Some say Gaétan Barrette is a bully, some say he is a political bulldozer, but few would not agree that Quebec has never seen such an hyperactive health minister.
Dr. Barrette, a radiologist, is the political phenomenon of the year in Quebec's "government of doctors" – Premier Philippe Couillard is a neurosurgeon and Education Minister Yves Bolduc is a general practitioner.
Before entering politics, Dr. Barrette was already a public figure as the head of Quebec's federation of specialized physicians. He would pick fights with general practitioners, with the government, with the bureaucracy – whoever was available to disagree.
His specialist colleagues considered him a hero after he negotiated historic pay raises for his organization's members. After a failed bid for provincial office with the right-of-centre Coalition Avenir Québec in 2012, he got elected last spring for the Liberals he had so often bashed.
Turning in his lab coat appeared to be the least of his problems. For starters, the task of effectively reforming public health care is presumed to be beyond any real human capacity. Add the fact that the man in charge of negotiating with doctors on the government's behalf was lobbying for the other side just months before.
Dr. Barrette has also come under constant attack and mockery for his weight. He is said to be 5 foot 5 and weighs at least 260 pounds.
"I think a health minister should preach by example," former Parti Québécois leader Pauline Marois said in 2012. A petition was launched to encourage Dr. Barrette to get lean.
Dr. Barrette's body has also become fair game in the media. How can you represent doctors and be obese? journalists have asked. In a popular comic weekly review on public radio, you hear a dinosaur footsteps sound effect every time he is personified.
Public figures have been mocked for their body shape before. But never before was a Quebec politician deemed to be incompetent or in a conflict of interest simply because of his weight.
Despite these obstacles, though, Dr. Barrette is on a roll. After just a few months in office, he had signed agreements with all the physicians associations to spread pay raises over a longer period, to give the province's ever-expanding health budget some wiggle room. Early last fall, he announced a major shuffle in the health bureaucracy that he called a "structural and cultural revolution." The number of administrators will be cut, the number of agencies will be reduced and power will be centralized. The National Assembly was called in early to pass closure on the bill last Friday.
That's only the first step. Next are new obligations for doctors to take care of a minimum number of patients. And then a new system of remuneration. All this will be done by summer, says Dr. Barrette, and judging by his past performance, you can trust him on that.
The medical profession says he is punching them in the face. The opposition is lamenting that his manners are autocratic. Dr. Barrette couldn't care less. What's been tried before did not work, he says in seemingly every interview – we have to change the system profoundly and stop pouring more cash into the hole.
His language may be brutal – he called one former minister a liar, said another should retire and accused the opposition of intellectual mediocrity – and his manners may be rude. But he is delivering like no other minister in the province's recent history.
Will it lead to chaos, like some doctors claim? It's hard to say. But for Quebec patients on a waiting list or looking desperately for a family physician, it's clear that the system is broken and needs to be fixed. Can he really make things worse?
The big man may be unpleasant, but he has a plan and he sure does know how to operate.