Bill 7: A Threat to the Health of Quebecers

The proposed "merger" of the Institut national de santé publique du Québec (INSPQ) and the Institut national d’excellence en santé et en services sociaux (INESSS) runs counter to Québec’s stated commitment to strengthening disease prevention and population health. At a moment when public trust in institutions is fragile and the need for independent public health leadership has never been greater, diminishing the visibility and coherence of Québec’s public health infrastructure would weaken—not reinforce—the province’s capacity to protect its population.

Public health systems across Canada are navigating a period of profound uncertainty marked by declining trust in institutions, growing skepticism toward scientific expertise, and a post-pandemic erosion of support for long-established public health measures, including routine vaccination programs. The resurgence of measles and the loss of Canada’s elimination status illustrate the consequences of weakened confidence and reduced investment in prevention. At the same time, the turmoil facing the U.S. Centers for Disease Control and Prevention—long regarded as a global anchor of public health leadership—demonstrates how institutional instability can rapidly erode public confidence and impair national and international health security. The spread of coordinated anti-science narratives and politically motivated campaigns that undermine public health authority has further amplified mistrust, politicized decision-making, and complicated efforts to protect population health. In this climate, public health requires greater independence, visibility, and stability to counter misinformation, rebuild trust, and demonstrate the value of evidence-informed action.

Within this broader context, structural reforms that risk diluting or obscuring the public health mandate—such as the proposed "merger"—deserve careful scrutiny. Public health relies on strong, independent scientific expertise; robust surveillance and laboratory capacity; meaningful connections with research and training institutions; and the ability to provide timely, evidence-informed guidance that is protected from short-term operational pressures. These functions are foundational to prevention, health equity, and the long-term well-being of populations.

The concerns raised in Québec resonate with CPHA’s broader national perspective:

• The need to preserve a distinct and visible public health mandate. When public health functions are embedded within wider clinical or administrative structures, they can become less visible and less protected, particularly when competing with acute-care pressures.
• The importance of maintaining an integrated continuum of surveillance, laboratory science, research, and training. Separating these functions can undermine the agility and coherence required to detect emerging threats, interpret critical data, and translate evidence into effective action.
• The requirement for stable, dedicated resources and transparent accountability. Public health must be supported by predictable funding and clear reporting mechanisms—especially as jurisdictions across Canada seek to strengthen prevention and population health strategies.
• The imperative of scientific independence. Strong, credible public health institutions must be able to produce and disseminate evidence and advice free from political or operational influence, supported by formal governance structures that protect this autonomy.

These principles are consistent with CPHA’s long-standing commitment to strengthening public health systems nationwide. Regardless of the administrative model a province or territory chooses, every jurisdiction must ensure that public health retains the independence, expertise, and capacity required to safeguard population health and drive long-term prevention.

CPHA joins the Association pour la santé publique du Québec (ASPQ) in opposing the proposed "merger" of the INSPQ and the INESSS.