Montreal’s McGill university Health Centre was considered an anglophone bastion, a Goliath of English language and tradition, and many Quebecers were constantly flinging stones at it. I used to tell people that McGill University was first in Canada but second in Quebec. It was easily one of Canada’s finest institutions, yet its bilingualism was not enough to appease a great number of Quebecers. McGill was the red-haired stepchild. Canada was the dysfunctional parent. And the province of Quebec was the rebellious, dissatisfied teenager still trying to discover itself in the world.
Quebec should have separated from Canada following its second referendum on the matter in 1995. The vote had been close, with 49 percent in favour of separation. Since then, discontent had continued to fester. Quebec carried on like an adolescent girl stomping her heels. She wanted to do something, but mommy and daddy would not let her. This desire for independence manifested itself in all the wrong ways. Many signs in the province could be printed only in French, and in no other language. Let us call it hambourgeois, not hamburger. An Italian restaurant in Quebec was even ordered to remove the word pasta from its menu because it was considered too ethnic and not “French.” Once I was hired, my secretary was required to say allô or bonjour before hello when she picked up the phone. In Quebec, the French lacked the power they wanted, so they fretted about the small stuff. If the sovereigntists had won the referendum, Quebec could have become a country in its own right. It would have grown to become an adult, capable of adult conversations.
As with the fight over the Shriners Hospital, the building of McGill’s super-hospital was a microcosm of a much larger issue in Canada. In some respects, the process felt more like a complex sociological experiment than a business transaction.
When the McGill University Health Centre first called me in 2004, they had been trying and failing for more than a decade to build their new hospital. Running alongside their plans, but with equal ineptitude, was another mega-project mounted through the University of Montreal. The huge difference was that the University of Montreal medical facility, if successful, would be exclusively French. As it was, neither project could get off the ground. The politics and the linguistic tensions in Quebec never stopped swirling, leaving the issues of the day frozen in place.
Some people were in favour of combining the two projects. While the theory made sense, there was already too much baggage to make that practical. A united hospital might also have received support from the French community, but some considered such a proposition an affront to McGill. The English establishment feared that once a joint mega-hospital was built, the French would simply take over. It was an odd state of affairs. Everyone seemed to be in the same boat. We were all Canadians. And yet we were clearly divided. My mandate was to make the English hospital happen.
The McGill board had hired me for the aggressive, no-holds-barred approach I’d demonstrated in Detroit. Even though I had been an outsider there, I had played politics, stood up to the establishment and prevailed. On my first day in Montreal, I was presented with enough reports, plans and designs to fill an entire room. The board had gone through several administrators, but nobody seemed to get the job done. What they needed was someone different, someone not afraid to go in for the kill.
In Detroit, I had fired thousands of people with the stroke of a pen. In Canada, though, nobody has the same cutthroat mentality. Let’s not fire people now, they say. Let’s retain them to do other things, look at attrition and when employees are sixty-five, escort them quietly out the door. Some might say this approach is very Canadian. In my opinion, it was not generally Canadian so much as indicative of hospital administrators in the country. I brought a radically different approach to the Quebec healthcare scene.
At first, I thought returning to Canada would be a homecoming. But this was not Alberta. I might as well have been dropped into a foreign country. Montreal, with all its differences in language, politics and culture, was not accessible to my wife and family. They stayed in Nassau. Since I was in the city alone, I didn’t live in Montreal seven days a week—I kept a place there but left on weekends for the Bahamas. I ran my cancer clinic and saw patients in Montreal, but the Bahamas was home. My children went to school there and had friends. I had considered bringing them to Quebec initially, but the province’s laws quickly changed my mind. Since my daughters had never attended school in Canada, they would have been forced to attend a French-speaking institution. They were teenagers and did not speak a lick of it. These kinds of language laws and linguistic racism never let me feel entirely at home in Quebec.
