By William Crooks
Local Journalism Initiative
In a passionate call to action, Jean-Guy Gingras, co-president of the Vigilance Committee on Health and Social Services for the MRC Memphrémagog (CVSSSM), has urged Santé Québec to reinstate local governance for health services. His appeal, bolstered by a detailed letter co-signed by key municipal leaders and health advocates, highlights the inadequacies of centralized decision-making, particularly in rural and aging communities.
Strong local governance once ensured quality care
“Before the Barrette reform, our hospital operated very well,” Gingras said in a recent interview. “Services were efficient, staff were motivated, and the community felt involved.” He contrasted this period with the challenges following centralization, which he claims has negatively impacted services in the region.
The Barrette reform centralized control under the CIUSSS de l’Estrie-CHUS in Sherbrooke, removing local oversight. Gingras highlighted that the reform has led to a loss of efficiency and responsiveness. Decisions, he said, are now made far from the communities they affect, undermining the quality of care.
Lack of flexibility harms vulnerable populations
The committee’s recent letter, dated Nov. 23, further explains these issues. It cites examples of patients needing to travel to Sherbrooke for care that could be provided locally and of specialized services such as geriatrics being discontinued. “We’re the most aging region in Quebec,” Gingras pointed out. “Yet services for seniors, like geriatrics, have not been restored despite promises.”
The letter emphasizes that rural areas like Potton and Sainte-Catherine-de-Hatley face unique challenges. Residents often lack access to reliable transportation, making centralized services inaccessible. Furthermore, decisions made at a regional level fail to consider the diverse socio-economic and linguistic needs of the MRC’s population.
Services deteriorate under centralization
Both Gingras and the letter point to specific examples of declining services. In the interview, Gingras noted that hospital facilities remain underutilized due to staffing shortages. “We have entire floors waiting to be renovated, but no progress is being made,” he said. Specialized services like orthopedics and neonatology are no longer available locally, forcing residents to travel.
The letter echoes these concerns, describing the “siloed management” that has arisen under centralization. Each service now reports to its regional director rather than functioning as part of an integrated local team. This approach, it argues, has eroded the overall quality of care.
Structural issues outweigh individual efforts
While acknowledging the goodwill of current CIUSSS management, Gingras maintains that the problem lies in the centralized structure itself. “We need someone local who’s accountable and knows the community,” he said. He recalled a time when the director of the local hospital was a well-known figure, attending community events and directly engaging with residents.
The letter elaborates on this point, arguing that local governance fosters a sense of belonging and attentiveness among staff. It questions the feasibility of a central office in Sherbrooke managing hospitals across seven municipalities while also overseeing a major university hospital.
Community-driven advocacy
The CVSSSM, formed in 2017, includes health professionals, community organizations, municipal leaders, and residents. All members, except for elected officials, volunteer their time. The committee meets monthly with CIUSSS leadership to address issues, but Gingras emphasized that these efforts can only go so far without structural change.
In the interview, Gingras highlighted the importance of community engagement. “Residents with concerns can contact us directly,” he said, adding that the committee relies on public input to identify pressing issues. “We’re here to ensure that problems are addressed and don’t escalate.”
A call for action
The letter to Santé Québec was addressed to Geneviève Biron, president and CEO, and Christiane Germain, chair of the board. It was also copied to key figures, including local MP Gilles Bélanger. In it, the CVSSSM requests a meeting to present their case for local governance.
Gingras expressed hope that this advocacy would lead to meaningful change. “Our ultimate goal is to bring decision-making back to the local level,” he said. The committee believes that establishing local governance would not only improve care but also restore community trust in the healthcare system.
Looking forward
The centralization of healthcare services has sparked debate across Quebec, with regions like the Outaouais and Abitibi-Témiscamingue facing similar issues. As the Santé Québec agency begins its mandate, the voices from Memphrémagog add to the growing demand for a more decentralized approach.
Gingras reiterated the urgency of the matter. “This isn’t just about healthcare,” he said. “It’s about ensuring that the people of our region are treated with the dignity and care they deserve.”