One step forward, one step back

Quebec's 2003–04 health and social services regionalization policy

Bibliographic Data

ID9784353
AuthorsElisabeth Martin (0000-0003-4789-1712, Université Laval, corresponding author), Marie‐pascale Pomey (0000-0001-5180-8139, Université de Montréal), Pierre‐gerlier Forest (Pierre Elliott Trudeau Foundation)
Year2010
Volume53
Issue4
Pages467-488
Publication date2010-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueCanadian Public Administration (JOURNAL)
Journal identifiersISSN: 0008-4840 • E-ISSN: 1754-7121
PublisherWiley (PUBLISHER • GB)
DOI10.1111/j.1754-7121.2010.00144.x
PMID21132937
OpenAlexW1486884533
LanguageEN
Citations received1
References cited25

This article focuses on Quebec's most recent reform in the regionalization of health care to understand why the government chose to transform the regional boards into agencies. This case study used interviews and documentary analysis. Rooted in a political science perspective, the conceptual framework is inspired by the work of John Kingdon (1995) and draws on the four variables that influence the choice of policy: ideas, interests, institutions and events. Results of the case study suggest that Quebec's Commission of Study for Health and Social Services (the Clair Commission) in 2000 and the 2002 pre‐electoral environment put the issue on the agenda. In 2003, the newly elected Liberal government passed Bill 25 – An Act Respecting Local Health and Social Services Network Development Agencies, which represented a political compromise: originally slated for eradication, the regional tier survived but in a new form. The element that sparked reform was the change in government following the elections. Different inquiry reports spread the reform's ideas, while interest groups articulated contrasting visions on the transformation. Above all, regional institutions showed great resilience in the face of change. From a historical perspective, this regionalization policy is a step backward: the regional tier is now stronger from a managerial and technocratic point of view, but it is politically and democratically weakened. This suggests a government intention, at that time, to maintain the regional level as a means of retaining centralized control over Quebec's health‐care system

Commission · Compromise · Government (linguistics · Health care · Health care reform · Political science · Politics · Psychological resilience · Sociology · Technocracy · Vision · Canadian Identity and History · Healthcare Systems and Practices · Law · Public Administration · Social Sciences and Governance · Health Policy

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