September 15, 2011

I told you in my last blog that this morning the FIQ would be presenting its recommendations on the measures contained in proposed Bill 16, An Act to amend various legislative provisions concerning health and social services in order, in particular, to tighten up the certification process for residences for the elderly.

The question of certification of private residences has been tackled many times by the media since the beginning of the consultations on this proposed bill and you probably already know that the application of several of the measures proposed in it by the government will be done according to criteria to be determined at a later date.  Who? When? What? Where? How? No guarantee of the quality and safety of the care to be given to our elders, but we know that the private businesses will get something out of it!

Is there anything more vague?  Absolutely! And, in this same proposed bill which, in its second part, deals with the responsibilities of joint procurement of goods and services.

The procurement responsibilities are roughly summarized as a standardization of purchases which can be carried out in a group. Joining together to purchase and save by purchasing in volume is the principle behind “Costco” applied to the health and social services network. A system already in place in the network for many years and known as “groupes d’approvisionnement en commun” (joint procurement groups) and for which the ministry has very little information on. So little, in fact, that the Auditor General in 2008 concluded that “the MSSS and the agencies cannot determine if it is worth the effort to use such groups.” (our translation)

This makes sense so far? You’re still following me? The next few paragraphs may seem difficult, but they will be worth the effort!

So, with proposed Bill 16, the Minister of Health and Social Services is acquiring the power to significantly reduce the number of joint procurement groups by merging the existing groups as he pleases and forcing the regional agencies to impose its use on the institutions.  This will have the effect of considerably increasing the volume of purchases for each procurement group and, at the same time, the possible savings in volume.

One can question the relevance of the savings that can be achieved in this way when, put in the equation, is the fact that the institutions will once again find themselves even further away from where the decisions are made on procurement according to their specific needs or still the harm that will be caused to the local and regional economies. The debate remains to be had on these questions.

What therefore, could the main motivation be for the Health Minister in this file? Why this? Why now?  And especially why try to pass it quietly within a proposed bill on private residences for the elderly?

Go a little further in your reflection if you really want to. We know that Ottawa is currently holding negotiations that should end with a free-trade agreement with the European Union. We know that some of the most pressing demands of the European negotiators surround the healthcare sector. We also know that the purchase of goods and services must be submitted to the rules of such an agreement after a certain minimum limit. According to the information that is circulating, these minimum limits would be easily reached by concentrating the volume of purchases within a reduced number of procurement groups.

Now, take into account that the definition of “goods and services” here includes human resources as much as material and concrete. Knowing that temporary employment multinationals already exist everywhere in Europe, we can expect them to try and set up in Québec. And do multinationals who contest existing laws and practices in a jurisdiction on the pretext that they harm their primary role of making a profit for their shareholders, remind you of anything?

It was one week ago today, that the European Commission was referred a complaint against the French government "for violation of free competition of healthcare facilities and "illegal aid to the benefit of public institutions"" (our translation) (read the article published in Le Monde, in French).

The Charest government is using a proposed bill intended specifically for private residences for the elderly in order to conceal the measures that risk opening the Québec public health network to private multinational corporations as it never has before. All this in a sneaky fashion. And the implications from it are terrifying.

Another good example of how the Charest government does things, a government with two hands on the wheel and a clear destination in mind: the privatization of public services.