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Establishements Formed into Networks
The Québec health and social services system has approximately 300 institutions providing services in more than 1700 service points, including approximately 200 public institutions, around 50 non-profit institutions under agreement and around 50 private institutions offering residential and long-term care. It also comprises over 3000 community organizations and approximately 2000 private medical clinics and offices. The whole sector employs more than 10% of the active workforce in Québec.
The ministère de la Santé et des Services sociaux ensures that the system operates smoothly, while the eighteen (18) regional authorities are responsible for the organization of services in their respective territories, and five categories of public institutions, listed below, provide health services and social services under a configuration which favours integration as a mode of organization.
Five Categories of Public Institutions
Health and social services centres (CSSSs) were born out of the merger of local community services centres (CLSCs), residential and long-term care centres (CHSLDs) and, in most cases, a hospital centre (CH). These centres:
- provide the population of a local territory with services of a preventive, evaluative, diagnostic and curative nature, rehabilitation, support and public institutional residential services;
- coordinate the services offered by all providers working in the local territory;
- offer general and specialized hospital services (emergency, outpatient services, local medical specialties and basic diagnostic facilities).
Residential and long-term care centres (CHSLDs):
- offer services to persons with decreasing autonomy and older persons.
Hospital centres (CHs):
- ensure the provision of short-term primary, secondary and tertiary services in general or specialized health care and in psychiatric care.
Rehabilitation centres (CRs):
- offer specialized health services and social services to persons suffering from a physical impairment (related to hearing, vision, language and speech or motricity);
- or offer specialized health services and social services to persons affected by a mental impairment or persons with a pervasive developmental disorder;
- or offer specialized health services and social services to persons suffering from alcoholism or other problems of addiction.
Child and youth protection centres (CPEJs):
- ensure the provision of social services to young persons with developmental or behavioural or social adjustment problems (abuse, neglect, delinquency, etc.);
- ensure the provision of social services to the families of young persons with problems;
- ensure the provision of specialized services devoted to young persons (adoption, placement and social rehabilitation).
Fourteen (14) organizations report to the Minister of Health and Social Services. Most play an advisory role with regard to a specific mandate. Others, such as the Office des personnes handicapées du Québec (OPHQ) and the Régie de l’assurance maladie du Québec (RAMQ), have a broader mandate and more considerable resources. The MSSS collaborates with all the organizations in accomplishing their mandates. In 2007, these organizations, in alphabetical order, were as follows:
- the Agence d’évaluation des technologies et des modes d’intervention en santé (AETMIS, the Québec government agency responsible for health services and technology assessment);
- the Bureau de gestion des projets de modernisation des centres hospitaliers universitaires de Montréal (Centre hospitalier de l’Université de Montréal, Centre universitaire de santé McGill, Centre hospitalier universitaire Sainte-Justine);
- the Research Ethics Central Committee;
- the Hemovigilance Committee;
- the Public Health Ethics Committee;
- the provincial committee on the provision of health services and social services to persons from ethnocultural communities;
- the provincial committee on the provision of health services and social services in English;
- the Health and Well-being Commissioner;
- the Conseil du médicament;
- the Corporation d’hébergement du Québec;
- the Corporation d’urgences-santé (Urgences-santé);
- the Institut national de santé publique du Québec;
- the Office des personnes handicapées du Québec;
- the Régie de l’assurance maladie du Québec.