<\/ul>\n

          The grouping of institutions into CSSSs provided a lucrative playground for a number of private companies that appropriated public resources through subcontracting agreements. The integration of the quest for performance and principles of competition clearly worsened working conditions in the network, particularly under Minister Yves Bolduc.<\/span>\u00a0<\/span><\/p>\n

          It also made it possible to misuse public funds! Arthur Porter <\/span><\/span>\ud83d\ude09<\/span><\/span><\/em>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”2015 – Barrette reform ” tab_id=”1758636244682-7fca55bc-0825″][vc_column_text css=””]2015<\/span><\/b> – <\/span>Barrette reform<\/span><\/b>\u00a0<\/span><\/p>\n

            \n
          • Mergers (from 182 to 34 institutions)<\/span><\/li>\n
          • Austerity<\/li>\n
          • Centralization of decisions<\/li>\n
          • Disorganization\u00a0<\/span><\/li>\n<\/ul>\n

            CISSSs and CIUSSSs were created and became mega institutions where power was centralized. The reform aimed to reduce administrative costs and increase the network\u2019s efficiency. Healthcare professionals\u2019 workload increased, and services were cut.\u00a0<\/span>\u00a0<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”2020 – COVID-19 pandemic ” tab_id=”1758636308646-75e2aebc-b05e”][vc_column_text css=””]2020<\/span><\/b> – <\/span>COVID-19 pandemic<\/span><\/b>\u00a0<\/span><\/p>\n

              \n
            • Governing by decree<\/span><\/li>\n
            • Outrageous mobility<\/li>\n
            • Huge expansion of the private sector and IL\u00a0<\/span><\/li>\n<\/ul>\n

              The government took advantage of the health crisis to appropriate powers and centralize decision-making in the health sector, creating appalling working conditions and a mass exodus of healthcare professionals, in particular to the private sector and employment agencies.<\/span>\u00a0<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”2023 – Dub\u00e9 reform ” tab_id=”1758636436961-0ae11988-8dd4″][vc_column_text css=””]Dub\u00e9 reform<\/span><\/b>\u00a0<\/span><\/p>\n

                \n
              • Mergers (from 34 to 5 institutions)<\/span><\/li>\n
              • Privatization<\/li>\n
              • Austerity\u00a0<\/span><\/li>\n<\/ul>\n

                The creation of Sant\u00e9 Qu\u00e9bec was the ultimate merging of institutions: unprecedented centralization in the network. The role of private for-profit companies has been formalized, and the structure made more complex, all against a backdrop of unprecedented budget cuts. The government is citing a labour shortage yet is cutting jobs.<\/span>\u00a0<\/span>[\/vc_column_text][\/vc_tta_section][\/vc_tta_accordion][\/vc_column][vc_column width=”1\/2″][vc_column_text css=””]<\/p>\n

                Acronyms<\/h4>\n

                CISSS: Centres int\u00e9gr\u00e9s de sant\u00e9 et de services sociaux<\/span>\u00a0<\/span><\/p>\n

                CIUSSS: Centres int\u00e9gr\u00e9s universitaires de sant\u00e9 et de services sociaux<\/span>\u00a0<\/span><\/p>\n

                CLSC: Centres locaux de services communautaires<\/span>\u00a0<\/span><\/p>\n

                SMC: Specialized medical centre<\/span>\u00a0<\/span><\/p>\n

                CSSS: Centre de sant\u00e9 et de services sociaux<\/span>\u00a0<\/span><\/p>\n

                FMG: Family medicine group<\/span>\u00a0<\/span><\/p>\n

                RAMQ: R\u00e9gie de l\u2019assurance maladie du Qu\u00e9bec<\/span>\u00a0<\/span><\/p>\n

                ARHSSS: Act respecting health services and social services<\/span>\u00a0<\/span><\/p>\n

                IL: Independent labour<\/span>\u00a0<\/span><\/p>\n

                MSSS: Ministry of Health and Social Services<\/span>\u00a0<\/span>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"

                [vc_row][vc_column][vc_column_text css=””] 55\u202fyears of health reforms The health network has undergone several reforms in the last 55 years, reforms that have had major impacts on the work of healthcare professionals. With the Dub\u00e9 reform, we are witnessing the culmination of these major reforms, which are unravelling, law by law, the very foundations of the RSSS.\u00a0\u00a0 […]<\/p>\n","protected":false},"author":2,"featured_media":9721,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[89],"tags":[],"class_list":["post-9724","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-magazine-la-resonance-en"],"acf":[],"yoast_head":"\n55\u202fyears of health reforms - F\u00e9d\u00e9ration interprofessionnelle de la sant\u00e9 du Qu\u00e9bec<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.fiqsante.qc.ca\/en\/55-ans-de-reformes-en-sante\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"55\u202fyears of health reforms - F\u00e9d\u00e9ration interprofessionnelle de la sant\u00e9 du Qu\u00e9bec\" \/>\n<meta property=\"og:description\" content=\"[vc_row][vc_column][vc_column_text css=””] 55\u202fyears of health reforms The health network has undergone several reforms in the last 55 years, reforms that have had major impacts on the work of healthcare professionals. With the Dub\u00e9 reform, we are witnessing the culmination of these major reforms, which are unravelling, law by law, the very foundations of the RSSS.\u00a0\u00a0 […]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.fiqsante.qc.ca\/en\/55-ans-de-reformes-en-sante\/\" \/>\n<meta property=\"og:site_name\" content=\"F\u00e9d\u00e9ration interprofessionnelle de la sant\u00e9 du Qu\u00e9bec\" \/>\n<meta property=\"article:published_time\" content=\"2025-04-23T13:57:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-09-23T14:40:26+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.fiqsante.qc.ca\/wp-content\/uploads\/2025\/09\/capture-decran-le-2025-09-23-a-101101.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1364\" \/>\n\t<meta property=\"og:image:height\" content=\"710\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Benoit Riopel\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Benoit Riopel\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.fiqsante.qc.ca\\\/en\\\/55-ans-de-reformes-en-sante\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.fiqsante.qc.ca\\\/en\\\/55-ans-de-reformes-en-sante\\\/\"},\"author\":{\"name\":\"Benoit Riopel\",\"@id\":\"https:\\\/\\\/www.fiqsante.qc.ca\\\/en\\\/#\\\/schema\\\/person\\\/e4cd421486cf950acd26794b9d29516f\"},\"headline\":\"55\u202fyears of health reforms\",\"datePublished\":\"2025-04-23T13:57:00+00:00\",\"dateModified\":\"2025-09-23T14:40:26+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.fiqsante.qc.ca\\\/en\\\/55-ans-de-reformes-en-sante\\\/\"},\"wordCount\":747,\"commentCount\":0,\"image\":{\"@id\":\"https:\\\/\\\/www.fiqsante.qc.ca\\\/en\\\/55-ans-de-reformes-en-sante\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.fiqsante.qc.ca\\\/wp-content\\\/uploads\\\/2025\\\/09\\\/capture-decran-le-2025-09-23-a-101101.png\",\"articleSection\":[\"Magazine La R\u00e9sonance\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/www.fiqsante.qc.ca\\\/en\\\/55-ans-de-reformes-en-sante\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.fiqsante.qc.ca\\\/en\\\/55-ans-de-reformes-en-sante\\\/\",\"url\":\"https:\\\/\\\/www.fiqsante.qc.ca\\\/en\\\/55-ans-de-reformes-en-sante\\\/\",\"name\":\"55\u202fyears of health reforms - 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