“It seems impossible to me”: Santé Québec will have to do better with less money in 2025

In 2025, the health network will have to improve access to care for Quebecers… while reducing expenses by $1.5 billion. This is the “impossible” mission received by the brand new state corporation, Santé Québec, the sole employer of the vast network since 1^is December.

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An immense challenge, believes Régis Blais, professor at the School of Public Health at the University of Montreal. “It’s squaring the circle […] To cut $1.5 billion and do better seems impossible to me,” says the expert.

“The year 2025 will be a year of budget cuts […] But if we want to provide better access to care, we must be careful not to cut too much,” argues Danielle Girard, president and CEO of the Association of Managers of Health and Social Services Establishments (AGESSS) .

And Quebecers will wait for results firmly, tired of waiting on ever-longer and longer waiting lists.

The first year of Santé Québec

The next year will mark the first with Minister Christian Dubé’s reform in action. The state-owned company, Santé Québec, will take the reins of the health network with “top gun” Geneviève Biron at its head.

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“But by next fall, we will have to see results. Otherwise, we will be entitled to wonder if it was worth creating this,” says Régis Blais, who believes that the government was mainly trying to save time.

“Many other reforms in the past have wanted to cut budgets and keep everything the same access to care, but there are no magic recipes,” says Danielle Girard, pleading for her members in the field to be consulted.

Negotiations with doctors

The standoff between the government and doctors is likely to continue in 2025. Quebec must negotiate a new employment contract for the remuneration of family doctors and specialists and already this fall, discussions are tense in public.

Quebec is asking doctors to do more, even threatening to impose penalties on the least productive. Minister Dubé also seeks to control up to 40% of their salary envelope, that is to say the value given to medical procedures, compared to barely 5% currently.

Doctors want to increase their remuneration.

“Access to a doctor is one of the big problems in our health system,” says Régis Blais.

End of private agencies… for real?

The bill for private health agencies has crossed the $2 billion mark in recent months. An astronomical sum which digs a huge hole in the gargantuan budget of the health network. But Minister Dubé, who had promised to abolish them in Montreal, Quebec and the surrounding areas, had to back down last year, under strong pressure.

The new target for weaning establishments is now March 2025.

But Régis Blais notes that the agreement concluded with the FIQ this fall, for nurses, has not led to a rush towards the public network and that the increasing recourse to the private sector is also eating into staff.

A catch-up always postponed

Once again, the catch-up objective in surgery will not be achieved in 2024… and pushed back to 2025.

After missing his 2021 and 2022 targets, last year, Minister Dubé presented yet another catch-up plan to reduce the number of patients waiting for an operation for more than a year to 2,500 by December 31, 2024. .

There are currently more than 10,000 waiting and the target is to reach 2,300 patients by March 31, 2025.

The only positive point on the table is that more than 22,000 Quebecers have been waiting for more than a year in 2022. Their number is decreasing even if it remains far from the objective.