Stupor and tremors, the title of one of Amélie Nothomb’s best-known books, corresponds perfectly to the emotions I felt following the announcement of the composition of the board of directors of Santé Québec. The Legault government revealed the names of the 15 members of the board of directors of the new agency whose mandate is to manage and coordinate the daily activities of the entire health network, which brings together more than 300,000 workers.
This agency’s mission is to bring about a cultural change in the health network in order to make it more efficient. Christiane Germain was appointed president of the board of directors and surrounded herself with a team that includes manager, economist, engineer, analyst, nurse, pharmacist and two specialist doctors, all certainly carefully chosen for their skills, but this list does not even have a single family doctor!
Amazement, astonishment, amazement, surprise! No family doctor, therefore, is present on the board of directors of the health agency! I would never imagine planning a reform of the Canadian Space Agency without the contribution of an astronaut or rethinking the development of a territory without an urban planner. The work of the family doctor is complex, and it would have been extremely desirable for this specific expertise to be understood and recognized as a stakeholder in this desired reform.
For years, we have not stopped talking about the difficulty of access to the first line. However, family doctors constitute the funnel in which all patients must converge to have access to health services (consultation in specialty medicine, physiotherapy, occupational therapy, social services, psychology, etc.). They are unfortunately the main absentees from this new board of directors.
However, the participation of family doctors is essential to make council members aware of the multiple and often unsuspected issues as well as the pitfalls that we encounter as professionals in the network, to also propose solutions and to express the concerns of our patients in regarding accessibility of the care they entrust to us on a daily basis.
Tremors, shivers, wobbles. How can we carry out a reform that is intended to be so important without certain crucial partners? I am surprised, according to the same principle, at the absence of an IT expert, as our medical IT system is far behind many countries and suffers from a flagrant lack of global vision. Not to mention the lack of representation of other professional bodies (physiotherapists, occupational therapists, etc.).
I would also have expected that a patient representative would be asked to be part of this board. While mental health is a crucial issue, it would have been relevant to give a major place to experts in the field. I tremble with worry and a certain pessimism in the face of the solutions that could be proposed by a board of directors that does not include experts in these fields.
Can we blame family doctors and place the deficiencies of a health system on them when the new health agency does not even seek to benefit from their essential contribution? I hope that the CA will consider filling this gap to give itself the best chance of achieving a real partnership.