After decades of broken promises and dashed hopes, we can understand that the prospect of yet another reform of the health network leaves many skeptics.
It is even surprising that 39% of Quebecers still believe that Christian Dubé will succeed in carrying it out, according to a recent Léger poll, while 34% have given up all hope and 28% no longer know what to think.
Much of this relative optimism rests on the credibility his handling of the pandemic has given the current minister. One out of three Quebecers (32%) considers that Mr. Dubé has been the most effective health minister of the last twenty years, twice as many as for his five predecessors combined.
Misfortune is good for something, they say. The habit of failure has lowered expectations, and the minister has a knack for presenting a setback as an opportunity to jump better.
While the CAQ clearly failed in its initially unrealistic commitment to give everyone access to a family doctor during its first mandate, the number of “orphans” actually doubled. Mr. Dubé now promises to cut it in half by the end of March 2023, giving priority to the most vulnerable clientele.
We know the song: things will get better… After the next election. Hard to blame those who will find it difficult to take another leap of faith.
We must be delighted with the “structuring and key” agreement announced on Sunday with the Federation of General Practitioners of Quebec (FMOQ) to promote collaboration between the various categories of health professionals.
The problem with agreements often lies in the interpretation that each other makes of them, those famous details where the devil hides. Despite the participation of specialized nurses, pharmacists and other professionals in the new front-line care one-stop shop, Mr. Dubé calculates that doctors working within family medicine groups (GMF) will necessarily offer more appointment hours. .
However, the agreement is voluntary, otherwise there would not have been one. The president of the FMOQ says he is convinced that the majority of his members will subscribe to it, but why would they agree to work more if they believe they are already doing enough?
Last fall, Prime Minister Legault criticized general practitioners for not taking care of enough patients and threatened to use data from the Régie de l’assurance maladie to flush out the shirkers.
The FMOQ had replied that its members worked 45 hours a week and that the problem was rather that there was a shortage of 1,000 doctors, when Quebec already has more per 100,000 inhabitants than elsewhere in Canada.
It feels like deja vu. Gaétan Barrette had also decided to use the hard way, but Philippe Couillard had preferred to avoid confrontation, relying on promises that did not materialize. We’ll see.
After two and a half years of pandemic, it goes without saying that health will be a central issue in the next election campaign. Everyone can understand that the health crisis has upset projects in many sectors, health first and foremost, but the virus has a broad back. Before the pandemic hit, things were already going in the wrong direction. The opposition parties will not fail to say that the past is the guarantor of a bleak future.
Obviously, they should not be counted on to preach patience, but it would be illusory to hope for a rapid overhaul after decades of alternating between procrastination and bloodshed.
Thus, Mr. Dubé seems very optimistic in setting himself the objective of freeing the network of private employment agencies within three years, particularly in the regions, where the local workforce is largely insufficient to meet the needs.
If collaboration with physicians is essential, it is just as important with other health care workers. In December, the president of the FTQ, Daniel Boyer, deplored the absence of “social dialogue” with the Legault government. Last week he had changed his tone and now saw an opening. “I think the Minister of Health has understood that it is a guarantee of success to talk to us and try to get along with us,” he said.
Precisely because of the trust he enjoys, Mr. Dubé has no right to failure. If he does not succeed, the population will conclude that the system is fundamentally flawed and that the only solution is to throw the doors wide open to the private sector, as Éric Duhaime’s Conservative Party is proposing. A final leap of faith is necessary, but another failure would be fatal.