Quebec will have given the private health-care sector more than $6 billion in 2023-2024, the Confédération des syndicats nationaux (CSN) calculated from public financial reports.
This amount was calculated by adding the cost of independent labour and purchased services in each CISSS and CIUSSS. Purchased services can cover a fairly wide range, including maintenance contracts, the cafeteria, but also the use of occupational therapists, psychologists and nutritionists, among others.
The CSN research department noted that the government would have saved more than $700 million if it had used employees from the public health and social services network.
“For us, these figures show that it’s not true that private health-care costs less and is more efficient. It’s not true,” said CSN vice-president David Bergeron-Cyr.
The CSN is once again trying to get its message across to the Legault government. The central labour body wants to see an end to the expansion of private health care.
“What we’ve seen over the past 30 years is the failure of the neoliberal and capitalist policies of our various governments and of our public health and social services network. These policies involve privatization, centralization, systematic underfunding and the destruction of the network,” said Bergeron-Cyr.
He also pointed out that access to care is not improving and the number of people on waiting lists remains very high. He acknowledged that the COVID-19 pandemic has not helped the situation, but believes that the problems of access to health-care services were already present beforehand.
Health Minister Christian Dubé already announced he wants to get rid of private agencies. Hospitals in urban centres recently stopped using employment agencies, and other regions are expected to follow suit in the coming months.
Dubé hoped to repatriate staff from the private sector to the public network. He says that in the last year, 5,100 employees have returned to work in the public network.
The pool of health-care professionals is the same in the private and public sectors, and working conditions are often more attractive in the private sector because private clinics are rarely operational in the evenings or weekends.
“The private sector in health care is not complementary, it’s a competitor,” said Bergeron-Cyr.
The initiative to gradually withdraw from private agencies is a step in the right direction, said Bergeron-Cyr. But, he said the minister has no choice since recourse to these professionals had become uncontrollable and very costly.
“When it started, independent labour was supposed to meet a one-off need in a few regions. Eventually, it became a panacea. It exploded,” he said.
Dubé wants to use the private sector to support the public network, which is unable to meet the needs of the population, for example with the surgical waiting lists that have grown longer in recent years.
He often talks about offering private care that people could pay for with their health insurance card. But Bergeron-Cyr warned against this strategy.
“It’s the government’s intention to offer health-care services to the private sector, but reimbursed by the state. What we’re saying is that people are going to pay twice,” he said.
“When you have a public private sector like that, you pay twice because we pay with our taxes, and on top of that, [the private establishments] are going to take a hit. It’s not true that they’re going to offer the same service at the same cost. It’s going to cost the state more to do business with these people, and we’re going to be paying a second time for their profits.”
The CSN wants the health minister to curb the exodus of doctors to the private sector by May 1, by going further than Bill 83, which would prevent doctors from moving back and forth between the private and public sectors and would require new doctors to practice for five years in Quebec’s public network.
The CSN is also calling on the government to stop issuing permits for private for-profit clinics immediately and to impose a moratorium on all types of privatization of work and tasks performed in the public sector.
This report by The Canadian Press was first published in French April 14, 2025.
