Fraudulent Primary Care Policy
Action
by health care workers in Lévis, April 14, 2026, against
Quebec government's austerity policies, and for the
right to
health care. Action was part of the third week of regional
actions.
On March 27, the Coalition Avenir Québec (CAQ) government announced a "Government Policy on Primary Care and Services" which is intended to be "a profound transformation of the way we provide care and support." Among other things, "we will ensure that CLSCs [Local Community Service Centres] can once again become a physical gateway to primary care for everyone who needs it," announced Health Minister Sonia Bélanger. She added that "CLSCs are a source of pride for Quebec, a founding principle of our public system."
CLSCs were established in the early 1970s to integrate the numerous initiatives of grassroot organizations into the public health care system, especially in working-class neighbourhoods. They were intended to be what the Minister promises -- the gateway to health care -- and they included preventive, educational and social components.
But the CLSCs became the first victims of the crisis of the Quebec welfare state and of the so-called "debt crisis" of the 1970s. This was a self-serving interpretation of the hoarding of financial and other resources by powerful private interests to the detriment of health care and the other needs of Quebec society. The CLSCs had also been doomed from the start because the state instituted corporatism for the medical profession. This gave rise to a boycott of the CLSCs by doctors, with only a very few deciding to bet their future on the community-based organization of services.
Then, with the anti-social offensive of the 1990s, CLSCs were even further starved of resources in favour of a hospital-centric approach and the ever-greater centralization of management. Workers and other health care professionals have continued to be sidelined from decision-making to the point that today, at this "final phase" of the Legault health care reform, the entire Quebec health care system is managed by a single body, Santé Québec. This body makes its decisions without being accountable to anyone except the powerful private interests who control decision-making, the epitome of neo-liberal state restructuring.
Speaking on behalf of a government that has done more to destroy Quebec's health care ecosystem than any government before it, Sonia Bélanger had the nerve to say that "the CLSCs are a source of pride for Quebec." No one in the health care system or among Quebec people is fooled by this sudden 180 degree turn in the CAQ government's health care policy. In fact, Bélanger herself said that the "new" policy on primary care and services is the "definitive step" in the health care "reform" undertaken by the Legault government. In other words, it is meant to cap its eight years of nation-wrecking in health care. It means vigilance is required.
The "new" policy may be an electoral ploy, announced as the elections approach with the aim of appeasing the anger of health care workers and the people. Or it may be simply yet another scheme to subjugate the health care system to the demands of privatization. Or it may be both. There are several reasons for believing this.
In its press release responding to the Health Minister's announcement, the Confederation of National Trade Unions (CSN) notes that "these are good ideas" but "completely at odds with the CAQ's past decisions." The union argues that decentralization to the CLSCs is "highly desirable" but "it must be noted that the government has been moving in the opposite direction for years, notably with the creation of Santé Québec."
The Alliance of Professional and Technical Staff in Health and Social Services (APTS) notes, in the announced policy, "the absence of clear governance and funding commensurate with the stated ambitions." Without the necessary resources, "CLSCs could be reduced to playing a mere triage role, redirecting patients to family medicine groups (private), pharmacies or self-care, without providing any real care themselves." And this is in a context where private services continue to comprise an ever-greater share of health care services.
The Interprofessional Health Federation of Quebec [FIQ] press release states that "The desire to establish population-based responsibility and to better anchor care in local realities, especially by restoring the CLSC's prestige, aligns with principles that the FIQ has long defended." However, "for this vision to become a reality, Santé Québec must actually implement the announced decentralization and grant CLSCs the necessary tools to exercise genuine local governance," the FIQ states. "CLSCs must not simply become a new point of access," said FIQ President Julie Bouchard, who fears that the essence will be lost "if we merely refer patients to Family Medicine Groups (GMFs -- private doctor-centric clinics) or redirect them to self-care."
Many say that the "idea is appealing" and creating that impression is undoubtedly the intended aim of the government's announcement in this election year. But it is important to look back at what happened to the concept of CLSCs in the 1970s. First they were co-opted and then they were the first to be sacrificed when the "Quiet Revolution" did not make us "masters in our own home." The people were not given the power to decide, and they have even less power today. For eight years this government has busied itself passing one bill after another, most often under closure, to silence and exclude any expression of the popular will, to centralize decision-making to an extreme degree, and to suppress workers' organizations so that what serves the interests of the wealthy oligarchs can be imposed without any hindrance.
There will be no remedy from the gods of plague.
This article was published in
Volume 56 Number 23 - April 24, 2026
Article Link:
https://cpcml.ca/TML2026/Articles/T560234.HTM
Website: www.cpcml.ca Email: editor@cpcml.ca