So on a personal level, taking the job in Montreal was hard. In Detroit, my family and I had lived far outside the city, and while I tended to work crazy hours downtown, at least we were together in the same country. It bothered me that now I could not spend much time with my wife and children. I sometimes failed to properly calculate the timing on milestones such as birthdays, anniversaries and graduations, especially as plans for the new super-hospital really started to heat up. I had more than one of those “I don’t understand” moments with Pamela, and perhaps with the kids. At the end of each day, I was tired, and I lacked the energy even to speak on the phone and explain my job to my wife. Montreal was my reality, not hers. To her, it felt like she was asking: What did you do yesterday on the moon? As for me, where could I begin? The space between us felt vast.
It was a lonely time, and Montreal’s famous parties and social life only made that feeling worse. My position continually necessitated appearances at events and soirees like the Red Cross Ball and the Canadian Cancer Society’s gala. I would purposely show up at the beginning of the cocktail hour, making sure everyone knew I was there. I did the rounds and chatted with a few key people. But when the dinner bell rang and couples began to head to their tables, arm in arm, I would slip out the front door. I was embarrassed that there would be an empty seat beside me at the table. I suppose, in some way, that seat represented my isolation in Montreal. I usually enjoyed socializing, dining and dancing, but in general I did not partake of the Montreal social scene.
I did host parties from time to time, organized by my secretary and put on at my penthouse apartment on Doctor Penfield Avenue. I was with people constantly through my work, and as tends to happen, I would often hear the phrases “let’s have a drink soon” and “we simply must get together.” They were often empty words, of course, but it behooved me to meet with twenty or thirty “obligatories,” as I liked to call them, from time to time. We would have a drink or two, perhaps something to eat, and fulfill social conventions.
I had arrived in the city as somewhat of a misfit and a curiosity. People knew I had come from Detroit. Was I American? Yet I had worked in Alberta and Ontario. So I must be Canadian. But I also held a diplomatic passport from Sierra Leone. I was a wild card, with an approach the board of directors at the McGill University Health Centre was not accustomed to. It was a position I felt comfortable with by now.
I did not disappoint them. I did my homework before our first meeting. By speaking with fellow executives, I learned that the chairman of the board typically sat at the head of the boardroom table. He led the meeting and simply asked the hospital staff questions. I knew this arrangement would not work for me at all. So I came in early the morning of the meeting and slid a second chair alongside the first one at the head of the table. There I sat, smiling in my bow tie, fingers linked on the table in front of me, as the board filed in. They represented the icons of business in Montreal, mostly anglophone, although they had held little power since the so-called Quiet Revolution of the 1960s. French families had gradually eroded anglophone corporate and political influence. Many of the big English banks and institutions had uprooted and headed for Toronto. But these anglophones were still prominent members of the community. They had good names.
Not one of them, however, was quite sure how to react to my game of musical chairs. It was somewhat of an emperor’s clothing scenario. One of the biggest differences between Canada and the U.S. is that Americans will tell you exactly what they are thinking, especially when it comes to business. I got a few looks from board members that day. I knew what they were thinking. And yet we all let it slide.
At our second meeting, I understood, something would need to be said. I arrived early once more. This time, I left only one chair at the head of that table, and I sat in it myself. I had instructed all of my staff to stay home. Once the board members had taken their seats, I explained to them that I would be running the meeting. They were used to having other hospital executives at meetings for questioning as well. From now on, I told them, they would deal with only one employee—me. The other fourteen thousand people at McGill University Health Centre were my employees. If the board wanted to speak with my employees, they could do so through me. If they did not like what was happening, they could always fire me. I also requested—perhaps demanded—that my title be amended to include CEO. “Director general” never did feel right on its own. I was not the leader of the Salvation Army.
It is in my personality to take over. I was never one to take a back seat. Beyond that, I was living up to expectations. I was brought to Montreal for a reason, to take control and get things done, although the reality turned out to be far more complicated. In keeping with the English and French tension in Quebec, there was a divided mindset towards the mega-hospital. It was clear that the city was of two minds. One side of the brain kept saying yes, while the other said no, which is presumably why nothing had happened for so many years.
I got the sense that the board was relieved I had arrived. But in private corners, there was panic that change was coming. Charest and Couillard epitomized this division.
