Philippe Couillard's quick jump from his seat as health minister into the Persistence Capital Partners business venture raises some crucial ethical questions.
For instance, how could the person who was the official custodian of Quebec's public health-care system for more than five years go directly into Canada's first private investment fund that looks to extend and profit from the delivery of private health-care services throughout this country?
In doing this, did his recent position as health minister serve his personal financial interest by bringing him to PCP? And what are we to make of a career move to a group whose goal is to extend for-profit services that can be said to be against the public good by increasing unequal access to health-care?
This week, fewer than two months after he quit the Charest government, Couillard announced he was joining Dr. Sheldon Elman and his son Stuart at PCP. Elman, a renowned physician who counted former federal Liberal leader Paul Martin as a patient, founded the Medisys health group with former Liberal senator and fundraiser Leo Kolber who sat on its board.
Through the acquisition and creation of a series of private clinics and companies, Medisys grew into a lucrative major provider of health services across Canada for corporations, insurance companies, provincial and federal government agencies, and individuals. In other words, Couillard has joined an influential, politically well-connected and highly profitable business network.
There's no getting away from it: The speed and the circumstances in which it all took place raises enough ethical questions to warrant an inquiry by Quebec's lobbyists' commissioner.
For one thing, the commissioner must find out if reports that Couillard met with the Elmans when he was still a minister are founded. And if so, was their future partnership discussed when Couillard held public office?
The commissioner must also look into one of the last things Couillard did as minister - increasing from three to 50 the number of medical procedures the public system could outsource to private clinics, as well as cut down by half their cost of exploitation permits. Was there a direct or indirect link between his future employment with PCP and the extension of the market for private clinics?
Another question: By going into PCP so quickly, will Couillard profit unduly from his five-year stint as health minister and from his laws and regulations favouring outsourcing to private health-care services and the use of private health insurance plans?
And what about Couillard's privileged access to confidential information as a member of cabinet? How are citizens to be assured that none of it will be transmitted privately to PCP or any of its clients? Regardless of Couillard's undeniable professional credentials, there is here at least the appearance of conflict of interest.
But Couillard's deeds as a minister, and now as a businessman, are just details in the larger picture. The private sector's appetite in this field has in fact been growing since Lucien Bouchard created the winning conditions for it when he imposed drastic cuts throughout the public health-care system.
There's been no greater gift to private health businesses than Quebecers' ensuing worries, founded or not, about how they'll be treated in that public system. Unless you count the gift of the blind eye - sometimes even open collaboration - that Péquiste and Liberal governments turned to the private sector.
In fact, there is a troubling lack of political alternatives on this issue in Quebec. None of the three main parties advocates limiting the impressive 30-per- cent private health spending - the highest rate of all Canadian provinces.
If anything, there's a strong push, lead by the new president of the Canadian Medical Association, for even more for-profit health services. Here's hoping for more voices like that of the Médecins québécois pour le régime public, which just penned the Montreal Declaration against this trend.