At the best of times, the health portfolio in Quebec is not for the faint of heart.
Yet Dr. Philippe Couillard, Quebec's new health minister, appears undaunted by the challenge even though he is a political neophyte — probably because the 46-year-old neurosurgeon is quite accustomed to working under pressure. “I realize the scope of the task and mandate that the premier has entrusted me with,” Couillard told CMAJ. “But I feel entirely ready to assume it.”
He has his work cut out for him. The previous Quebec government was dogged by health care controversies because of long waiting lists and congested emergency departments (EDs). Couillard recently announced an annual injection of $240 million to help address those and other concerns, including $60 million to shorten surgical waiting lists and $25 million to unclog EDs.
He gained first-hand experience with these problems while practising in Sherbrooke, where he was head of surgery at the Centre hospitalier universitaire de Sherbrooke. “The vast majority of people are satisfied with the quality of care they receive,” he insists. “The problem is access — the waiting lists. People no longer have confidence that they will be able to see their doctor in time, they no longer have confidence that they will have their surgery or diagnostic test in time. And that is what gives rise to this loss of confidence, this cynicism toward the public system.”
Couillard says solving the system's problems will require more than money. He spent a week in Alberta before the election at the behest of Liberal leader Jean Charest. “It's not that we are going to do the same thing as in Alberta. But there are certain elements that were done there that will strongly inspire us, including the method of financing the regions. We want the management to be a lot closer to the places where the services are offered.”
Couillard has already spent more than half his life in medicine. A physician by age 22, he was a neurosurgeon at 28. He practised in Montreal and Saudi Arabia before moving to Sherbrooke in 1996.
Although pundits question his lack of political experience, they acknowledge his familiarity with the system. “Already people in the ministry have remarked just how much easier it is to brief me on dossiers,” says Couillard. “Having practical knowledge makes a big difference.”
Sherbrooke neurosurgeon Jacques Boucher considers Couillard's decision to enter the political realm a “big loss” to medicine because he was at the height of his career. He says his former colleague is decisive and “will have a very independent spirit” as a politician.
Couillard performed his last procedure 3 days before the Quebec election on Apr. 14. Boucher says Couillard relished complicated cases, and this should serve him well in government. “Philippe loves challenges more than anything else,” he says. — Brenda Branswell, Montreal