Couillard, known by some in politics as “the Bear,” was about six feet tall, with a very striking face, bright blue eyes and a fuzzy white beard. Of course, I never called him the Bear; to me, he was always Philippe. My close relationship with him in particular would be well documented by the media.
While it’s true that we had a very close personal relationship, I remember our first meeting was rather uneventful. When I was first interviewed for the job, I stopped by his office and we shook hands and had a very official kind of conversation. Even after I was appointed, I was pretty guarded in my discussions with him. In the beginning, you want to listen more than you speak. It was very clear to me, however, that he was very important when it came to healthcare in Quebec. And it was equally clear that the anglophone hospital administrators had not played a very good political game. Prior to my arrival, a swagger, a tone of arrogance, characterized their dealings with the provincial government. They did what they wanted. So my tenure would be defined by extending the olive branch. From there, a friendship grew between us.
Couillard and I were similar in some respects. He was a fairly accomplished neurosurgeon, and we had each experienced a kind of meteoric rise in the medical profession. Despite our successes, I suppose we both got bored and developed interests in doing other things. It wasn’t long before Couillard and I started meeting for lunch a couple of times a week. I remember having dinner once at his apartment, which was located above a shop in downtown Quebec City. He served fish that night, a fish that he had caught himself, I recall, and we prepared it together with his wife on hand. I even slept over that night.
Fishing became a common theme in our friendship. I had a moderate interest in the sport, but Couillard was passionate. Then again, he was like that with most things he did. Once he had an idea, or decided that he liked something, he pursued it 100 percent. He loved to become an expert at things. He was like that with fishing: he bought the book, the rod and the tackle box, and he and I went on several fishing trips together during my years in Montreal.
When you become a cabinet minister or premier of Quebec, you’re expected to have a driver. So off Couillard and I would go, in the back of a government vehicle, usually a minivan driven by a security staffer, the trunk stuffed with fishing equipment and suitcases. Once, we went to New Brunswick for salmon fishing. Another time, he and I travelled via helicopter to Anticosti Island in Quebec, a rather exclusive salmon fishing retreat in the Gulf of Saint Lawrence. Couillard and I would share a log cabin on these trips, rising at 5 AM to push our boat out onto the glassy lake. We would fish until 11 AM, return to the cabin for a big lunch, fish again in the afternoon, and then have a big dinner. We got pleasantly drunk at night, and came to know each other well enough for him to confide in me on a number of matters, and well enough for me to provide support over the years, whether that be financial, professional or psychological. In public positions such as ours, one does not have many friends. It was helpful to have someone I could trust.
Indeed, there was a period when Couillard called me every day, asking what I thought about this issue or that decision. He craved approval, I realized. Couillard wanted to be told that he was doing a good job.
In terms of healthcare policy, Couillard and I rarely butted heads. We each evolved our policies to find a common ground, and if a decision was controversial, he tended to seek my approval first. To be honest, I think he was worried about how I might react to bad news. I was somewhat of a free spirit. Perhaps I might have suggested to him that the emperor was wearing only a loincloth. And Couillard would have done anything to protect his reputation. He would call me to explain that he had to appease the French hospital by being silent and “understanding” when he gave them more money, or by making policy changes that were unfavourable to McGill. “It is only politics,” he would say. “I have to do it. You understand. Do not worry. I support the English hospital. It will all get sorted out in the end.” It was soon clear to me how badly he wanted to be premier of Quebec. He almost wanted it too badly, in fact.
But despite his faults, I thought he was a very smart man and would make a good premier. He understood Quebec and Canada, and he had a good grasp of international issues too. He was cosmopolitan. And he was a creative and flexible thinker, qualities that I think are key to leadership. Having firm ideas about how to do things is important, but you also need the flexibility of mind to really listen and respond. He had those qualities. When it came to McGill’s mega-hospital, however, Couillard struggled like everyone else.
From the beginning, Jean Charest had also assured me that he was on board. I believed him. But the premier was a pragmatist as well. Nobody wanted to stick his or her neck out, Charest least of all. He was gazing into the tea leaves, as if decades of division would suddenly shift, while licking his finger and trying to feel where the winds were blowing.
