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29 June 2018

RESPONSE: The Banker

Gaétan Barrette

MNA for La Pinière
Minister of Health and Social Services


Source: LaPresse

I must admit that I was surprised both by the tone and the content of your opinion piece published in La Presse yesterday.

I had the pleasure of meeting you in various events and activities and discussing our health and social services system. Clearly, you were more reserved when we met face to face.

You have given much of your time and energy, especially for the CHU Sainte-Justine Foundation. You deserve recognition for that. Your position as a banker and, as a result, your ties with the Québec economy have been most useful. The government having its budgetary limits, all foundations play a fundamental role in our network.

Your political career, like that of many politicians, has been quite successful, but not without controversy, and has obviously taught you something else.

Yet, it should have taught you that the health and social services system cannot be compared to Amazon. You are right to stress the importance of logistics in this corporation’s management. In fact, doesn’t managing it simply boil down to transporting an inanimate product from point A to point B?

The story of Amazon is a spectacular success, as is FedEx’s and those of other similar ventures. They have one thing in common: they are largely purely logistical operations with very little public relations. Great for them!

Transposing such an approach to health and social services demonstrates your lack of understanding of our system’s issues.

Patients are not boxes to be moved. Nothing, absolutely nothing at Amazon or elsewhere comes close to the complexity of the problems to be solved, a complexity that is inherent to the delivery of necessary treatments and services.

I dare say that the job categories, or the types and levels of competence at Amazon are infinitely less varied and complex. This fact does not diminish their employees’ value, dedication or quality whatsoever. But a hospital, no matter its size, could never be likened to a vast hangar in which boxes are lined up on shelves, or for your information, to a territorial distribution of ATMs!

The position of Minister of Health and Social Services is a management position, which therefore involves direction, and, as in other fields, certainly benefits from an incumbent who has extensive knowledge of the environment he or she manages.

This was and still is the case for Amazon’s Jeff Bezos and FedEx’s F.W. Smith, who started at the bottom of their respective industries, one with a simple web-only bookstore and the other with a small intercity mail service. You know all about the rest and have cited it.

One thing these stories have in common: these people made choices; they now direct and no longer perform essential field logistics themselves. Same thing for us: skilled and dedicated men and women take care of logistics on-site in our various institutions. And they do so very well.

One huge difference in our situation: in the context of public finances, we don’t have the luxury of doing all that we could or want to do. As an organizational standard, growth will always be foreign to us.

Through your involvement with some foundations, you observed our network’s complexity first-hand. You have the joy of seeing your daughter start her medical career. I am very happy for her and understand your pride. However, neither this situation nor your past career gives you the authority to say such things. Our health and social services network is not a business. With your experience, you should know this. Or should I read between and beyond your lines that you’re promoting the partial or entire privatization of our system? I’ll let you compare patients with boxes, but I will never accept your analogy.


Gaétan Barrette
Québec Minister of Health and Social Services