January 7, 2005 Friday
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The saga of the French-language superhospital has gone haywire. The Charest government's indecision has given way to a cacophony of lobbies confronting each other through the media.
We are desperately seeking a health minister in this file.
Montreal's health agency, various community and patients-rights groups and the government's own Mulroney-Johnson committee want the new CHUM to be downtown at St. Luc hospital.
Facing them, a lobby of influential businessmen support Universite de Montreal rector Robert Lacroix's project: A "technopolis" that would integrate a new hospital with U de M medical faculties in a former CP rail yard in Outremont. This large-scale project could end up costing close to $2 billion.
With Charest hesitating, the business aristocrats spoke up. This week, nearly 30 of them published an open letter in La Presse, including current and former CEOs of Bombardier, Cogeco, Alcan, Jean Coutu pharmacies, Industrielle Alliance, Provigo, Transcontinental, National Bank, Domtar, Gaz Metropolitain and Merrill Lynch - a business Who's Who of those with close ties to the Liberal Party.
Most of the signatories have no real link to the public health-care system. But a number of them stand to profit directly or indirectly from the spinoff from Lacroix's project that would allow for enough space for adjacent private clinics, research facilities, condos and hotels.
Businessmen may voice their opinions like other citizens, but the problem is that their influence is so great that it risks outweighing that of most taxpayers. It was the business lobby that persuaded Charest in December to delay his decision yet again, months after his Mulroney-Johnson committee recommended St. Luc.
So while Charest is rumoured to support the Outremont site, his cabinet remains divided, and Health Minister Philippe Couillard is known to favour St. Luc, the lobbying campaign for both site keeps escalating.
Yesterday, without openly taking a position, Patrick Molinari, president of a very divided CHUM board, reminded the government St.Luc would be easily accessible, safe, functional and have the necessary 700 beds at one site and be less costly than Outremont.
A few hours later, Montreal Mayor Gerald Tremblay weighed in. After some Polyannaish musings about a "new concept that could unite everyone" and dreams of outperforming Boston, he sounded more in favour of Outremont. At the same time, he asked for transparency on the cost of the new infrastructures, roads, public transit routes and the decontamination of the CP rail yard.
But the mayor's preference aside - all mayors love grandiose projects on paper - the issue of money points to an obvious bottom line: The Outremont site stands to cost hundreds of millions of dollars more than St. Luc while offering 150 fewer beds. It would cause the closing of two major downtown francophone hospitals - St. Luc and Hotel Dieu.
Which also brings us to an existential question that puts Lacroix's grandiose vision in a larger perspective: With an aging population and growing health-care needs, how is it that public services keep diminishing, including the reduction of the number of hospital beds without corollary home care? Private services keep growing while the proportion of Quebec's budget devoted to health care - now 42 per cent - keeps increasing. Who's minding the store?
How did we get here? Paul Saba, co-president of the Coalition of Physicians for Social Justice that favours the St. Luc site, said "the crisis of our system isn't caused by our old hospital buildings, which could be renovated. The reason is a shortage of doctors, nurses and resources as well as the closure of seven Montreal hospitals in the 1990s, a problem no megaproject will eradicate."
As for the CHUM saga, what was supposed to be a modern, accessible francophone university hospital able to provide quality care to patients has turned into a three-headed monster: a hospital-university campus-business centre.
Lacroix contends no new CHUM is feasible without merging with a new faculty of medicine on one site. But the U de M has always trained the best doctors and nurses without such synergy. Could Lacroix be looking mainly to expand his university?
For the business lobby, the Outremont site is a possible gold mine for private health care, research and pharmaceutical facilities as well as for real-estate development.
Hence, another question on the CHUM: Where is patient care in all of this and who will ensure its financial responsibility?
When Charest and Couillard finally do Quebecers the honour of informing them of their decision, they'll see which bed they choose to lie in: that of the patients and the taxpayers, or that of business and the U de M's ambitions.