Forcing medical specialists to provide more services and increasing the mobility of nurses are cornerstones of the Dubé reform that make us dream of a more efficient health network. These changes are necessary, but the confrontation with their unions will require courage.
The caquistes once promised to get $ 1 billion in doctor’s compensation, and it did not happen.
This time, the Minister of Health, Christian Dubé, maintains that a principle of “population responsibility” will allow us to get more for our money.
The interminable press conference following the tabling of his bill on Santé Québec did not allow us to have a clear idea of the additional care that patients would benefit from.
This will be determined by the territorial medical directorates, we said more or less convincingly on Wednesday.
Even if there is no number of overtime hours written into the law, Minister Dubé assures that specialists will have to accept for the first time a principle of specific medical activities, such as general practitioners, who must devote 12 hours a week to an emergency or a CHSLD, for example.
Changes are absolutely necessary.
In all, 161,000 Quebecers were waiting for surgery at the start of the year and 800,000 patients referred by a family doctor are waiting for an appointment with a specialist.
To put some pressure, Minister Dubé intends to make this list of pending appointments public in April, so that patients will then see the improvement when the medics do more.
The situation is not the same everywhere, but psychiatrists abandon practice in hospitals, without consequence for them, and worsen the waiting lists. Radiologists work from home and leave the hard work to those who work in institutions.
However, the Federation of Medical Specialists has already mounted the barricades.
Give everyone an example
They could learn from family physicians.
Christian Dubé negotiated with them the registration of patients with a GMF, after François Legault had threatened to force them to take care of 1000 patients each.
And the Dubé pilot seems inclined to grant a favor in return for this demonstrated goodwill: he will throw ballast in the allocation of positions in the regions, an irritant to attract young people to family medicine.
The FMSQ should take notes before going into a frenzy.
Convince the nurses
For nurses, the battle will take place on two fronts, and will be led by the President of the Treasury Board, Sonia LeBel.
She will first have to make the central unions swallow the principle of merging the agreements, in order to recognize the seniority of a nurse everywhere in Quebec.
Thus, Dubé could realize his dream of a bank of personnel able to meet needs in the regions, without resorting to costly private agencies.
Then, Sonia LeBel must convince nurses with more seniority to share evening or weekend shifts with their younger colleagues, to reduce the compulsory overtime.
This overload plagues the network and increases the shortage.
A trend reversal is essential, but implies a whole change of culture.
To achieve this, the government team is counting on higher salary increases for those who agree to get their hands dirty.
The moment seems favorable and the operation is led by two of the best elements of the Legault government.
The resistance will be great.
But the combination of Dubé’s bill and LeBel’s negotiation makes you want to believe it.