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Québec’s health and social services system was created in 1971 following the adoption of the Act respecting health services and social services (chapter S-4.2) by the Québec National Assembly.
The system is designed to maintain, improve and restore the health and welfare of the general public by providing access to a set of integrated and high-quality health and social services.
Funding for services
Most of the funding for health and social services is taken from the general tax base such that the risk is spread more fairly throughout society. Most of the revenues are derived from the taxes collected by the Québec government and deposited in the Consolidated Revenue Fund, and also from federal government transfers and contributions from employers and individuals to the Health Services Fund.
The population has access to hospital and medical services dispensed by the State through two universal plans: the Hospital Insurance Plan, introduced in 1961, and the Health Insurance Plan, introduced in 1970.
Public health sector coverage for all Quebecers was completed in 1997 with the introduction of the Public Prescription Drug Insurance Plan, a joint universal plan based on a partnership between the State and private insurers.
In addition, a number of services are available to specific population groups free of charge, provided they meet certain criteria. These include dental services, vision-related services, and devices that compensate for physical impairments.
Individuals may also subscribe to private plans offering additional insurance covering services not covered by the public plans.
The Régie de l’assurance maladie du Québec administers the public health and prescription drug insurance plans. In addition, it:
- informs the public
- manages the eligibility of individuals
- remunerates health professionals
- ensures the secure flow of information
The Régie also administers various other programs, including those related to technical aids for people with a motor, visual or hearing impairment, financial assistance for domestic help and the financial contribution of adults accommodated in a healthcare institution.
Integrated health and social services system
In Québec, health and social services are integrated into a single administration. Nine service programs have been developed to meet the needs of the general population or address specific issues:
- Public Health, to promote, prevent and protect health and well-being, and to monitor the state of health of the general population
- General Services–Clinical and Assistance Activities, which covers frontline care for health issues and temporary social problems
- Support for Independent Seniors
- Physical Disabilities, for impairments related to hearing, vision, language and speech and motor activities
- Intellectual Disabilities and Pervasive Development Disorders
- Youth with Difficulties
- Dependencies, such as alcoholism, drug addiction and compulsive gambling
- Mental Health
- Physical Health, which covers emergency services, specialized and highly specialized services, continuous services requiring systematic follow-up (e.g. chronic diseases, cancer) as well as palliative care
The Ministère and its main partners
The Ministère de la Santé et des Services sociaux is in charge of regulating the health and social services system as a whole and coordinating its activities. It establishes policy directions related to the organization of services and resource management and ensures their implementation.
The Ministère also carries out province-wide functions pertaining to public health, inter-regional coordination of services and the distribution and control of resources. It evaluates results for the network as a whole with a view to improving performance.
At the provincial level, various bodies and committees in the health and social services sector report to the Minister of Health and Social Services. Most play an advisory role with regard to a specific mandate. Others, such as the Régie de l’assurance maladie du Québec, have a broader mandate and greater resources.
Since the coming into force of the Act to modify the organization and governance of the health and social services network, in particular by abolishing the regional agencies (CQLR, chapter O-7.2) on April 1, 2015, the Québec health and social services network consists of:
- 22 integrated health and social services centres (CISSS), nine of which are designated as integrated university health and social services centres (CIUSSS)
- 7 institutions that were not amalgamated with an integrated centre: 4 university hospital centres (CHU) and 3 university institutes (IU)
- 5 institutions not covered by the Act offering services to an Aboriginal and northern population
Each institution may offer services in several sites that are physical locations where health and social services are provided.
In addition to the services provided by public institutions, the population benefits from services such as lodging and long-term care that are provided by private institutions.
The main responsibility of institutions is to provide high-quality services that are accessible on a continuous basis, safe and respectful of the rights of users. They provide general and specialized services that correspond to the five major missions defined in the Act respecting health services and social services and vary according to whether they are a
- local community service centre (CLSC)
- hospital centre (CH)
- residential and long-term care centre (CHSLD)
- child and youth protection centre (CPEJ)
- rehabilitation centre (CR)
Among the Ministère’s other partners, are:
- medical clinics, including family medicine groups, super clinics (FMG network) and network clinics
- community-based pharmacies
- pre-hospital emergency services
- community organizations and social economy enterprises for in-home support services
- private residences for seniors
- family-type and intermediate resources affiliated with public health and social services institutions
Lastly, the Ministère and its network maintain ties with local, regional and provincial partners from other sectors (education, housing, revenue, environment, transportation, etc.).
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