Will we need to revisit Yvon Deschamps’ formidable formula? We think about it. Saying that “it is better to be rich and healthy than poor and sick” is perhaps no longer enough in a Quebec where it is also better to fall ill in large centers… than in the regions.
Beneath the joke, there is nothing to laugh about and everything to cry about in the crumbling of care experienced in remote regions. We came close to – and fortunately avoided – disaster this week on the North Shore. We should not rejoice too quickly: a spark would be enough to revive the threat of closed beds and suspended services. Similar fires are also smoldering elsewhere, starting with Abitibi-Témiscamingue and Nord-du-Québec.
The Quebec Federation of Municipalities (FQM) is right to denounce these service breakdowns — past, present and anticipated — because they are documented, chronic and harmful. The evil is so great in certain regions that in a letter whose The duty obtained a copy, the federation notes that those who pay the price consider themselves “second-class citizens” since they cannot “benefit from the same rights as their fellow citizens”.
“There is money in the system. It is poorly distributed,” note the municipalities. Let us add that there are resources in the system, but they are also poorly distributed. Dependence on independent labor (IOM) has become endemic in certain territories. On the North Shore, it fills up to 60% of positions. Last year, Abitibi spent nearly 130 million. In Gaspésie, approximately 80% of the deficit incurred by the Integrated Health and Social Services Center in 2023-2024 was attributable to the MOI.
Freeing yourself from employment agencies requires ironing out wrinkles, walking on paint and tolerating turbulence, so be it. Minister Dubé has planned a reasonable “withdrawal” schedule, the first major blow of which is expected this fall where it is easiest to recruit: Montreal, Laval, Montérégie, Capitale-Nationale and Chaudière-Appalaches. The other regions benefit from a current reprieve for some until the end of 2026.
Several voices — from the opposition, unions and regional leaders — had called for additional protections for these most fragile regions. We see the hard way that they were right: a distant deadline will not be enough to protect them. Quebec also seems to have misjudged the combativeness of the agencies whose recent warning shot resonated throughout these regions with sufficient intensity to sow legitimate panic.
At the heart of the agencies’ grievances: the entry into force of the mammoth contract which caps MOI rates from May 19. The approximately 170 agencies that agreed to provide services under these conditions say today that they will not succeed. The Association of Private Healthcare Personnel Companies of Quebec squarely contests the contract. Since the Public Procurement Authority did not uphold its complaint, it turned to the courts.
Is it fair game? To tell the truth, the question seems secondary as the political and social consensus is solid in favor of the disappearance of the ME. We welcome Minister Dubé’s categorical refusal to deviate from his objective. Especially since after this stormy episode, his skiff paradoxically seems a little more solid. Certainly, its poaching is still stalling even if it is accelerating: the number of agency employees returned to the public has increased from 1000 to nearly 2400 since March. The minister even launched the idea of an “I contribute” 2.0. As long as you pilot it correctly, why not!
The emergency above all allowed Christian Dubé to draw from his game a pin won in negotiations: the voluntary mobility of staff. This is how he announced, in concert with the Confederation of National Unions and the Quebec Federation of Workers, the creation of a “public flying team” which will be deployed “as a priority” in regions where “the situation is critical, like the North Shore and Abitibi-Témiscamingue.”
A troubleshooting mechanism on the public network is music to the ears of many people. However, we would like this first fruit to also be cultivated in complicity with the Fédération interprofessionnelle de la santé du Québec (FIQ). Unfortunately, his negotiations with Quebec bogged down. The union announced on Thursday that it would resume its pressure tactics “as of now” to maintain them “as long as necessary”.
However, from the margin, the minister will have it with the end of the ME. The network will save at least 1.3 billion by 2029. Christian Dubé has already committed to devoting part of this sum to hiring additional staff. It would be desirable for it to add to this reflection a lucid examination of the equity of care in Quebec in addition to opening up to approaches better adapted to regional realities. More attractive, too, because the crux of the matter is there and not elsewhere.