Montreal badly needed the mega-hospital. The McGill University Health Centre, formed in 1997, represented the merger of five hospitals: the Montreal General, the Royal Victoria, the Montreal Children’s Hospital, the Montreal Neurological Institute and the Montreal Chest Institute. Lachine Hospital would join in 2008. Overall, it was a network with nearly 1,400 beds and more than 14,000 employees serving close to a million patients each year.
While the network was relatively new, the hospitals definitely were not. The Royal Victoria, for example, had been built in 1893. Many areas of the hospital did not have air conditioning, sometimes four beds occupied a single room and superbug infestations were sickening patients at alarming rates.
Superbugs are formed from hospital contaminants in rooms that cannot be adequately cleaned. They live in the walls or in crevices. They can cause terrible bowel illness, bringing on diarrhea and other serious intestinal problems. At the time I arrived in Montreal, there were several documented deaths at the McGill University Health Centre due to these superbugs. Most patients also became carriers.
The majority of us have sufficient resistance to fight off this kind of infection, but superbugs have a great impact on the weak, the young and the elderly. They are also very hard to treat because, having evolved in a hospital, they become antibiotic-resistant. For these reasons a key feature of the new $1.3-billion mega-hospital was single-patient rooms. In Detroit, we had all but defeated the superbug problem through single-patient room policies. The new hospital rooms in Montreal would also have no sharp edges, making them easier to clean; the floor and wall would blend into a curve to eliminate crevices. I was frequently criticized on both these grounds, though neither plan was terribly unusual. Every suggestion and step forward was met with some kind of delay or opposition.
My critics branded the new mega-hospital “Porter’s Hotel,” saying I was more concerned with amenities than with the medical side. My true priority, of course, was quite the opposite. In this modern age, you could not start off by designing a hospital for the year 2000. We needed a hospital that reflected its proposed opening date of 2015.
While superbugs were an invisible problem and perhaps harder for people to understand, at least at that time, the sheer dilapidation of the McGill University Health Centre was a less contentious issue. It was more than rooms and hallways appearing worn and in desperate need of paint. The Royal Victoria, for example, sat on the side of a mountain, and had rampant leaks the equivalent of four Olympic-sized swimming pools running through the basement and walls every year. Because the hospital was so old and its architectural plans not well defined, these leaks were almost impossible to fix. We had pumps running constantly. The leaks were especially bad in the winter and when it rained. Over time, many walls simply melted away from moisture. We built new ones and continued with repairs, but only so much could be done. I can say without exaggeration that we spent tens of millions of dollars every year on repairs during my time at the centre.
The state of the hospital was a liability from the patient’s point of view, not to mention a gross misappropriation of taxpayers’ money. The cost of keeping these buildings going was higher than the value of the hospitals. Every year it was a battle to secure the necessary funds for maintenance. In Detroit, much of our ongoing capital had been spent on repairs. I had one-quarter of the Detroit budget to work with in Montreal. Every year, regardless of expenditure, the hospitals were deteriorating. Renovations would not cut it anymore. The hospital network needed a fresh start.
In addition, I pointed out constantly that the longer we delayed, the more expensive the mega-hospital would be, due to inflation and the price of materials. When I first arrived, the project could have been completed for $800 million. The price tag ended up being $500 million higher than that by the time we broke ground.
From day one in my new position, I put in place an aggressive internal structure to get the job done. What did we want as an institution? What were we trying to achieve? These matters had been discussed endlessly prior to my arrival in Montreal. Under the new regime, once we decided on something and knew what it would look like, the discussion was closed. We then moved on to the next item. Part of the problem was that, in Canada, I was mostly dealing with civil servants who had no “private” money at stake. All they had to do was move paper around their desks and make sure none of it fell off.
