The health crisis that has been raging for almost two years will have revealed a lack of foresight, preparation and organization on the part of governments. The now famous expression of the Prime Minister of Quebec in March 2020 who mentioned that we “built the plane in full flight” perfectly illustrated the seriousness of the lack of preparation. After 24 months of tinkering, it is high time to build on solid foundations in order to correct the shortcomings that have been identified in several areas, starting with the lack of personnel and the management of caregivers in emergency situations.
With its 23,000 doctors, 80,000 nurses and thousands of health professionals, the Government of Quebec is fully responsible for providing health services to citizens. This area is one of our “sacred cows” in terms of areas of expertise. However, for thirty years, our system has been undermined and constantly under pressure, even when the situation is normal. The federal government has opened its checkbook since the beginning of the health crisis to finance various measures, but money will never be able to create from scratch the essential resource in an emergency situation: qualified personnel. Even the armed forces, called in for reinforcements in the panic, were in no way capable of fulfilling the medical functions that Quebec needed.
Since last December, the Premier of Quebec has imposed restrictions and new health measures, given the lack of beds available in intensive care throughout the network. The health crisis is exerting exceptional pressure on the health network, but to deal with it, how many additional hospital beds would it be necessary to create to unclog the regular system? 500? 1000? I dare to hope that the MSSSQ already knows this, and if this is not the case, it would be urgent to produce a realistic estimate.
An emergency situation such as the Oka crisis, the Saguenay flood, the ice storm and now the COVID19 health crisis requires 24/7 intervention management. The Executive Council has exceptional crisis management powers, including decrees and emergency budgets. With such tools, the government can assume its responsibilities, manage the situation and mandate various agencies, various departments or organizations.
Emergency Support Unit
I believe that the missing piece to the puzzle lies in Civil Security. Quebec must imperatively invest, modernize and professionalize the Civil Security organization and provide it with permanent resources, in particular by creating an emergency medical unit (UMSU). The mission of this UMSU would be to organize a medical deployment capacity throughout Quebec in order to guarantee the opening of additional beds in a targeted manner, in an emergency situation. This unit must be provided with permanent logistical, financial and human resources in a regular situation. When an emergency is declared, a reserve force would be added to the USMU.
It would be a flexible mobile force, structured, trained and remunerated accordingly when mobilized. The key positions required would be filled on a voluntary basis directly in the health network. The UMSU would constitute, in a way, a system of shock absorbers for the entire network, in order to help it counter the shocks that can affect the provision of regular care during an emergency situation.
It would also be wise to harmonize, improve and review, with existing partners, first aid courses for the general population. Under the aegis of the UMSU, a new formula of first-line caregivers in emergency situations could be created in order to train, supervise and organize volunteers or civilian volunteers effectively when the situation requires it. We will remember, for example, Quebec’s request for the intervention of the armed forces and the rapid relay to the Red Cross that I advocated at the time.
In the present century, the world, including Quebec, will have to prepare to face several contingencies in terms of civil protection and manage a multitude of risks or threats to its security. The reorganization and modernization of the Civil Security organization could greatly contribute to being ready to face the challenges of today and tomorrow.