Almost a year after the announcement of the surgical intervention catch-up plan, 60 of the 400 million dollars planned to reduce waiting lists have been spent, according to the Institute for the Relevance of Medical Acts (IPAM). The Federation of Specialist Physicians of Quebec (FMSQ) welcomes this first step, but signals to the government that it has access to the entire pot to speed up the pace in the operating theaters. The office of the Minister of Health, Christian Dubé, responds that he reminded health establishments of the existence of this money and that “the conclusion of collective agreements will make it possible to accelerate the use of the available sums”.
Minister Dubé and the president of the FMSQ, Dr.r Vincent Oliva, presented in May 2023 the plan to catch up on surgical interventions aimed at catching up with the delay accumulated during the COVID-19 pandemic. An envelope of 400 million dollars – coming from the pockets of specialist doctors and reinvested thanks to the work of IPAM – was attached to it. It was to be used to pay for voluntary overtime for teams of professionals in operating theaters. According to Christian Dubé’s office, the $60 million spent so far has been “made available to health establishments” for this specific purpose.
The vice-president of the FMSQ, Dr Serge Legault is delighted that 60 million have been “cleared” in this way. “It’s good news,” he said. To my knowledge, I do not believe that these amounts were paid to the local teams for the plan. We will applaud when they are. » The FMSQ encourages local administrations to disseminate their plan so that it “gets underway”.
At the end of March, Quebec missed its first target of 7,600 patients waiting for surgical intervention for more than a year: 11,861 people were still on this list. The office of the Minister of Health argued that this number was 22,200 in September 2022. He added that a “letter” was sent “in the last few weeks” to the establishments in order to remind them of the 400 million dollars of IPAM planned by 2027 “to optimize” operating theaters.
“We follow the work of our managers very closely to ensure that the results are there for patients,” says the firm in a written statement, specifying that the catch-up “never goes fast enough for our liking “.
According to Christian Dubé’s office, “the conclusion of collective agreements will make it possible to accelerate the use of the available sums.” The agreement in principle rejected by the 80,000 members of the Interprofessional Health Federation (FIQ) provided for a budget of 40 million dollars for the implementation of incentive measures as part of the catch-up of surgical interventions, we can read on the FIQ website. A joint committee was to agree “on measures to be put in place, and these should come into operation in October 2024”.
The effects of the catch-up plan are slow to be felt on the ground. “The efforts are very ad hoc in one center and another, and there are few well-coordinated, systematic efforts, where there are priorities [opératoires] additional needs that need to be filled,” indicates the president of the Quebec Surgery Association, Dr.r Patrick Charlebois.
“There are still rooms, daily, where there are cases canceled at the end of the day for different reasons. » Operating theaters are still not running at 100%, he adds. “There is still a shortage of staff. »
Outaouais “in survival mode”
The situation is critical in Outaouais. During the summer holidays, the regional CISSS plans to open a maximum of four operating rooms in total in its three hospitals (Hull, Gatineau and Buckingham), compared to 7 currently and 12 before the pandemic. The teams will prioritize urgent operations, such as cesarean sections and “certain cases of oncology”, according to the Dr Wadih Matar, head of the surgical interventions department at the CISSS de l’Outaouais. “You can’t do elective cases. We are completely in survival mode. »
The staff shortage is particularly glaring at the Gatineau hospital, where only one room will remain open this summer. CISSS employees leave to work in Ontario, where salaries are higher. “In the operating room of the Gatineau hospital, we are at 29% of the staff we had before the pandemic,” indicates the Dr Matar. This includes overtime worked by existing staff and retirees who come to help, he specifies. It is impossible to envisage catching up in this context, he adds.
Across the province, the government has set a goal of reaching the pre-pandemic number of patients waiting for surgery for more than a year, or approximately 2,500, by December 31.
To achieve this, he will have to apply the catch-up plan “100%”, judges the Dr Serge Legault. It will therefore be necessary to carry out the operations planned in the program and “pay people accordingly” if it is necessary to extend the day, as well as find teams to carry out surgical interventions “in unfavorable times, for example between 6 p.m. and 9 p.m.”. “If we were able to put this in place, we would have a real chance of reaching the targets, of breaking the curve so that it falls more quickly,” he thinks.