Outaouais health network faces scrutiny over $216 million in private sector spending
Tashi Farmilo
The Outaouais health authority (CISSSO) is spending over $216 million a year on services from the private sector — a move unions criticize as harmful to the public system, while the agency defends it as necessary to ensure patient care during staff shortages and resource gaps.
The data comes from CISSSO’s own annual financial report (AS-471), which shows that a large portion of this spending goes toward private service contracts, including specialized medical clinics, group homes, home care, and reimbursements for care provided outside the province. Another $17 million is spent on hiring independent workers, such as nurses and respiratory therapists, when public staff aren't available.
Union leaders say this level of private spending undermines the public healthcare system and makes it harder to attract and keep qualified staff. “This is an organized dismantling of our public services,” said Alfonso Ibarra Ramirez, president of the Outaouais chapter of the CSN. “We’ve seen policies that encourage privatization and underfunding, and now we’re all paying the price.”
CISSSO, for its part, says the goal is not to privatize healthcare, but to maintain services when public resources are stretched. The region faces challenges like workforce shortages, wait lists, and limited operating space in hospitals — all of which make it harder to meet patient needs without external help.
“For example, we sometimes rent space and surgical teams from private clinics to perform procedures that we can’t currently do in-house,” said CISSSO spokesperson Qeren Boua. “These agreements help reduce wait times and ensure that patients get the care they need, especially those who don’t require hospital stays.”
Boua also noted that CISSSO has already reduced its use of independent labour by nearly 50% in recent months, and continues to focus on recruiting staff locally and internationally, while also investing in training for current employees.
The Quebec government has passed legislation to end the use of independent health workers by 2026. CISSSO will be among the last regions to implement the change, but says it is on track to meet the target.
Meanwhile, the CSN is calling for the public system to be fully “weaned off” private sector reliance by May 1, 2025. In a press release, union leaders warned that privatization increases costs for taxpayers and puts essential public services at risk.
“Everyone loses with subcontracting,” said Alain Smolynecky, president of the Outaouais health workers’ union. “We lose skilled workers to the private sector, and the public pays twice — through taxes and through private fees.”
While both sides agree the healthcare system is under pressure, the debate over how to fix it — and who should provide care — is far from settled.