It’s a refrain we’ve heard all too often, especially in our little corner of Quebec.
Citizens across the province, and especially here in the Pontiac, have lamented the recent centralization of the province’s healthcare system.
In 2015, the implementation of Law 10 meant that the boards of individual health institutions – like the Pontiac Community Hospital – were abolished and replaced by 28 regional boards across the province.
That meant that service coordination moved from the local hospital to the centralized location in Gatineau.

Many people have complained that this has led to a decrease in service and level of care.
But Health Minister Gaétan Barrette has argued that centralization is necessary and that some short-term pain is necessary to get a long-term gain out of the healthcare system in the province.
But many doctors and frontline healthcare professionals have said that the plan isn’t working.
Needless to say, Barrette has had a rocky relationship with frontline healthcare staff – look no further than the ghostbuster stickers that adorn many Quebec ambulances for evidence of that.
Bill 130, which Barrette is currently promoting, will take away some of the independence of doctors, which could bring him into the crosshairs of another group of healthcare professionals.
The centralization of Quebec’s healthcare system has definitely seen short-term pain, but residents are wondering when the long-term gains will start to pan out.
There is no debate that the healthcare system in Quebec was far from perfect before the introduction of Law 10. So some type of reform was necessary.
But removing the day-to-day decision making from the actual people with boots on the ground has had predictable results.
In an editorial in the Montreal Gazette this week, senior associate researcher at the Montreal Economic Institute Germain Belzile argued that it doesn’t take much to throw the current system into a tailspin.
“The slightest thing, like hospital staff vacations or the early onset of winter flu season, creates a chaotic situation in emergency rooms,” he argued.
Many people from the Pontiac have complained that service levels have dropped at the local hospital since the creation of the regional health board Santé et services sociaux en Outaouais (CISSSO).
Many people remember, mainly because it was only a few years ago, that the Pontiac Community Hospital was one of the better-run healthcare facilities in the province before it was forced to amalgamate with others in the region.
Doctors, nurses and patients have all expressed worry, and in some cases outrage, about the path our health system seems to be headed down.
Many experts have pointed to Sweden as a potential answer for the province. The Swedish system is a decentralized one that combines both private and public facilities, all in a universal coverage system.
Not only that, but the delays experienced by patients to get elective surgery or to see a specialist are much lower than they are here.
In a community like the Pontiac, where memories of balanced budgets are still fresh, people wonder why a good thing was sacrificed for something that doesn’t seem to perform nearly as well.
We all know that government, and especially bureaucracies, move at a snail’s pace. Not only that, but governments tend to be fairly stubborn when they feel they know the “right” answer.
This means it’s unlikely that the province will reverse its decision and hand power back to local healthcare institutions.
With that in mind, let’s hope that these so-called long-term gains start to show some signs of appearing.
It appears that what’s done is done. But that is no reason to root against the current system in the hopes that the government will hand power back to local institutions with its tail between its legs.
Ideally, the efficiencies that have been touted as the reason for reform start to appear soon. But, for the time being, all we can do is wait and see.
If these efficiencies don’t appear, Barrette and whoever takes his post next will feel the full fury of both healthcare workers and patients alike.
And if centralization doesn’t work, maybe the solution is to hand power back to the local level, regardless of how hard the government finds that to be.
After all, plenty of people in these parts remember the times when a de-centralized healthcare facility did a pretty darn good job.

Chris Lowrey