Almost everyone has had the frustrating experience of finding a family doctor, not to mention a consultation with a specialist, or an endless wait in an emergency room.
The pandemic has, however, allowed all Quebecers to suffer at the same time from the shortcomings of a health system which nevertheless monopolizes half of the state’s revenues, without the slightest improvement being perceptible.
This week, it was particularly infuriating to hear the Premier of Ontario, Doug Ford, explain that despite the contagiousness of the Omicron variant, the health network of his province was strong enough to begin deconfinement.
At the same time, Prime Minister Legault declared that the slightest relaxation of sanitary measures represented too great a risk for our network, which an exhausted staff kept at arm’s length in an almost miraculous way.
Since the start of the pandemic, it has been explained that the proportionately higher number of cases, hospitalizations and then deaths in Quebec than elsewhere in Canada was attributable to different accounting methods, which had the effect of underestimating the seriousness of the situation in the other provinces.
That is possible. Unless our neighbors don’t know the difference between a bed and a table, however, it seems undeniable that Quebec’s hospital capacity is lower than in the rest of the country. The figures speak for themselves: Quebec has 1,865 beds per million inhabitants, compared to 2,500 in Canada, 5,800 in France and 12,800 in Japan.
This reality and its consequences have been known for a long time. In a premonitory text published on February 28, 2020, two weeks before Mr. Legault put Quebec “on pause”, Gaétan Barrette wrote: “By definition, without being alarmist, our network operates permanently at full capacity. There is no wiggle room […] This is a real issue that could be highlighted even more with the arrival of COVID. »
According to him, the addition of 3,000 beds was necessary in the Greater Montreal region alone, otherwise a rapid increase in cases would lead to the postponement of many non-urgent interventions. Even a very successful first line in home care would only free up 300 beds, he said.
In a global report on the performance of the health system published in 2016, the Commissioner for Health and Welfare (CSBE) pointed out that the number of beds had been falling steadily over the previous 20 years, without outpatient services that should have compensated have been improved. The same year, Mr. Barrette instead decided to abolish his position.
It is true that the many shortcomings noted by the CSBE made it all the more difficult to understand the austerity policies decreed by the Couillard government. It was better to shut him up.
Granted, Mr. Barrette was not responsible for this lack of beds, which dated back to the Bouchard years. Besides, it’s always someone else’s fault. He explained that he had planned the opening of 711 new beds in the Montreal region when he was minister, but that his successor, Danielle McCann, had not followed up. And, of course, M.me McCann is gone…
We can undoubtedly count many mistakes made, here as elsewhere, in the management of the pandemic, but it was clear that such a fragile network presented an enormous risk. For years, a simple flu epidemic has been enough to clog hospitals. The creation of “overflow units” was a permanent alarm signal that we preferred to ignore.
It has to be admitted: despite the competence and undeniable dedication of those who work there, our network does a poor job compared to that of most G20 countries. You may not have to drive a Cadillac, but that doesn’t mean you have to settle for a clunker.
The Minister of Health, Christian Dubé, has clearly determined what must be the top priority of the announced “refoundation plan”: human resources. Adding beds obviously assumes that the necessary nursing staff is available, and therefore that the remuneration and working conditions are sufficiently attractive.
The network can probably be better organized, but more staff also requires more money. The wealth gap with Ontario that Mr. Legault continually talks about finds a concrete illustration here. If the number of beds has decreased more in Quebec than elsewhere in the country in recent decades, it is because he did not have the means to keep them open.
On the other hand, Quebec physicians have nothing to envy their Canadian colleagues. In their case, the wealth gap does not exist, even if they are less accessible. The clunker lugs around millionaires. It is to be hoped that Mr. Dubé will not forget them in his refoundation.