On October 19, at the behest of the Minister of Health and Social services and in his presence, I outlined the concept of creating an integrated McGill Health and social services network before a room full of representatives of all McGill University related health and social service institutions. The Gazette reporter was also present. The text of my presentation was widely circulated by the Ministry to all stakeholders as part of a consultation undertaken by Dr. Arvind Joshi at the request of the Minister. In that context, I recently took the initiative of summing up the content of this presentation in a letter distributed to all employees of our CIUSSS with a view to enabling them to have an informed understanding of my vision.
My proposal of re-establishing director general positions in major institutions is specifically linked to the creation of a fully integrated McGill health and social services network, an integrated system more fully adapted to the needs of the population. The question is not about “undoing” the present networks, I never said or implied anything of the sort, but about evolving to another type of organization. Bill 10 is predicated on the need to establish networks of care by bringing together institutions under the direction of integrated health and social service centres. In my view we now have the opportunity to move forward and advance quality and access by bringing the two CIUSSS and the MUHC together in an integrated system covering the full range of services people require. This would call for different governance and organizational structures.
What we have today are two CIUSSSs and the MUHC, all under the McGill University umbrella, all serving the same population, but operating independently from one another. Patients need to go from one to another to get all of the services they require, and they have to adapt to each institution, rather than the institutions adapting to their needs, as they should. Services and patient files are often duplicated and fragmented.
We can do much better. We have the technology, the resources, the know-how, the competence required to create a seamless integrated health and social services system where patients entering from any service point would be directed to the nearest available resource required by their condition. This is the essence of the concept of creating truly integrated health and social services systems focused on access, value and quality for the user. It is the direction in which health and social services are moving throughout North America.
Describing this concept, I said the following on October 19:
“In such a network consisting of a substantial territory and population, and encompassing the complete range of operations with an operating budget of some 2.5 B$ it would be necessary and desirable to empower decision-making at the operational level in order to be responsive to local needs and circumstances in a timely manner. In this regard, in my vision I believe there should be director generals in the major institutions in order to ensure that these local considerations are managed according to the needs of the community level.”
As for the councils of physicians, dentists and pharmacists (CPDP), local CPDP sub-councils are possible under Bill 10. In fact, we have created them in our CIUSSS and they work well. They are effective and the preoccupations of each establishment are taken into account. I said all of this in my October 19 presentation, clearly stating that this feature should be carried over in the McGill network concept.
To be clear, in an integrated McGill health and social services system, our current establishments would continue, they would have local management, but they would also have common standards of care and performance. The focus would be on the user and the obligation of the system to enable them to move through it seamlessly.
Our healthcare institutions must adapt to changing times. These are vitally important matters that require informed, in-depth discussion. I welcome any opportunity to further this discussion.