Minister gone private

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National Post, Friday, August 22, 2008

The timing of Philippe Couillard's career move was unintentionally symbolic. On the same day the former Quebec health minister joined the country's largest firm of private clinics, the Canadian Medical Association opened its annual convention in Montreal.

How's that for context in framing a discussion of public and private health care? It was the talk of the town, and not just in the corridors and coffee breaks of the CMA meeting.

Couillard is not just any former provincial health minister, but a brain surgeon and former hospital executive, the best and the brightest of Jean Charest's Cabinet. And Persistence Capital Partners is not just any firm -- it's the parent of Medisys Health Group, a Montreal-based network of executive health clinics with more than 4,000 corporate clients, including nearly two-thirds of the Financial Post 500, across Canada. Medisys was once listed on the TSX and later converted to an income trust before its founder, Dr. Sheldon Elman, and his family, took it private earlier this year.

To all appearances, Couillard has abandoned the public health care system he was in charge of as recently as two months ago, when he shocked the political class by resigning from the Cabinet and legislature. Couillard has since acknowledged that PCP had contacts with him before leaving office, and his prospects were discussed in general though not specific terms. "Questions of ethics," La Presse bannered in a war-type headline over two pages. For his part, Elman said Couillard would take a leading role in developing PCP's network and services across the country.

Quebec's code of post-employment guidelines is clear: A former minister shouldn't have contact with his department for two years. But as an executive of a private health provider, Couillard normally wouldn't have any need to be in touch with the Quebec health ministry.

Perhaps the real story is that in hiring Couillard, Elman has succeeded in keeping a leading health authority in Canada, when he might well have gone to the United States for a lot more money. Any top American hospital, from Harvard to Johns Hopkins, would have paid big bucks for someone with a resume like Couillard's. This is not brain surgery.

Couillard's departure from politics in June, on the day before his 51st birthday, was not as sudden or as shocking as it appeared.

It was no secret, after a full term in the health ministry, that Couillard wanted to be moved to an economic portfolio to broaden his political resume. That hope was derailed when the 2007 election returned a shaky minority Liberal government, and Charest asked Couillard to remain at his post, where he had already injected another $4-billion into the system, reduced waiting times and confronted the unions that drive Quebec hospitals around the bend.

By last Christmas, Couillard made it clear to the Premier's office that if he wasn't moved soon, he would be leaving. When the spring session of the legislature came and went without a Cabinet shuffle, it was clear to insiders that Couillard would be moving on.

By then it was evident that Charest wouldn't be leaving anytime soon and Couillard, as the obvious heir apparent, was faced with some difficult personal and professional choices.

With no obvious or imminent path to the Liberal leadership, could Couillard afford to remain in government at a Quebec Cabinet minister's salary of $146,500 a year? This is less than a family doctor makes in general practice, where billings are capped, as are those of brain surgeons, who max out at around $250,000 a year.

Nope. Couillard can genuinely say he gave at the office, in terms of foregone earnings, while he worked for five years in the most complex and demanding portfolio in the Quebec government, one that accounts for nearly half of the entire provincial spending envelope and well over half of all new investments.

What was he supposed to do, become director of a neighbourhood health clinic? Or, with the top job in Quebec politics closed to him for the foreseeable future, would he do something more creative and remunerative during the best earning years of his life?

This week, Couillard gave his answer. But in a way, he'll still be serving the public interest. Every patient seen at a Medisys clinic is one less waiting in line at a public one.

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