François Legault has already, for all practical purposes, renamed Christian Dubé Minister of Health. It’s an excellent decision. This one will have many pots on the fire. But he should tackle five projects as a priority in order to hope to get the system back on track.
Implement an electronic health record. Effective care of a patient requires knowledge of their history. An electronic health record allows family doctors, specialists, nurses, various professionals to access relevant medical information in real time. The nursing staff can then make more informed decisions, avoid duplicating certain tests, etc.
Currently, according to the MESS, the information is collected, but on thousands of software which, generally, do not “talk to each other”. It is then necessary to rely on the fax to receive the data in spare parts… It is therefore urgent to impose a uniform system for Quebec. The Privacy Act also creates many pitfalls and needs to be changed.
Eliminate unnecessary acts. As the system is not sufficient on demand, this is an additional reason to focus on what is essential. The now defunct Quebec Medical Association estimated the cost of unnecessary procedures at $5 billion annually. How many tests are done to secure the patient and… the doctor? These fearing in particular lawsuits, want to rely, sometimes excessively, on tests. Consideration should be given to the introduction of a “no fault” system, as in the field of car insurance.
Diversify and increase the nursing workforce. The obligatory visit to a family doctor creates a bottleneck. If a patient needs a physiotherapist, psychologist or whatever, a nurse clinician can very well refer them. Doctors are now accepting that other professionals take care of certain care. But it is relatively recent. This approach should be generalized rather than aiming for everyone to have a family doctor.
Currently, the care teams are not enough for the task. This will increasingly be the case with retirements and the growing and aging population. We therefore need to train more nursing staff. Since the need is so immediate, we must be aggressive and expeditious in recruiting abroad, particularly in the Francophonie. Fortunately, we already have diploma recognition agreements with France. We are told that all the formalities are settled in two months for ours who are going to practice in France, but that it takes eight or more when it is the opposite. Who puts sand in the gears?
Increase hospital capacity. Quebec has 17,000 hospital beds, or two per thousand inhabitants. The Canadian average is 2.5. In France, it is 5.8. No wonder the emergency room is overflowing, because we have to keep patients there who should be transferred to the floors
A thousand additional beds are currently in the “gestation”. Much less than the 4000 required to reach the Canadian average. The two private mini-hospitals promised during the campaign will not be enough. In France, Germany and elsewhere, one-third of hospitals are privately owned, but under contract with the state, which pays for care. Why not take inspiration from this formula, in particular to speed up catch-up?
Decentralize the network. The excessive centralization of the Barrette reform did not lead to better access to care or efficiency gains. But this has demotivated a lot of people.
As promised, the MESS must quickly divest itself of the management of operations. People on the ground will do it much better! Staff must be given the opportunity to use their talents, their spirit of initiative, their intelligence. Each point of service must have a manager who coordinates all activities and ensures the well-being of customers and staff!
Despite certain measures that will increase the efficiency of care, additional billions will be required to complete these projects. During the campaign, the CAQ promised tax cuts and checks. Many Quebecers do not want this money. They just prefer to be cared for when they are sick!