Dozens of community and institutional leaders have expressed deep concerns about Bill 10 which proposes changes to the Health and Social Service Act via a sweeping reorganization of the institutions and the governance of the health and social service network.

Supported by a petition that has been signed by more than 9000 Quebecers (, more than three dozen groups, including school boards and community associations, have joined together to demand that Health Minister Gaétan Barrette make major modifications to the proposed legislation which they say will have a negative impact on the vitality and identity of Quebec’s English-speaking community.

In summary, Bill 10 proposes to abolish Agencies, the planning and coordination bodies in each region and eliminate 185 institutions by merging them on a regional basis. If passed a single institution called a Centre intégré de santé et de services sociaux (CISSS) would plan and manage the delivery of all health and social services in each region, including one that would cover the island of Laval.

Community leaders worry that if adopted as currently drafted, Bill10 would abolish the English-speaking community's hospitals and nursing homes such as the Jewish Rehabilitation Hospital in Laval, as stand-alone institutions. As well, it would eliminate community volunteers from the governance of our health and social service system; fatally compromise the bilingual status of our institutions; and exclude these community institutions from the critical role they play in the vitality of the communities they serve.

“Bill 10 goes too far, too fast,” warned former Liberal MNA Clifford Lincoln, noting that “suddenly reducing the number of health and social service institutions from 182 to 28 will have an undeniable impact on accountability, transparency, volunteerism and citizen participation. And for Quebec’s English-speaking community this means the loss of 23 out of 24 of its bilingual institutions and boards, and their protection under law,” he said. There will be a total of 20 CISSSs in the 16 regions of the province. On the island of Montreal, because of the size of the population, demographics, and the number of institutions, there will be five CISSSs, one in the west island, a second in the center, a third in the southeast, the fourth in the north, and the fifth in the east island. The CISSS in the southeast will assume some of the responsibilities of the former Agency.

The Cree and Inuit territories in the far north are not touched by these changes. In addition there will be four super-regional institutions, all in Montreal: The McGill University Health Center (MUHC), the Centre hospitalier de l’Université de Montréal (CHUM), the Centre hospitalier universitaire Sainte-Justine, and the Institut de cardiologie de Montréal.

While there will be no more institutions directly identified with the English-speaking community, except for the MUHC, the Bill continues provisions to guarantee access to services in English, though these require some additional precision.

“If the Charter of the French Language saw fit to create exceptions that allow the protection of the English-speaking community’s institutions, the Health Care Act can and must do the same,” added Sara Saber-Freedman, President of the Board of the MAB-Mackay Rehabilitation Centre in Montreal. “Bill 10 must be amended in order not to abolish institutions -- and especially not those that are designated to provide bilingual services.”

“The goals of the government can be achieved without eliminating this unique and irreplaceable community heritage,” added Saber-Freedman, noting that some important modifications to Bill 10 are essential to ensure that the legislation does not compromise a 30-year consensus that is crucial to the vitality of Quebec’s English-speaking minority.”

The Health and Social Services Committee of the National Assembly held several weeks of hearings on Bill 10. The large majority of briefs were critical of Bill 10 for one or more of the following reasons:

  • The new CISSSs will be too large and distant from those who use their services;
  • The range of medical and social mandates a CISSS must manage is too varied to be successful;
  • Social service mandates will be get short shrift next to the medical mandates within the same organization;
  • Too much control is placed in the hands of one person, the minister;
  • The reduction of the number of board seats, and the process by which board members will be appointed, will substantially restrict access to these seats to members of the community;
  • The pace of implementation of such a vast reorganization is too rapid. Bill 10 has not been adopted yet, and it is supposed to be implemented for April 1, 2015;
Amendments to Bill 10 were introduced on December 1. They include increasing the number of CISSS in four regions; according bilingual status to the CISSSs on the West Island and in the Centre of Montreal; increasing the size of CISSS boards and recognizing the participation of universities; according a seat to a person nominated from the English-speaking community on the boards of CISSSs that have merged at least one bilingual institution, for example: Laval (this applies to a total of seven regions outside of Montreal); and allowing boards to choose their own PDGs after the minister has chosen the first one.

An important issue not yet resolved has to do with the assets of the existing institutions that have owning corporations. Bill 10 transfers those assets to the CISSSs, but the minister has said the assets will stay with owning corporations. This is particularly important in hospitals and other institutions where large amounts of public and private donations have been invested.

At the time of this writing the study of Bill 10 continues, and may continue into the New Year. If you are concerned by Bill 10 and want to express your concerns, go to and add your name to the on-line petition.