In 1966, the Government of Quebec mandated Mr. Castonguay and Mr. Nepveu to prepare a report for the implementation of a universal healthcare system. In 1969, the Castonguay-Nepveu Commission1 recommended the creation of the Quebec Health Insurance Plan (Régie de l’assurance-maladie du Québec) and submitted, in 1970, a report that underlies the existing healthcare system…

Introduction Improving the performance of emergency room services in our hospitals has been a priority in Montreal for many years now and though there have been periods of improvement sustained performance have not been achieved. Considerable investment has been made to discharge patients more rapidly especially those who need long term and convalescent care and…

Introduction Over the past two years as CEO of the Montreal Health Authority I have participated in the preparation and now the implementation of what I consider the first real reform in healthcare since the beginning of Medicare in 1970. In my opinion Quebec is undergoing a second “quiet revolution” in healthcare as important as…

Introduction Healthcare is a complex sector to manage at the organizational level, and is even more complex at the systemic level. Healthcare functions in a professional bureaucracy (Mintzberg, 1983), where all professionals gain their authority to practice from their own licensing corporations and where the evaluation of their performance and discipline is done by bodies…