Quebec Party Plans Force Santé Québec to Reassess Its Structure

Quebec's healthcare administration faces a potential restructuring after the Parti Québécois won the provincial election, prompting Santé Québec to suspend recruitment for some headquarters positions while it reassesses staffing needs. The agency announced the temporary measure three days after the election as the incoming political leadership considers reducing its workforce and transferring responsibilities closer to hospitals and regional managers. According to Le Devoir, a memo dated Thursday from Martyne Charland, Santé Québec's director general of talent, culture and engagement, said the affected positions would be reviewed to determine whether they still met the organization's needs.

Spokesperson Marianne Paquette said the suspension would not affect employees scheduled to start in the coming weeks or recruitment processes already underway. Santé Québec declined to specify how many positions were affected or explain the reasons for the decision. The Parti Québécois also declined to comment, according to Le Devoir.

Party leader Paul St-Pierre Plamondon initially pledged to abolish Santé Québec if elected. By late September, however, he had proposed retaining part of the organization as a division of the Health Ministry while eliminating 900 positions and saving between $40 million and $100 million.

St-Pierre Plamondon has also called for greater authority for managers at the regional and hospital levels. Before the campaign began, he accused the Coalition Avenir Québec government of losing control of the agency and described it as a bureaucratic monster with nearly 1,300 employees at its headquarters. The proposed changes have intensified debate over whether Quebec should retain a centralized body responsible for organizing healthcare services or restore greater autonomy to individual institutions.

An October 9 opinion article in Le Devoir by a former secretary-general of the Quebec government argued that abolishing Santé Québec would accomplish little without a broader shift toward decentralization. The author advocated restoring hospital and healthcare facility boards of directors composed of people from their local communities, giving institutions more direct control over management, fundraising and development. The author said centralized administration had gradually expanded over approximately two decades under successive healthcare reforms associated with Couillard, Barrette and Dubé. The resulting structure, the author argued, had weakened the identities and autonomy of local hospitals, local community service centers and long-term care facilities.

The article cited the Montreal Heart Institute and a palliative care facility as examples of institutions operating outside the centralized system with independent boards and strong community fundraising. It also identified CHU Sainte-Justine, CHUM and the McGill University Health Centre as other institutions outside the system. Under the proposed decentralized model, regional administrative structures, including integrated health and social services centers, could become largely unnecessary.

The author argued that some administrative employees with healthcare backgrounds could return to frontline roles, while the Health Ministry would focus on monitoring results rather than prescribing operational methods. Cardiologist Gilles Goulet of CHUM has separately criticized the healthcare network's administrative burden and organizational problems. In an appearance on the radio program La commission, he argued that patient needs were being pushed aside by a structure disconnected from frontline realities.

Goulet also raised concerns about absenteeism, which he said directly affected scheduled surgeries and patient care.

A separate October 9 opinion article in Le Devoir presented a contrasting argument for retaining Santé Québec. Its author, a midwife and public affairs adviser at Catapulte, suggested that a minority government could provide a meaningful test of the agency's intended separation between political decision-making and operational management. Established in 2024, Santé Québec was designed to organize and administer the healthcare network, while the government retained responsibility for funding, public policy, strategic direction and legislative and regulatory frameworks.

Under that arrangement, the minister sets priorities, the Health Ministry translates them into policies and funding, and the agency implements them across the network. The author argued that a minority government could test whether Santé Québec can maintain operational continuity when political priorities and budgets require negotiations among parties. The article also emphasized that improvements to emergency department flow, staffing stability and clinical practices require years rather than a single electoral cycle.

Santé Québec has defended its record since its official launch in 2024, citing progress that includes shorter waits for surgery. Its future structure remains a central question as the Parti Québécois prepares to pursue workforce reductions and greater regional and hospital-level management authority.