Parti Québécois Leader Paul St-Pierre Plamondon’s pledge to dismantle Santé Québec if the PQ takes power on Oct. 5 is based on two claims: that the health system has turned into a “bureaucratic monster” since the state corporation was founded nearly two years ago, and that it would be relatively easy to “refocus” on medical care after it’s abolished.
Neither of those assertions stands up to scrutiny, however, a Gazette fact-check has found.
Santé Québec took over from the provincial Health Ministry on Dec. 1, 2024. Under the reform spearheaded by former health minister Christian Dubé, the ministry remained in charge of setting priorities for the system, while Geneviève Biron was appointed CEO of Santé Québec with the mandate to run day-to-day operations more efficiently.
Although nearly everyone agrees that access to health care remains problematic across Quebec, the front-running PQ makes the specific claim that bureaucracy in the system jumped by 70 per cent since Santé Québec was formed. That claim is misleading.
The number of employees at Santé Québec headquarters now stands at close to 1,300, according to the PQ. The claim of a 70 per cent increase in health bureaucracy is based on the PQ calculating that the Health Ministry had 1,232 employees in March 2024, a month before the Coalition Avenir Québec government announced it would create Santé Québec and eight months before the state corporation became operational.
Paul St-Pierre Plamondon, leader of the Parti Québécois, announces his party’s proposal to abolish Santé Québec and redirect spending toward direct patient care, in Montreal on Friday, August 21, 2026. Evan Buhler / Montreal Gazette
By January of this year, the ministry employed 950 bureaucrats and Santé Québec had 1,176 employees — for a combined tally of 2,126, the PQ observed in its presentation. Subtracting the Health Ministry figure of 1,232 in March 2024 from the combined total of 2,126, one arrives at the sum of 894 additional employees, or an increase of 72.5 per cent.
In fact, however, the size of the Health Ministry bureaucracy decreased as many of its employees were transferred to Santé Québec. A government spokesperson noted the ministry employed 1,752 regular and occasional bureaucrats on Nov. 30, 2024 — the day before Santé Québec came into being — and that total dropped to 954 by March 31 this year.
Thus, if one were to add 954 Health Ministry employees with the latest Santé Québec figure of 1,288, the sum is 2,242 — an overall increase of 490 employees or 27.9 per cent from Nov. 30, 2024. That’s still a relatively significant hike, but not the 70 per cent the PQ claims.
Are the savings real?
The PQ has also estimated that getting rid of Santé Québec will lead to at least $40 million in annual savings as a result of having to pay the salaries of fewer bureaucrats, and those savings could reach as high as $100 million. This claim is unverifiable.
The PQ has not explained how it arrived at the figure of at least $40 million in savings in a health and social services budget of $68.7 billion. The Institut de la statistique du Québec has calculated that the average salary, plus benefits, of a public sector worker was $79,924 in 2025. If one were to multiply that sum by the additional number of health bureaucrats of 490, one arrives at a payroll of more than $39 million.
At first glance, this would appear to back the PQ’s claim that scrapping Santé Québec would lead to savings of $40 million a year. However, the government would likely have to pay substantial severance to laid-off health bureaucrats, said longtime patient-rights activist Paul Brunet.
“The sum of $40 million is nothing compared to the cost of having to rebuild the structure with the (Health Ministry), transferring jobs, and the indemnities that are going to be paid to the people who are not going back to the ministry,” explained Brunet, of the Conseil pour la protection des malades.
“There are no savings there. (St-Pierre) Plamondon needs to do a better job in terms of the savings he claims he’s going to make, because $40 million is nothing.”
Damien Contandriopoulos, professor in the School of Nursing at the University of Victoria and an expert on health policy in Quebec, agreed with Brunet’s view.
“It’s not an easy thing to do,” Contandriopoulos said. “It’s not like you can push a button to go back to the way things were before. I don’t want to quote a number of how much it’s going to cost, but it’s definitely going to be a very significant amount.”