There was no particular tipping point at which the project finally got underway. The process was simply six long years of skirmishes; constant little fights with executives and various levels of government. It was an exhausting and drawn-out affair, in which each side kept score and fired back at the other at the appropriate time. However, the battle had an entirely different feel from the one in Detroit. Montreal felt more like guerrilla warfare than a stand-up fist fight. It was hard to know who your enemy was. When I saw provincial government officials or influential members of the business community, it was always smiles and handshakes. But when push came to shove, nothing happened the way you expected. Behind closed doors, the same people frowned. Their goal was to delay and make us wait. My goal was to get things done, and sometimes to embarrass.
To drive home the financial reality, I told the press that for every day we delayed, the hospital would cost $100,000 more to build. I even threatened to put up a sign on the mega-hospital’s proposed site, similar to those you see in front of McDonalds that read “more than 100 million customers served.” My sign would show the perpetual increase in cost. The suggestion did not earn me too many friends, but I made my point.
As we got closer to construction, the various planning authorities often challenged me. Their sole purpose, it seemed, was to block, hamper and delay. The forty-two-acre site for the mega-hospital was the site of the former Glen railyard. Part of the area had also been a dump. It was a huge area, relatively virgin open land in the middle of a small neighbourhood. Decontamination was a constant point of contention and one source of delays. Given my past experiences, I decided to bypass the application for excavation, since I knew it would be denied. I brought in a legion of bulldozers and got started. The bureaucrats did not stop us, though they were more than a little annoyed. I pleaded ignorance. Sorry, I’m new to Quebec, I said. I did not know that we needed to apply for permits before bulldozing. Some might have considered these practices aggressive or unscrupulous. I considered them proactive and progressive. I was tired of the roadblocks. Every time we moved forward, something new would be thrown up in our path to prevent construction. In my mind, that was unscrupulous.
Even after McGill’s years of planning, every so often the Quebec government would try to reopen the debate on whether we should combine services with the French hospital. As one example, the premier suggested that McGill University Health Centre should offer joint clinical services spread across the city. Anyone in the medical field knew that would be unworkable. Can you imagine telling specialized physicians they had to provide the same service at multiple hospitals throughout Montreal? I had never even heard of the concept, though its proponents managed to give it a name—clinical complementarity. It was a ridiculous and impractical notion. After we shot it down, the government came back and suggested we share laundry and other services. The exercise had descended into farce.
As the years passed by, anxiety also grew that the McGill project had pulled too far ahead of the French hospital. The University of Montreal was finally starting to get its act together, aided by certain key figures in the provincial government. They put the right staffing in place. They even brought in a deputy minister as an advisor. They exhibited a renewed sense of urgency and focus. But it was all too little, too late. By then, my team and I had boxed the province into a series of irrevocable decisions. These were subsequently cemented by the creation of an intricate bidding process for the McGill mega-hospital’s construction.
It was agreed that responsibility for the project would be placed in the hands of a public-private partnership, or PPP, a complex process involving the hospital, two government ministries and scores of other people—nearly one hundred participants in total.
In essence, a PPP is a process in which the contracting party determines what it wants to build and then puts a series of specifications out to bid. The successful bidder designs the project, builds it, provides financing and maintains the completed project for a predefined period of time, at the conclusion of which the contracting party can buy the project for a nominal amount.
In a way, the process is like buying a home in a new development. You tell the builder your needs, such as three bedrooms, two bathrooms and a garage, he provides a couple of designs for you to look at, and you choose one of them. The developer then gets you a mortgage and builds the home, and you move in when it’s finished.
We set to work on determining what we wanted in the mega-hospital, including the number of rooms for patients, the number and type of operating theatres, labs, kitchens and so on. Teams of experts worked on these specifications. They visited hospitals in Europe and across the U.S., looking for best-in-class and what I would term “future-ready” designs. While this process was going on, a second group was charged with determining who had the skills to do all that was required to build a PPP of this size and complexity, the likes of which had hitherto not been seen in Canada.
So who were these groups of decision makers? Three entities were involved.
