2023-12-31 05:00:00
With the adoption under a gag order of Bill 15, the government now has free rein to move forward with the Santé Québec agency in 2024. This umpteenth reform of the enormous health network will bring in its wake “ a lot of chaos and instability” in 2024, believes researcher Anne Plourde, from the Institute for Socioeconomic Research and Information (IRIS). Less than 10 years after the controversial Barrette reform, the next year will see the Dubé reform take shape.
• Read also: Here’s what to expect in 2024 at the National Assembly
A gigantic state corporation
Minister Christian Dubé wants to take his ministry out of operational decisions about the health system and leave management to the Santé Québec agency. But according to Anne Plourde of IRIS, we should not underestimate how enormous the new liner will be to maneuver.
The new state-owned company will have more than 300,000 employees and 1,500 facilities (hospitals, CHSLDs, CLSCs). In comparison, Hydro-Québec, which serves as inspiration for the minister, employs 22,000 people.
Ms. Plourde sees this as an “even more advanced” centralization of the network. “However, it was very clear to everyone during the pandemic that this centralization was causing serious problems in the organization of services and the ability to offer them effectively,” she is surprised.
Minister Dubé, however, promised to bring decisions closer to the ground with his reform.
Photo d’archives, Stevens LeBlanc
“The potential is there,” believes Nadia Sourial, assistant professor at the School of Public Health at the University of Montreal. But what powers will these local managers have, who will be able to sign checks for the purchase of equipment?
Employees wanted
Despite the best intentions with his reform, Minister Christian Dubé will first and foremost need to find personnel if he wants the network to regain health.
The period before the holidays was marked by overwhelmed emergency rooms, with dozens of hours of waiting on stretchers, due to the lack of employees. Not to mention the strike by state employees, who are demanding better salaries and working conditions within the network.
Photo Agence QMI, JOEL LEMAY
IRIS estimates that the network would need an addition of 100,000 workers, in addition to improving staff retention.
Nadia Sourial adds for her part that family medicine must be promoted as quickly as possible to improve access to the first line.
Slide to private
In the past year, the government has spent hundreds of millions of dollars on private clinics to perform surgeries that the public was unable to provide.
This increasingly marked opening of the government towards the private sector in the health network worries the two experts, who do not see the end in 2024.
Photo d’archives, Chantal Poirier
“The private sector is clearly contributing to draining resources from the public network. It’s not because we open private clinics to do surgeries that suddenly we will have more employees available in the network,” notes Anne Plourde.
“There is this idea that the private sector will help us, but we are just impoverishing the public network,” underlines Nadia Sourial in turn.
Ever-longer waiting lists
At the end of the year, more than 160,000 people were still waiting for surgery in Quebec. At this time last year, the number was virtually equal.
The year 2023 did not allow the government to catch up and shorten its waiting lists in several areas.
More than 820,000 Quebecers are waiting to see a specialist doctor. Of this number, 107,000 people are still hoping for a consultation with a dermatologist.
And around 21,000 seniors still rely on a first home care service, while 4,500 are waiting for a place in a CHSLD.
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