By Trevor Greenway

editor@lowdownonline.com

Marc Bilodeau has gone from caring for Canadian soldiers fighting in Kabul, Afghanistan to advocating for healthcare in the Outaouais as the new CEO of CISSS de l’Outaouais.

Bilodeau served as surgeon general in the Canadian Armed Forces from 2020 to 2023, after serving for 28 years in military roles including physician leader and military physician. He was deployed to Afghanistan in 2003, where he was responsible for pre-hospital and primary care. 

The former major was hired as president and chief executive officer of the Centre intégré de santé et des services sociaux de l’Outaouais (CISSS) in the fall of 2023 and began his official four-year mandate in the position this past January. He’s fully bilingual and says he wants to be an engaged CEO in the Outaouais. 

The Low Down interviewed Bilodeau on March 20 as part of our four-part health series, “Health in the Hills”. 

His answers have been edited for length, grammar, style and clarity. 

Low Down (LD): You spent the first couple of months of your mandate meeting with local health organizations throughout the region. What did you learn about the MRC des Collines’ healthcare situation and its challenges?

Marc Bilodeau (MB):  The biggest challenge for the whole region, I would say, is human resources. Unsurprisingly, we are in a very challenging environment with lots of demand and few human resources available in the specific context of youth. Our region is very close to large Ontarian employers, as well as the federal government, which is making it very challenging for us to bring new employees in but keep them as well. The MRC des Collines is impacted by that…A challenge of the MRC des Collines is that it’s close enough to the city but far enough from the city to be in between those challenges. So, that makes it a bit unique, and this MRC’s needs must be considered in their uniqueness.

LD: We lose a lot of nurses to Ontario. What is your plan for recruiting and retaining healthcare professionals in the Outaouais?

MB: Some conventions are being negotiated right now at the ministry level…. This hopefully will give us a few additional tools to keep our nurses and bring additional ones. On top of that, we’re working very closely with academic institutions to train more nurses in the area because we know that if they’re trained here, they’re more likely to stay around…. On top of that, we are trying to make working conditions as compatible as possible with a work-life balance and giving a bit of respite to our nurses, who have been working very hard for so many years due to the pandemic. 

LD:  Why are nurses leaving Quebec for Ontario?

MB: There is a significant discrepancy in salaries between the two sides of the [Ontario-Quebec] border. This is the main factor, in my opinion. We’re trying to provide the best working conditions possible. It’s becoming very challenging, though, when you’re below a certain number of people. In some areas I’m staffed at about 30 per cent of the total number I would need. Maintaining good working conditions in that environment is also hard because there is so much pressure on the few people we have. So, even if we have good working conditions, it is less enjoyable to work in because of the amount of work and volume. So, workload as well. I guess it’s a combination of both. 

LD: The Outaouais has been grossly underfunded in healthcare, as evidenced by a 2018 Institut de recherche et d’informations socioéconomiques (IRIS) report, which put the shortfall at $250 million. What will you do to fight for healthcare funding in the Outaouais?

MB: My goal is make sure the Ministry of Health is fully aware of the unique challenges we are facing here. This is part of my role as CEO – to ensure that there is visibility and understanding of the reality of the situation here. I’m doing that in partnership with local officials, and so far, we have had very good collaboration from the deputy minister and his team in Quebec City. And I hope to keep working with them to find long-term solutions for the Outaouais situation. We know it’s been a challenge for many decades here.

LD: Healthcare watch dogs are concerned that the new Santé Quebec will centralize services, causing them to lose autonomy over spending local money and making local decisions. How will you ensure that these important groups will still have a voice?

MB: The reading I have of the new Bill 15 is that I really believe it won’t change much in terms of how we do business internally within the CISSS de l’Outaouais. I’m still going to be the CEO; I’m still going to have the same powers I have now. Yes, it’s going to be different at the ministry level with the creation of the agency – I won’t have a board of directors anymore at my level – it’s going to be more of an advisory board that will help inform my decisions. So, on a day-to-day basis, I don’t think it will change a lot. Honestly, I’m kind of reassured by the fact that I’m going to keep the same tools, and hopefully the agency will be a bit more agile than the ministry currently is.

LD: Will you still work and consult with health watchdog groups like Action Santé and Vigi Santé?

MB: I think we have to. We have to collaborate with all these partners and figure out ways to address the Outaouais’s needs. I think it’s a societal responsibility that we work together to do better, and it goes well beyond just healthcare, in my view. So, we have to work in partnership with all organizations, whether they are charities or other community organizations – and that includes the media and the politicians…. That is my goal: to engage with all those groups to ensure that we have a consistent message for Quebec City and to try to secure a better future for the Outaouais region. 

LD: How will you ensure that English services are maintained under the new Santé Quebec in places with fewer than 50 per cent anglophones?

MB: It’s always a challenge to maintain services in both official languages. My opinion, though, is that this is a patient safety issue if we don’t. I think access to healthcare depends on your ability to communicate in your own language. However bilingual you are when you are sick, you are suddenly less bilingual, and that’s the reality. So, I really believe that we have to keep working on this one and make sure that, at least at the frontline, we have the ability to answer to people in their preferred language and hopefully keep doing the best we can to support patients in our region, despite what their primary language is.

LD: What is your number one priority for the region?

MB: Trying to stabilize the human resources and staffing situation is my number one priority because this directly affects my ability to provide safe care to Outaouais citizens. So that is my number one, two and three priorities.