Is health minister Barrette the cure or the disease?

Gaétan Barrette, smug AF

We started hearing the sounds of sirens many years ago, when Gaétan Barrette — who led the Quebec association of radiologists and then the Fédération des médecins spécialistes du Québec (FMSQ) for eight years each between 1998 and 2014 — was recruited by the Coalition Avenir Québec as a star candidate and presumptive health minister in a CAQ government.

Barrette’s reputation for brusque arrogance and bullying style of leadership served him well as the chief negotiator for the elite of the Quebec medical corps at FMSQ. It was a coup for CAQ, but not enough of one for Barrette to win over the voters of Terrebonne in the 2012 election. Barrette was defeated by 3,600 votes and returned to the FMSQ to lick his wounds.

He didn’t wait long before returning to the political arena. When the minority PQ government was forced to call a new election in 2014, Barrette switched to the Liberals, where he once more had the inside-track to become the head honcho of health, a post once held by soon-to-be premier Philippe Couillard.

Since easily winning the Liberal seat in the South Shore riding of La Pinière, Barrette has presided over what Québec political columnist Josée Legault this week called a rotting health system. “Hypercentralization, managers disconnected from the real needs of the population, austerity, privatization, surge in doctors’ pay, gaps in home care, forgotten vulnerable people, omerta, no checks and balances…

“History will one day remember that the reign of Dr. Barrette — under the approving eye of his premier, also a business-first doctor — will surely have been the worst in decades.”

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The false crisis of the Liberal’s “zero-deficit” policies provided Barrette with the perfect opportunity to gut the health system of his opponents by eliminating more than 1,400 management jobs. In one fell swoop, he removed many of the most experienced managers in the system, placed a much larger burden on the shoulders of the remaining managers and solidified his own control by expanding his ministry’s power to fill the vacuum.

The Liberal spin was that the cuts eliminated an unnecessary level of bureaucracy in the health system thus making it more efficient, but that’s a little like saying you can make an assembly line go faster by doing away with quality controllers and preventative maintenance.

There aren’t many people who want to sing the praises of “bureaucracy,” but you really wouldn’t want to see what the Québec health system would look like without it.

Barrette, meanwhile, created new bureaucratic institutions and processes to replace the ones he’d eliminated. For example, the Centre de répartition des demandes de services (CRDS) was supposed to streamline the process for seeing a medical specialist, but instead created bottlenecks and added new hoops for patients to jump through before they can see a cardiologist or oncologist.

The Fédération des médecins omnipraticiens du Québec said they were hearing so many complaints about Barrette’s new systems and their effects on patient care that they wanted to create a forum where doctors could vent about the biggest problems. Two months ago, they implemented a complaints hotline which has since been flooded with calls. Simply the name of the phone line — LUCIDE, or “Ligne utilisée pour communiquer l’inacceptable et le désastreux” — highlights the seriousness of the gripes.

Even Barrette’s former colleagues at the federation of specialists are fuming about the “appalling failures” of Barrette’s CRDS, among many other shortcomings. In March, the current president of the FMSQ wrote in an editorial that the health minister had turned his back on the province’s doctors and refused to listen to anything but his own voice.

“The year began as it ended: in total chaos,” wrote Dr. Diane Francœur. “Bills and regulations are poorly written, poorly planned and disconnected from reality on the ground.”

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I’m not even going to get into the details of the fiasco of the McGill University Hospital Centre management crisis, which compelled 10 community members of the MUHC board to resign in protest this week over Barrette’s contemptuous disregard for their input on the fate and future of the hospital.

But if the MUHC is a “superhospital,” then the Quebec health minister must be carrying kryptonite as his actions cause the spanking new institution to bleed money while ultra-modern operating rooms stand idle. Barette’s new system is incapable of allocating sufficient human resources to meet patient demand.

Demoralization of workers in the health and social services network is rotting the system from the inside. People who have devoted their lives to caring for others often come home frustrated and depressed by a constantly changing, ever-rigid, Byzantine system that makes it increasingly difficult to provide adequate or timely care for their clientele. All the while, the health minister tinkers with his latest bureaucratic inventions, that seem more often than not to worsen the problems they were intended to solve.

Has the “reform” disease spread so widely that the damage can’t be repaired? We’ll never know as long as we have a health minister who has not only misdiagnosed the biggest problems, but also won’t admit that his prescribed cures are making the patient worse.

It’s time for a second opinion — and that means appointing a minister who knows how to listen … and who doesn’t see God every time he looks in the mirror. ■

Peter Wheeland is a Montreal journalist. His sardonic observations about the city and province appear on Cult MTL every week. You can contact him by Email or follow him on Twitter.