Bill 15 at a glance

Introduced: March 29, 2023 in the National Assembly (Government bill)
Status: Adopted December 9, 2023

SYNOPSIS

After the government invoked closure to end debate on the proposed legislation, Bill 15 was adopted at 5:15 a.m. on December 9, following an electronic vote at the National Assembly, with 75 votes in favour, 27 against and no abstentions. The Legault government had offered opposition parties the option to extend the session and resume study of the bill in a legislature committee. But that offer was rejected in part because it included a deadline. The government had insisted that the work be completed by Dec. 15 at the latest, despite hundreds of articles not being studied.

Composed of nearly 300 pages and containing 1,180 clauses that modify more than 30 other existing laws, Bill 15 was the second-largest piece of legislation ever put before the National Assembly. It sets out a complete structural reform of Quebec’s current health and social services system. At its core, the bill reshapes Quebec’s healthcare and social services system. It establishes “Santé Québec,” a new provincial agency responsible for overseeing all aspects of the public health-care system. The bill merges various public institutions, effectively becoming the exclusive employer for all health-care network employees. With its own board of directors, the agency will be answerable to the Minister of Health, who holds authority over its priorities, objectives, and directions.

HIGHLIGHTS OF DEBATE

The proposed bill encountered resistance from multiple stakeholders and organizations. Notably, six former premiers, including Lucien Bouchard, Jean Charest, Philippe Couillard, Daniel Johnson, Pierre Marc Johnson, and Pauline Marois, expressed their concerns through an open letter. The ex-premiers rallied together in an unprecedented show of unity to draw attention to the potential consequences the merger of hospitals and other institutions may have on research, board expertise as well as hospital foundations and fundraising programs. A QCGN-crafted petition demanding the government pause the bill to allow more consultation and amend specific parts of it, which was posted to the National Assembly’s website by MNA Jennifer Maccrone, garnered more than 6,000 signatures in two weeks.

Additionally, some fear that the mergers may affect the distribution of funds across the entire health system. Apart from funding concerns, community organizations have raised questions about the practical impact of the health reform on minority communities’ access to health care and social services. In response to the financial worries raised by the ex-premiers’ letter, Health Minister Christian Dubé introduced two amendment packages, one aiming to strike a balance between institution coordination and autonomy and the other aiming to diversify institution councils to facilitate local community consultations. However, there has been no update on concerns about minority access, such as amendments granting institution councils a say in the English access programs.

WHY THE QCGN IS CONCERNED:

• The over-centralization of Quebec’s health and social services system is a disservice to all Quebec, since the decision-making power would then be in the hands of administrators who are further removed from institutional realities and local communities. Centralization runs the risk of neglecting minority communities’ interests that previously would have been addressed by institutions attuned to local realities.
• Groups serving English-speaking Quebecers are concerned the bill could limit access to health care in English and jeopardize the status of bilingual institutions. In the past, access programs that guarantee access to health and social services in English were maintained by institutions, with input from the community. As Bill 15 is implemented, management of these programs will be under the authority of Santé Québec.