By the end of the election campaign, the editorial team of the To have to will offer an analysis of the main commitments of political parties on themes that concern all Quebecers. Today: health services.
Voters would like to take seriously the health commitments that parties include in their platforms. After all, health services are of crucial importance, and considerable sums are engulfed in them, that is to say 42% of the expenditure of the portfolios of the State, or 54 billion. But if there is one area where promises have been broken, election after election, this is it.
This time around, these commitments should carry all the more weight as the pandemic has exposed the deep shortcomings of our healthcare system. Because, what the health crisis has shown, in addition to the serious problems in CHSLDs, is the glaring lack of capacity of our health system. The critical overcrowding threshold for hospitals is much lower in Quebec than in other provinces, not to mention other developed countries. The governance of the Ministry of Health is the fundamental cause of “our collective failure”, affirmed in a report the commissioner of health and well-being, Joanne Castonguay.
At the end of the pandemic – insofar as we believe we have come out of it – an even worse health system is emerging. Wait times in emergency rooms have increased since the election of the Coalition avenir Québec, and the number of people waiting for surgery has jumped to over 150,000. , despite a few improvements here and there, is still a problem.
The waiting time before seeing a doctor in the emergency room far exceeds the 90 minutes that the CAQ platform was dangling four years ago. And there are still some 800,000 Quebecers who do not have a family doctor. The Legault government may have fulfilled the majority of its 2018 election commitments, but not in health.
In its electoral platform, the CAQ presents elements of the “refoundation” of the health system to which Christian Dubé has embarked. In the first line, we advocate a model of management by a Family Medicine Group (FMG) which does not always rely on monitoring by a single doctor. Other health professionals, especially nurses, are called upon to play a greater role. We would launch an electronic platform for access to the first line. For the duration of the mandate, we promise 900 million more for home care. We would create the Agence Santé Québec responsible for operating the network: the department — and the minister — would simply define the major orientations, set the objectives and evaluate the results.
To reduce the waiting lists for surgery, the CAQ judges that it has no choice but to resort even more to specialized private clinics.
For its part, the Liberal Party of Quebec proposes to give each Quebecer who wishes it a doctor of their own. But basically, the first line would still be based on multidisciplinary FMGs that we would rename Team Access Health. In addition, Dominique Anglade’s liberals intend to offer universal access to psychotherapy. Their platform also includes investments in home care.
The Parti Québécois plans to reduce the remuneration of doctors, and it is more than 3 billion per year that it intends to inject into home care.
Québec solidaire casts its net wide by proposing to extend public mental health coverage, following the example of the Liberals, free dental insurance, universal public drug insurance and to rely on CLSCs open 24 hours a day, 7 days a week. 7. In all, it’s almost 3 billion commitments per year that QS, ambitious, even prodigal, has taken in health. He intends to recover some 520 million by reducing the excessive remuneration of doctors.
Unsurprisingly, the Conservative Party of Quebec defends a radical change: the partial privatization of the health care system. Physicians could be remunerated at their choice by the RAMQ or the patient, establishing a real two-tier medicine. The wealthiest Quebecers could take out private insurance for private care in clinics or new private hospitals.
Apart from the highly questionable Americanization proposed by Éric Duhaime’s conservatives, many of the commitments presented by the political parties could be difficult to keep, since the shortage of doctors, nurses and psychologists must be remedied. The amounts needed to meet these commitments are also very substantial. And the aging of the population will not simplify things.