Quebec reforms threaten Jewish health, social institutions: brief

The Jewish General Hospital is concerned that it won’t be able to recruit top professionals if it loses its individual identity under Bill 10.

MONTREAL — The Quebec government’s proposed sweeping overhaul of the province’s health and social services will have a detrimental effect on Jewish institutions’ ability to raise funds and attract volunteers, according to a brief submitted to the parliamentary committee studying Bill 10.

In fact, the Jewish community fears that the institutions’ very religious and cultural identity is at risk and that they could lose control over physical assets and even their names.

Under the proposed legislation, the five health and social services institutions on the Island of Montreal with deep roots in the Jewish community would lose their individual legal status and be administered, along with five other institutions in the West End, by a single, government-appointed board. 

The sixth, the Jewish Rehabilitation Hospital (JRH) in Laval, would similarly be grouped with institutions in that city. 

Overall the number of separate institutions in the province will be reduced from 182 to 28, and the regional health and social service agencies will be eliminated completely, saving $220 million annually, according to the government.

The creation of these mega-organizations, called Centres integrés de santé et de services sociaux (CISSS), would “severely compromise fundraising and volunteerism, since longstanding donors and volunteers would not feel the same loyalty and kinship to substantially reorganized and modified versions of their institutions,” stated the joint brief submitted Nov. 18 by the Jewish General Hospital (JGH), Maimonides Geriatric Centre, Mount Sinai Hospital, Miriam Home and Services, Jewish Eldercare Centre, JRH, the Centre for Israel and Jewish Affairs, and Federation CJA.

The JGH, in particular, would have difficulty recruiting top clinical staff and researchers from elsewhere in Canada and around the world, the brief stated, because its individual reputation would be “overshadowed by and subservient to the CISSS.

“Prospective recruits would… be reluctant to join the JGH, given the deterioration of the hospital’s academic mission through the loss of its supra-regional status.”

The community is worried because the bill, tabled by Health Minister Gaétan Barrette in September, does not contain any explicit safeguard for the distinct religious or cultural identity of institutions, or for their bilingual status.

“It is only a matter of time before donors and volunteers will begin to wonder why they owe any allegiance to an institution whose values and direction are dictated from above and are no longer consistent with many decades of history and tradition,” the brief states.

Article 14 stipulates that when appointing board directors, the health minister “must take into account adequate representation of the various parts of the territory served by the institution and consider the sociocultural, ethnocultural, linguistic and demographic composition of the user population.”

Article 131 also allows the minister to set up an advisory committee “charged with making recommendations to the institution on the measures to be implemented to preserve the cultural, historic or local character.”

The community believes this is inadequate, and offers no protection “against the possibility of arbitrary and unfair changes by a future government. Nor is any protection provided to the institutions that would give them the ability to retain control over their corporations, assets, names and branding.”

The brief notes that the JGH foundation is the second-largest of its kind in Quebec.

On the positive side, the community says it supports the bill’s aim of making the system more efficient, both financially and in the delivery of care.

The brief describes the proposed reform as possibly “the greatest modern transformation in the delivery of health care and social services… since the introduction of medicare [in the 1960s.].”

The brief’s authors recommend that the Jewish institutions, and others in central Montreal, remain distinct legal entities with their own boards of directors, which would be accountable to the new CISSS. As they are all volunteers, there is no cost to the public purse, it is pointed out.

Under the bill, the five Montreal Jewish institutions would be administered by the CISSS du Centre-de-l’Ile-de-Montréal, one of five CISSS groups on the Island of Montreal.

The authors of the brief say the institutions’ own boards should be responsible for their clinical and research mission (including selection of professional administrators and clinical chiefs), preservation of the institution’s distinct identity, the relationship with its foundation and with McGill University (where applicable), and suggesting nominations for the overarching CISSS board. They would retain the right to veto any mergers and responsibility for the disposal of assets. 

The CISSS would have the authority to oversee the streamlining of services in the territory, the community recommends.

The community also wants the JRH to continue be a separate institution and to able to accept Jewish patients from Montreal – beyond its territory.

While Barrette, a physician by profession, has offered assurances that the rights of anglophones will be protected and that he will seek recommendations from the community in making appointments to the CISSS, the Jewish community believes these guarantees must be spelled out clearly in the law.

As it now stands, “the fate of member institution’s bilingual status and the continuity of its special religious/cultural legacy depends upon the benevolence, compassion and understanding of those on a regional board or of the minister, and not directly upon the individuals who represent the member institution.”

The federation is asking community members to sign the Quebec Community Groups Network’s online petition to Barrette, which calls for the retention of all anglophone institutions’ distinct character and autonomy, at http://bill10.com, as well to join the social media campaign at the Bill 10 Wrong Prescription Facebook page and comment on Twitter using the hashtag #bill10wrongprescription.

“Taking these actions will help let the minister know that members of the Jewish community stand with others who have serious concerns about the impact of the proposed reform,” federation president Susan Laxer and CEO Deborah Corber  said in an open letter.