Government & policy
Dispute over delivery of hospital
services in Montreal
Quebec Health Minister Philippe Couillard (pictured
at left) announced the creation of a task force to re-examine the
concept of “clinical complementarity” between the Montreal Children’s
Hospital and St. Justine Hospital. The announcement
was made after a dispute arose over the proposed sharing of clinical
The task force will also evaluate complementarity between Montreal’s two university
teaching hospital networks – the McGill University Health Centre (MUHC)
and the Centre hospitalier de l’Universite de Montreal (CHUM).
The task force is to be presided over by Dr. Michel Baron, former dean
of medicine at the Universite de Sherbrooke.
The creation of a task force comes on the heels of a dispute over the
proposed transfer of of complex cardiac surgerty and other
specializations from the Children’s Hospital to Ste. Justine.
The task force will include four representatives from the MUHC, four
from the CHUM, two from Ste. Justine and two from the Children’s. In
addition to the chairperson, there will be an observer from the Health
Department. The task force is expected to report back to the government
in the next few months. Dr. Baron will act as a mediator or
“facilitator” between McGill and the U de M.
The Health Ministry hopes to optimize the delivery of services as it
creates two new “super-hospitals” over the next few years, one for the
McGill organization and other for the CHUM. It is also expanding the St.
Justine Hospital. The three projects are expected to cost on the order
of $2.5 billion.
For its part, the Quebec government would rather create centres of
excellence for various procedures, concentrating expertise in one
location, rather than spread capabilities across sites which experience
low volumes of surgeries.
Health Minister Couillard told the Montreal Gazette he was “struck by
the intensity of the reaction” over proposals to transfer the services.”
He added that, “It’s obvious that it raised some deep sensitivity in the
anglophone community, and I recognize that. Maybe we should have done
things differently. But still, I’m very committed to the fact that
because we are building these hospitals ... we’re trying to reach a new
level of excellence.”
Couillard, who was trained as a brain surgeon, gave as an example
surgery to remove tumors from the eyes of children. Doctors perform an
average of 10 such operations a year in Quebec. “What is best,” he told
the Gazette, “to have three done at one hospital and four at the other?
“Or is it better to have all the cases treated by the same team all the
time? That wouldn’t threaten the general mission of the hospital.”
The Montreal Children’s Hospital is affiliated with McGill University’s
medical school, and Ste. Justine with the Universite de Montreal. The
two medical schools have maintained positive relations in the past, but
the complementarity proposals have sparked a bitter rivalry.
Another government appointee, Clermont Gignac, is overseeing the
estimated costs and construction details of the hospital projects.
The first phase of MUHC’s $1.1-billion redevelopment will involve the
construction of the Montreal Children’s at the Glen Yard site in Notre
Dame de Grace. It’s scheduled to start in fall 2006.
Complementarity proposals for adult medical services have also been
controversial, but did not come under as much fire as the plans for
children’s services. For example, the government had recommended
transferring organ transplant services from the MUHC to the CHUM, as
well as concentrating all adult complex cardiac surgery at the Montreal