Health Quebec | Nearly 2 million for external consultants

(Quebec) Santé Québec imposes a slimming regime on the health network, but does not hesitate to spend 1.7 million to hire external consultants in order to achieve its transition, we learned The Press.

The state-owned company spent nearly $2 million in six months for the use of “services of external professionals and strategic advisors.” Around fifteen over-the-counter contracts have been concluded since June 2024, according to a compilation made by Santé Québec at our request.

In most cases, these external consultants have the mandate to support health establishments in their transition to Santé Québec, which has become the 1^is last December the sole employer of the health network. And even to “assist” the “top guns” of the new state company in their functions.

A contract estimated at $115,770 was, for example, concluded to support the number 2 at Santé Québec, Frédéric Abergel, in the “operations and transformations” of the network.

Santé Québec also retained the services of an external advisor at a cost of $115,000 to provide strategic support to establishments in their integration process. Another contract worth $90,945 is to provide management support. We also offer support for the implementation of the new governance model for boards of directors.

Advisors were also hired to implement new information technologies, confirmed Santé Québec.

The state-owned company has even retained the services of an “expert in operating theater management and access to surgery” to help it reduce waiting lists, a major priority of Minister Christian Dubé. . This specialist will have to “participate in the processes of implementing best practices in surgery by coordinating the process of supporting clinical environments,” we write.

These expenses occur at the very time when the state corporation wants to force the CISSS and CIUSSS to return to budget balance by making savings of 1.5 billion (projected deficit of the network’s establishments for the year 2024-2025).

The return to balanced budgets weighs heavily on managers, the objective being non-negotiable, warned Christian Dubé. The minister recently acknowledged that the exercise will have an impact on patient services, but that it will need to be “minimised”.

“Starting from scratch”

Santé Québec explains the use of external advisors by the fact that its teams “were formed from scratch” in the spring, starting with the executive team. “At that time, the vice-presidencies did not yet have the necessary teams to intervene in situations requiring immediate action in sectors where expertise is rare,” indicates spokesperson Jean-Nicolas Aubé.

The state corporation reminds that these are contracts to meet “one-off and short-term needs” and that they “are not intended[nt] not the hiring of permanent resources.”

“Our priority: quickly have the capacity to act and, above all, deliver significant results for the population, both in the management of health network operations and in the supervision of teams in establishments,” assures Mr. Aubé , in a written response.

Santé Québec also recalls that “the transferred support teams” from the Ministry of Health and Social Services “had not yet completed their transition to the new entity”. The transfer of some 900 civil servants, which was to take place in the fall, was postponed until January.

Reputation risk

However, there is a “reputational and image” risk for Santé Québec, which is barely beginning its operations, believes Ivan Tchotourian, professor of business law and corporate social responsibility and director of the Institute of applied ethics from Laval University.

“This is the issue that seems most fundamental and essential to me,” he said. On the one hand, you make cuts to save, and on the other, you spend to establish [votre] organisation. […] It may seem contradictory […] we must be vigilant and explain why we are spending this money in this difficult context. »

Mr. Tchotourian gives the example of the controversial use of the firm McKinsey by Justin Trudeau’s government, which made headlines in 2023. “There is a practice that is developing, that of calling on external firms. Maybe it gives the appearance that it’s better done […]but McKinsey showed that this was not always the case,” he emphasizes.

“We must ask ourselves the question of relevance. In this case, do we really need to go outside? […] I think that it is perhaps also an easy solution because rather than searching internally, you just have to contact certain consultants who will take the file because for them, it is remunerative, of course,” warns the professor.

Santé Québec is asking establishments in particular to reduce hours worked by 3.65% – which provokes an outcry from the unions –, to reorganize services, to review services without recurring funding, to reduce overtime and to eliminate vacant positions, including among nursing staff, to eliminate the deficit.