The College of Physicians of Quebec (CMQ) is concerned that the reform of the Minister of Health, Christian Dubé, focuses mainly on hospitals and little on access to care and hospitalization at home and groups of family medicine. He also stresses the importance of not concentrating all the powers of the network “in the same hands”.
“It is certain that the College will support this reform project with the aim of improving access to quality care for all Quebecers,” said its president, Dr.r Mauril Gaudreault, interviewed at Duty. However, he believes that Bill 15 must promote access to local care, including community resources, if he wants to achieve his goal of making the network more efficient.
“The silence of the bill in this regard leads us to question the government’s ability to remedy the overcrowding experienced in emergency rooms, where patients end up when it is impossible for them to obtain an appointment in clinic,” reads the CMQ’s brief. The latter will be heard on Tuesday during parliamentary consultations on the Dubé reform.
“We have to work on what happens inside the establishments, but also in the territory, all in the sense of social or populational responsibility. This means that all together, managers, doctors, health professionals, we must work to better meet the needs” pre-hospital and post-hospital of the population, supports the Dr Gaudreault.
Questioned on this subject before the start of the work, Minister Dubé maintained that Bill 15 “does not solve everything, there is something else”. “There are several pieces of the puzzle that we have been putting together for a year,” he said, referring to Bill 11 passed last year to increase access to front-line services.
Doubts about “real independence”
The Dr Mauril Gaudreault says he is in favor of the creation of the Santé Québec agency, which will take care of the day-to-day operations of the network, while the Ministry of Health will be responsible for the major orientations. “But you have to be careful not to concentrate a lot of power in too few hands,” he stresses.
In its brief on Bill 15, the College of Physicians says it has “doubts about the real independence of political power, especially when we see that the Minister of Health and Social Services and the board of directors de Santé Québec designate the incumbents of all important positions within the network”.
The CMQ therefore recommends amending the legislative text so that the appointment of the national director of public health is ratified by two-thirds of the deputies of the National Assembly. At present, it is rather the government that appoints this person.
For each establishment, the Dubé reform also provides for the creation of a post of medical director. The College of Physicians of Quebec is concerned about a concentration of “powers in the hands of a small group of managers, resulting in a real risk of arbitrary decisions”.
“The medical directors within the establishments will have the power to give privileges to a doctor and will also have the power to adopt disciplinary measures against these same doctors. That, for us, is a conflict of roles which is dangerous, ”says the Dr Gaudreault.
In addition to the CMQ, the Order of Nurses and Auxiliary Nurses of Quebec, the Order of Midwives of Quebec, the Federation of General Practitioners of Quebec and the Federation of Medical Specialists of Quebec are among the groups consulted on Tuesday during the study of the bill. This is also the case of the Confederation of National Trade Unions (CSN), the Federation of Quebec Workers (FTQ) and the Alliance of Professional and Technical Personnel in Health and Social Services (APTS).