The first was Public-Private Partnership Quebec, later known as Infrastructure Quebec, which was an arm of the provincial Ministry of Finance. The second was the Quebec Ministry of Health, through the office responsible for healthcare projects, led by Clermont Gignac, a former project manager for Bombardier. The third group was the McGill University Health Centre. The PPP’s ultimate task was to award a 34.25-year contract to design, build, finance and maintain Montreal’s new mega-hospital. The group would pay rent, and at the end of the contract, the government would have the ability to purchase the deed for $1. A whole series of rules were established so that the process would be fair. An auditor sat in on every meeting. This was a tried-and-true model that had been successfully administered dozens of times throughout Canada.
Our first step was to decide on the candidates for the bid and qualify them financially. Two consortiums expressed interest and made the cut. One was led by SNC-Lavalin, the largest construction and engineering company in Canada, and by Innisfree Limited, the British infrastructure investment group; the other included companies based in Spain and France.
The bidding process kicked off with ten separate groups, comprising individuals selected by the two government ministries and the hospital and other analysts, grading these two consortiums based on their pitches. The criteria were quite broad, including everything from patient flow, architectural design and aesthetics to proven experience with heating and cooling large buildings. The consortium led by Innisfree and SNC-Lavalin would eventually achieve the higher score.
But the bidding process involved more than that. There was also the matter of money. Only the provincial government branches had access to the financial details that the two consortiums submitted for the design, construction and execution of the project.
The process appeared to be going well. However, I soon discovered from government authorities that both consortiums were way over our projected budget in their estimates, and not by a few dollars and cents. Both bids were hundreds of millions over the budget we’d set. That was scary. It had taken us years to reach this point. I honestly did not care which consortium won the bid. But I had invested a huge amount of time to reach this stage, and I was concerned that, because the estimates were too high, the Quebec government would disqualify both bidders and retreat to the drawing board. That would have been a disaster.
The naysayers were looking for an excuse to derail the entire process, and, as I had feared, the inflated bids reignited the same objections we had heard from the very beginning. Perhaps we should just renovate the existing McGill hospitals rather than overspend on the bid? Maybe the University of Montreal project should combine with McGill?
The process was saved by a second round of bidding for which the government modified the process and the rules. They asked the McGill hospital group to work with both bidders to modify their wish lists and come up with new plans. These would then be translated by the two bidding consortiums into “best and final offers,” or BAFO, that would be reviewed by a new series of committees in an abbreviated fashion. The final decision would be made by a triumvirate: Normand Bergeron, CEO of Infrastructure Quebec; Clermont Gignac, in charge of the modernization of Quebec hospitals; and Arthur Porter, the embattled director general and CEO of McGill University Health Centre.
With Bergeron as our chairman, our job was simply to take all the scoring from the initial review groups and add it up, while making sure everyone was following the rules. The three of us were sealed off in a room, everyone had to sign in and out, and the auditor and Quebec’s ethics commissioner were there to ensure it was all done properly. In the end, a fifth-grade student could have polished off the process. The scores spoke for themselves.
Once again, the consortium led by Innisfree and SNC-Lavalin came out on top. Our triumvirate endorsed the decision unanimously to award that consortium the contract to build Montreal’s new mega-hospital.
I still think that the PPP made the right decision. SNC-Lavalin was a dynamic, progressive and uniquely global Canadian company, and its consortium stood out in a number of ways. First and foremost was the proposed design, which was gorgeous, clean and curvaceous. We knew Quebecers wanted a hospital that was sleek, modern and a symbol of the future of healthcare in the province.
The French and Spanish consortium’s design was bland, square and ugly. It was a utilitarian approach, but what we were seeking was something future-ready, and there was general agreement on that point. Other faults with the competing bid had less to do with its aesthetics. Many committee members were concerned about the overall solidity of the rival consortium. During the process, some of its contractors and subcontractors had dropped out, only to be replaced by others with less experience. The SNC-Lavalin-led consortium had a more consistent base and the right kind of experience.
These were not just my own opinions; the dozens of committee members involved in the bidding process shared them. The auditor who had sat in on the bidding process, André Dumais, would declare in his final report that the process was fair. “On the basis of my observations and verifications, I can confirm that the two bidders have always been treated according to the principles of equality, impartiality and transparency,” Dumais wrote.
