The Quebec government faces a choice: abandon the private CHSLDs or better support them. This is the message sent by the lawyer for the general manager and the owner of the Résidence Herron before the coroner who is investigating the wave of deaths in CHSLDs.
“As part of your recommendations, it will be important for the government to make a choice. Do we simply make a decision to no longer have private CHSLDs in the province of Quebec or rather do we decide to have better support and despite the fact that it is private, we still consider them an integral part of our healthcare system? “, said Me Alexandre Paradis, Wednesday, at the Trois-Rivières courthouse.
Me Paradis criticized the CIUSSS de l’Ouest-de-l’Île-de-Montréal for its lack of consideration for the requests of the CHSLD Herron in relation to the lack of personnel at the start of the pandemic.
He gave as an example in his representations a call from the director general, Andrei Stanica, which remained unanswered on March 27, 2020 at the CIUSSS for a need for employees. He had to repeat his request the next day.
Private establishments also appeared as “second-rate customers” in terms of protective equipment which was mainly reserved for the public sector, mentioned Mr. Paradis.
Based on a survey by the Association of Private Institutions under Agreement, the lawyer said that many private CHSLDs still do not feel they have the necessary support from the CIUSSS.
“We have two choices. Are we abolishing or forgetting the private CHSLDs or are we including them more in the management that is done by the CIUSSS? Because there are no other options. We have to be there or we take them away, ”he reiterated, pleading for better links between private CHSLDs and public managers.
The lawyer representing the CIUSSS de l’Ouest-de-l’Île-de-Montréal, Me Jean-François Pedneault, instead reported a lack of cooperation on the part of Herron’s management, in particular to obtain list of employees and residents.
He also spoke of a disorganization that already existed at Résidence Herron before the pandemic, which was accentuated with the arrival of COVID-19. Me Pedneault said that the CHSLDs received from the Ministry of Health, on March 12, 2020, a guide providing for the updating of a contingency plan in the event of a shortage of personnel.
“A contingency plan in the event of a shortage of personnel is not to call for help when there is no one left, it is to plan what we would do if there is a lack of world in significant quantities,” he argued.
Me Pedneault detailed that the CIUSSS de l’Ouest-de-l’Île-de-Montréal had sent several dozen employees to lend a hand to the CHSLD Herron between the end of March and the beginning of April.
Helping and not “managing for him”
The lawyer specified that the law provides that the CIUSSS have a role to help private establishments put in place measures to ensure the quality and safety of services. But not “to take over the management of the private establishment, therefore to go and manage it or operate it in its place”, he added.
An aspect shared by the lawyer representing six other CISSSs and CIUSSSs as well as the National Institute of Public Health (INSPQ), Me Luc de la Sablonière. He argued in his representations on Wednesday that the daily responsibility for the care provided to residents falls to private managers and not to the CISSS or CIUSSS.
Me Pedneault called for “appropriate means” to be given to the CISSSs and CIUSSSs to “monitor and remedy without delay when necessary”. It took an order from the Montreal public health department on April 7 for the CIUSSS de l’Ouest-de-l’Île-de-Montréal to officially take charge of the Dorval accommodation center, a- he recalled.
Résidence Herron is one of the accommodations that was the site of dozens of deaths during the first wave.
Coroner Me Géhane Kamel’s inquest is limited to events that took place between March 12 and May 1, at the height of the crisis. Its purpose is not to identify a culprit, but to make recommendations to avoid future tragedies.
Six CHSLDs and a private residence for seniors were designated as a sample. One death was reviewed for each facility, then the coroner considered the provincial management of the crisis.
The investigation will continue on Thursday with the lawyers representing the CISSSs and CIUSSSs concerned as well as the INSPQ.
Me de la Sablonière and her colleagues Rosalie Jalbert and Jonathan Desjardins Mallette began their performances on Wednesday. They reviewed overall the roles and responsibilities of the various stakeholders as well as the course of events related to certain issues, particularly in terms of human resources and equipment.
Lawyers from the Ministry of Health and Social Services are also on schedule Thursday. They are the last people provided for in the representations section, also allowing the parties to propose recommendations.