Dr. Lawrence Rosenberg, head of the Central-West Montreal health authority, is proposing what amounts to undoing some of Health Minister Gaétan Barrette’s more controversial reforms as he seeks the top job of managing hospitals and clinics in a large swath of the city.
Rosenberg, formerly executive director of the Jewish General Hospital, provided new details of his proposal in an email sent to staff last Thursday. In that email, obtained by the Montreal Gazette, Rosenberg said he would “recreate” the positions of some of the key decision-makers of major hospitals — which Barrette scrapped in his administrative reforms partly to cut costs.
The email was sent out ahead of a Feb. 28 meeting at McGill University’s medical faculty. That meeting has been convened by a Barrette appointee, Dr. Arvind K. Joshi, who is carrying out consultations on Rosenberg’s proposal as well as a merger plan put forth by the head of the West Island health authority, Benoit Morin.
Morin has proposed merging his Pointe-Claire-based authority with the McGill University Health Centre in a new organization that he would lead. Rosenberg, however, has shunned the word “merger,” and has instead recommended the creation of what he calls the McGill Health Network.
Under Rosenberg’s scenario, all McGill affiliated health and social services institutions — including the MUHC — would be managed under a single board of directors, and he would head this network. However, Rosenberg also favors giving back the institutions some autonomy.
“Institutions are grounded in their communities and are empowered to respond to their particular needs and special characteristics,” Rosenberg writes, proposing to reinstate the position of director-general at major hospitals as well as the councils of physicians, dentists and pharmacists (CPDP). The councils oversee the clinical standards at hospitals and review whether to add or discontinue medical services, among other duties.
Under Barrette’s administrative reform, the executive directors and CPDPs of each hospital were abolished, along with the positions of more than 1,300 managers. The boards of directors of hospitals were also eliminated.
In their place, Barrette created umbrella organizations known by their French acronym, CIUSSS. Both Rosenberg and Morin are the heads of their respective CIUSSSes.
One of the goals of Barrette’s reform was to cut $220 million annually in managerial salaries. But critics argue that the reform has left many hospitals in administrative chaos without key decision-makers, causing a negative impact on clinical care.
In his proposal, Rosenberg suggests that although a single board of directors would oversee the McGill Health Network, “advisory committees” would act as “sources of input and community engagement.”
Rosenberg was unavailable for an interview Wednesday, but a spokesperson wrote in an email that his proposal would “create room and mechanisms within the system for the institutions to be responsive to local conditions and needs.”
Barrette’s press attaché did not respond to an email asking the minister what Rosenberg’s proposed reinstatement of key decision-makers says about the government reform.
“The process is following its course and we are waiting for the report by Mr. Joshi,” Julie White responded.
Joshi, former executive director of St. Mary’s Hospital, did not respond to an email request for an interview. In a letter to the groups he is consulting, Joshi said he hopes to present the minister with recommendations that are the result of a consensus of the McGill network.
In that letter, Joshi added that he plans to wrap up his consultations by the end of March. The Feb. 28 meeting will take place in the Martin Amphitheatre, and is open to all members of McGill’s faculty of medicine, including students and medical residents.