The $1.3-billion mega-hospital was contentious. There could be no dispute on that point. And those feelings of resentment and bitterness did not simply melt away once the bidding process was completed. If anything, they intensified.
Plenty of people did not want us to succeed. And they especially had not wanted the SNC-Lavalin-led conglomerate to win the bid. SNC-Lavalin was the largest engineering and construction company in Canada, posting global revenues of more than $7 billion. It was one of the most powerful companies in Canada and routinely made substantial donations to political parties, particularly in Quebec. The moment that contract was signed and a PPP came into effect, the conglomerate would run the show. Quebec would not be able to slow down the process. The other bidder, a foreign entity and a relative alien in the province, would have been much easier for the government to stop by finding technicalities and loopholes and generally impeding their progress.
Of course, that did not stop the province from trying to do the same thing with SNC-Lavalin. Shortly after construction began, I received a note saying the site had to be shut down immediately. The hundreds of workers were to stop work because the construction company had erected personnel cabins that were somehow illegal. I cannot recall the actual technicality, but somehow it did not meet code. An injunction was filed, and the bureaucrats gazed at me gleefully, thinking they had finally got us. I told them it was no longer my problem. I sent the injunction by courier to the head office of SNC-Lavalin, giving the top executives a call in advance, just to make sure they knew it was coming. Control over construction was in the consortium’s hands now. They had a signed agreement. The issue had nothing to do with McGill University Health Centre. Suffice it to say, crews got back to work in an hour or so. All it took, presumably, was a few phone calls here and there.
The government’s impotence to stop what was happening only added fuel to the fire. And SNC-Lavalin would soon become vulnerable, revealing cracks in its once-mighty armour. For many years, the company had been admired for its success overseas. It did business in places few companies had managed to penetrate. Sadly, in the lead-up to the hospital contract, there had been controversies and scandals involving the company in places such as India, Bolivia and most notably Libya. SNC-Lavalin would be targeted for what many considered questionable business practices.
I highlight SNC-Lavalin because the company remained such an intense area of focus for Quebec media and investigators in connection with the mega-hospital. But people forget that it was not SNC-Lavalin that won the bid. It was the consortium of which the company was a part. SNC-Lavalin became a lightning rod, given its association with the province of Quebec. It was by no means the only major player at the table. But the scandals surrounding the company in other places provided more than enough motivation for the hospital project’s enemies to pounce.
And then there was Arthur Porter, the CEO and director general at the McGill University Health Centre, seen by some as the catalyst behind this black mark on the province’s French establishment. I knew very well that plenty of people were out to get me. In the lead-up to the groundbreaking of the hospital, a friend told me: “They are blaming you for everything in Montreal, including the snow.” During and after my tenure in Montreal, I would be targeted for just about everything, although admittedly the $22.5-million fraud charges against me would top the list as the most preposterous. But more on that later; I am getting ahead of myself.
As I said, I did not come to Montreal to be loved. But it was clear to me that, at least in some circles, there was an intense feeling that I could not be controlled. It was bad enough I did not speak French and had never really lived in Quebec. I was not one of them. How many CEOs in the country held a diplomatic passport for an African country? How many were mining and building infrastructure in Sierra Leone and Libya? How many had also been the CEO of a major hospital network in the U.S. and become a known Republican and a friend of George W. Bush?
In truth, I was already planning my resignation once the project was approved.
The date for the mega-hospital’s groundbreaking was set for April 1, 2010—April Fool’s Day, no less. It had been six years to the day, in fact, since I had accepted the post as CEO and director general of the McGill University Health Centre. The giant medical facility would be the largest in Canada, stretching across forty-three acres and integrating five major hospitals, a state-of-the-art research centre and a dedicated oncology department. Separate but closely related was the new Shriners Children’s Hospital. For me, six years of dedicated work boiled down to this day.
The day was not exactly going according to plan.
Politicians, businessmen and the mayor sprang from their cars and rushed through a gauntlet. Dozens of Montreal police were in full riot gear, holding back an equal number of protestors waving signs and hurling insults.