The only Canadian precedent for such an undertaking is found in Alberta. In 2023, the provincial government announced it would dismantle Alberta Health Services — a centralizing agency like Santé Québec — and instead create four distinct entities for acute care, primary care, continuing care and mental health.
The Alberta experience
The Alberta government budgeted $85 million for the breakup in a health system that is a little over half the size of Quebec’s, with the restructuring scheduled to take two years. Yet in each of the three years since Alberta’s announcement, health administration costs have kept rising, suggesting that restructuring did not lead to savings.
A Santé Québec source, who agreed to be interviewed on condition that their name not be published so they could speak candidly about the issue, said taking apart the state corporation would prove devilishly complex, not least because it deals with eight large unions representing 347,000 employees in the health network.
“Trying to undo Santé Québec will take another four or five years,” the source said. “We won’t be able to see any significant changes under a new government. That’s the problem. We are always starting from zero every time we have a new government and a new reform. We never give a reform enough time to show the fruits of its labour.”
In its defence, Santé Québec boasts that it has managed to slash the number of Quebecers waiting at least a year for surgery from a high of 22,197 on Sept. 10, 2022, to 3,822 by the end of July. But most of that decrease took place before Santé Québec was formed. Still, the state corporation has continued to reduce the year-long waits for surgery, although wait times for heart and cancer surgeries have barely budged in the past four years.
Should the PQ, which has placed consistently first in public-opinion surveys, actually follow through on its promise to eliminate Santé Québec, it will do so in the midst of two massive pilot projects involving electronic health records, known in French as the Dossier santé numérique. Those projects have been beset by glitches, and whoever oversees them — whether it’s the Health Ministry alone or Santé Québec — will face major challenges in the coming years.
The Santé Québec source said the state corporation needs more time to prove itself — a view shared by Brunet, who is nonetheless critical of its record to date.
For Contandriopoulos, the idea of replacing one health-care structure with another smacks of cynical politics. He also bemoans the obsession with structural reforms by not only the CAQ but previous PQ and Liberal governments.
“The Parti Québécois is keeping up with the traditions set by the Liberals and the CAQ of selling administrative reforms as if they were the only solution, as if the root problem of the system is that we’ve got bad administrative structures, so by fixing the structure, we’re going to solve all the problems,” Contandriopoulos added. “That simply hasn’t been proven to be the case.”
Where Quebec’s other main political parties stand on the future of Santé Québec
Quebec Liberal Party
It’s against abolishing Santé Québec. “Instead, we propose decentralizing decision-making, reducing bureaucracy and making Santé Québec truly accountable for results,” a Liberal party spokesperson said.
Coalition Avenir Québec
The CAQ created Santé Québec, so it’s no surprise that it wants the state corporation to stick to its mandate.
“At 18 months old, Santé Québec is still very young, but we’re already seeing results and expecting even more,” Sonia Bélanger, who took over from Dubé as health minister last year, posted on X the day of the PQ’s announcement.
C’est fini les réformes. On en a assez fait. C’était nécessaire, mais là, on est ailleurs.
Est-ce que PSPP pense aux travailleurs de la santé? À la population? Parce que moi, oui. Ce que les gens veulent, c’est pouvoir bien faire leur travail, avoir accès aux bons services et…
— Sonia Bélanger (@SBelangerCAQ) August 21, 2026
Québec solidaire
Although the left-of-centre Québec solidaire does not want to kill Santé Québec, it does want to decentralize some of its powers.
“A Québec solidaire government would decentralize some of the powers of centralizing megastructures, such as Santé Québec, to ensure greater decision-making autonomy for the regions,” spokesperson Guillaume David declared in a statement to The Gazette.
Conservative Party of Quebec
The right-of-centre Conservatives have not yet taken an official position on the future of Santé Québec. Officials did not respond to repeated requests for comment.
The party’s electoral platform includes a single reference to Santé Québec. “In health care, half a million Quebecers are waiting for a family doctor and nearly 900,000 for a consultation with a specialist. And what has the CAQ done? It created Santé Québec, a new layer of bureaucracy. As if the system didn’t have enough of that already.”
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