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Local Community Services Centers (CLSCs) in Quebec: Description, Evaluation, Perspectives

The health and social services reform of the Canadian Province of Quebec, launched in 1972, has been fairly widely described and evaluated. Such is not the case of the CLSCs (Local Community Services Centers) regarded as the most original institution created in the wake of that reform. This article purports to fill this void by describing to non-Quebecers what CLSCs basically are and do. This seems indicated inasmuch as the network of the Centers represents a some-what unique experience in the Western world. This descriptive and evaluative report is based on a synthesis of the pertinent information and on a series of interviews with “experts” and people in the field. The article describes firstly the nature of the Centers and their place in the health and social services system; it then presents an evaluation of the Centers and outlines a few perspectives fifteen years after their creation. The Centers were from the beginning entrusted with two interconnected missions: the provision of a range of medical and social services, and action on all possible conditions impinging on health and welfare from a local perspective. The article shows that the Centers, in the course of their tormented history, have gone a fair way in fulfilling this dual mission. A recent governmental policy statement confirms that, contrary to the wishes of various conservative circles, the CLSCs are here to stay. It would seem that the CLSCs' experience will continue to be an interesting, real-life health and social laboratory.