The Cost You Cannot See, Part 3: Votre Santé, the Cost Placed Beyond View
Here the failure is not only that a public technology project ran late and over its expected cost. It is that the public is not permitted to see what it cost.
The first two parts of this series described a pattern and its proven case. This final part turns to the version that is sharpest of all, because here the failure is not only that a public technology project ran late and over its expected cost. It is that the public is not permitted to see what it cost.
The question this case answers
Why was a finished, Quebec-built health portal set aside and rebuilt by an outside firm with no call for tenders, and why was that rebuild placed inside an unrelated contract in a way that makes its cost impossible to track and keeps it off the government’s own project dashboard.
What Votre Santé was meant to be
Votre Santé is a 2022 electoral commitment, a portal meant to let people obtain a medical appointment online by entering their health need and being directed toward care. A Quebec company, Akinox, built the portal under a sole-source contract awarded directly rather than through competition. Akinox was not an unknown quantity. It was the firm that had built the province’s pandemic vaccine passport for the government. By accounts that later reached the press, it delivered a working product.
The substitution
In 2024 the state set the Akinox product aside and tasked the firm Accenture with rebuilding it, without a new call for tenders. In June 2024 Akinox wrote to the then Minister of Health, Christian Dubé, protesting its exclusion from the project. Santé Québec disputes the suggestion that it turned its back on the Quebec company, noting that Akinox remains a partner and that several of its existing systems will continue to be used and integrated into the new portal.
The mechanism that matters
This is the part that sets this case apart from an ordinary overrun. In March 2024, Accenture had won a competitive tender for a 40 million dollar, three-year contract to help the ministry roll out the digital health record, known as the DSN, in two pilot regions. The Votre Santé rebuild was placed inside that existing contract. Yet Votre Santé is a province-wide system, while the DSN contract covers only two regions, and the two run on different timelines. According to sources cited in the reporting, the proper course would have been to prepare a fresh business case and run a new tender. As early as April 2025, a person close to the file said the money spent at Accenture was not being used for what the DSN contract had foreseen.
The consequence is the heart of this dossier. Folding a province-wide portal into a larger contract built for something narrower makes the cost of the portal impossible to follow. Votre Santé is absent from the government’s own dashboard of public information-technology projects. The result is not merely a project that costs more than planned. It is a public cost placed beyond public view.
It did not go well
The rebuild itself ran into trouble. On June 10, 2025, Santé Québec’s vice-president of information technology set out the agency’s dissatisfaction with Accenture in a letter that later circulated within the firm, citing a lack of rigour and concern about whether contractual commitments would be met, and describing the agency as deeply disappointed in a project it called a ministerial priority of the highest importance. The portal had been meant for province-wide deployment in 2024. It is now roughly two years behind that schedule. Santé Québec says corrections have since been made, that the situation is under control, and that adjustments along the way are normal in a project of this scale.
What the system is now doing about it
Investigators at the Autorité des marchés publics and auditors at the Ministère de la Cybersécurité et du Numérique are now examining the Votre Santé project. Both Accenture and the government declined to comment on the file, each referring questions to Santé Québec. Santé Québec maintains that everything was done within the rules, that Votre Santé falls under the digital health record program for which contractual and governance mechanisms are already in place, and that the work was carried out in conformity with the applicable authorization rules, including the requirements of the law governing the management of public information resources.
The pattern, in its newest form
The five recurring causes set out at the start of this series all appear here. The state’s own capacity, embodied in a Quebec-built and reportedly working product, was set aside in favour of an outside rebuild. That rebuild proceeded without a competition. Warnings were raised, by the displaced developer in 2024 and from inside the agency in 2025, before the problems became public. Oversight arrived only after the work was well underway. And no one has yet borne a personal cost.
To these the case adds a sharper element than either SAAQclic or the broader pattern showed on their own. The opacity here is not an accident of complexity. It follows from a contractual choice, the placing of a province-wide project inside a contract built for two regions, with the effect that the cost cannot be tracked and the project does not appear where the public would look for it.
The public cost
The cost of SAAQclic could at least be argued over, because there were figures to argue about. Here, the public is denied even that. A province-wide system is roughly two years late, rebuilt at a price that cannot be followed, by a vendor relationship that has broken down, on a project the government itself has placed outside its own accountability dashboard. The dollar cost is real but unknown. The cost to accountability is that the question cannot be answered with the public records that exist, which is precisely the failure this series set out to name.
What must change
The repair begins with restoring what was removed. The project’s cost should be made traceable and reported on the government’s dashboard alongside every other public technology project. Work of this scale and scope should proceed through a fresh business case and a genuine competition, not be folded into a contract written for something else. These are not novel demands. They are the same governance and transparency repairs that the Auditor General named in 2025, that the Commission Gallant named in February 2026, and that the Autorité des marchés publics named across eleven projects in May 2026, when it called for the central governance of public digital projects to be strengthened. The authority to act sits with the government and the Treasury Board. The recommendations are on the record.
Why this matters now
A general election is set for October 5, 2026. At the same time, the oversight processes touching these failures remain active, including the audits into Votre Santé and a continuing criminal investigation arising from SAAQclic. Across this series the same conclusion has been reached three times over, by an auditor, by a commission, and by the province’s own contracts watchdog, that the way Quebec runs its large public technology projects is structurally deficient, and that the repairs have been written down and left unimplemented. The reports exist. The evidence is public. What remains is whether the people with the authority to act will be asked, on the record and before the vote, what they intend to do, and whether, in the case of Votre Santé, they will first allow the public to see what it has paid.
Sources
- Radio-Canada — Le projet informatique Votre Santé dans la mire des enquêteurs à Québec [Live link]
- Gouvernement du Québec — Tableau de bord des projets en ressources informationnelles [Live link]
- Autorité des marchés publics — Veille sur les pratiques de réalisation et la performance des projets numériques publics du gouvernement du Québec [Live link]