Over the past two years as CEO of the Montreal Health Authority I have participated in the preparation and now the implementation of what I consider the first real reform in healthcare since the beginning of Medicare in 1970. In my opinion Quebec is undergoing a second "quiet revolution" in healthcare as important as the first one, a revolution not in structure but in the philosophy of how healthcare is provided to its population.

In December 2003, the Government of Quebec adopted draft bill 25, which launched a major reorganization of Quebec's health and social services system. Initially, the regional boards were abolished and replaced by new regional bodies called Agencies for the Development of Health and Social Services Networks. In January 2004, these agencies were given the mandate to propose a new way of organizing services on their territory, based on the concept of integrated networks, with the goals of bringing services closer to the population, facilitating case management and helping vulnerable patients obtain the care and follow-up they require.

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