Having come from Kenya, Sierra Leone and Detroit, I considered it a rather tame protest—no guns, no tanks, no bodies lying in the streets. I could see, however, that many of the esteemed guests were rattled. I was not going to let a few protestors ruin this moment. Instead of being held on the actual grounds, the event shifted at the last minute to a small community theatre. We tried to maintain calm and order as we guided people into a reception area on the second floor. We could not hear the chants and screams from up there. I circulated through the crowd, smiling, socializing and trying to put guests at ease. But as I scanned the room for those present, I was acutely aware of one who was not: Jean Charest, the premier of Quebec.
Earlier that day, I had arrived in the office to a message waiting for me from Charest’s public relations team: the premier would not be making today’s event. Word had spread that remnants of the Front de libération du Québec, otherwise known as the FLQ, were planning on crashing the party. The organization, made up of French separatists, rose to notoriety in the 1960s and was responsible for a number of terrorist attacks. In 1969, the FLQ bombed the Montreal Stock Exchange, and just one year later, it murdered a local politician and kidnapped the British trade commissioner. The party mostly fell off the radar over the coming decades, although it tended to rear its head whenever it identified an affront to French rights and sovereignty.
FLQ or no, Charest’s absence was unacceptable. After getting the message from his office that morning, I dropped everything and drove straight to see him. There was no sense calling. I arrived at his office at 9 AM and demanded to see him immediately. All I got was his chief of staff, because apparently Charest was unavailable. I told the chief of staff that the premier was making a big mistake. The groundbreaking was going forward whether he arrived or not, and I would say he had “chickened out” because of the protestors.
I did not care about backlash. If there was no groundbreaking, I would be history. If I postponed the event, more delays could be manufactured. Before you knew it, weeks would turn into months. Priorities would change, and suddenly you would no longer be the issue of the day.
We were moving forward with or without him. The course was set. And in many respects, his presence or absence would not have mattered. The contracts had been signed. The ink was dry, and yet denial remained. A few days before the event, I recall that a very senior Quebec politician, Raymond Bachand, called to congratulate me on a job well done. He assured me, however, that the English mega-hospital could never be built before the French one. All of my efforts would be for naught.
And yet there we were, just minutes before the groundbreaking, albeit without a premier. Collective nervousness and anticipation grew as the minutes ticked by. The guests kept looking at their watches. Rumour had it that Charest was on his way, although nobody knew for sure.
At the eleventh hour, only a few minutes before the festivities got underway, Charest arrived. The premier did not brave the gauntlet like the rest of the guests. He slipped in through the back door with his entourage. I had a feeling he would be upset with me after my ultimatum that morning.
None of that mattered once he arrived. It was politics. We smiled and shook hands. I led Charest, the board of directors and everyone else downstairs. The theatre had around a hundred seats, and we took the stage in turn, like a troupe of actors delivering tongue-in-cheek soliloquies. Everyone said the right things. I received a standing ovation. It was announced that one of the streets on the new mega-hospital campus would be named in my honour. We posed for photographs, smiling and laughing in a hail of clicks and flashes. The irony of it all was not lost on me. It was theatre.
Before the curtain fell on this performance, there would be one more act. While we were on stage, the staff had prepared an upstairs room for the final scene. We entered to find a huge cake in the shape of a shovel. On the floor lay some real shovels and a pile of dirt. Charest and I, along with a few others, each took up a shovel and gathered around. But these theatrical flourishes could not disguise the truth.
During my tenure, the McGill University Health Centre had received a $250-million grant for our research institute. Internationally, we had been recognized as one of the province’s finest institutions. At home, we had been recognized by the Globe and Mail as one of Canada’s top one hundred employers, and as one of Montreal’s top fifteen employers by the Montreal Gazette for several consecutive years.
Building that hospital was probably the hardest deal I had ever closed. Of anything I had done in my life, it had taken the most personal energy. It wasn’t easy, and indeed, my challenges were just beginning. But I came, I saw, and I got the job done.
I stuck my shovel in the dirt and took a bow.