The Health and Welfare Commissioner recently released a first report on the performance of government home care programs.
Have you heard of it ? Maybe not. The impact of this report did not match the importance of the issue. And it’s no wonder.
During the pandemic, we were more concerned than ever about the fate of our seniors, embarrassed by the carnage in CHSLDs and the fact that they were in the “blind spot of pandemic preparation”.
But the sense of urgency that drove us at the height of the COVID-19 crisis has dissipated. Our elders are back in the blind spot.
Up to a certain point, we can understand that attention is diverted by other more divisive subjects. In particular by the bill aimed at creating Santé Québec while improving the efficiency of the network.
It is clear that efforts will be necessary over the next year to give the issue of home care the place it deserves among the government’s priorities.
The report released by Health and Welfare Commissioner Joanne Castonguay is the first in a series of four. This document seeks to “understand” the home care ecosystem.
Translation: to understand how suboptimal it is!
Reference is made to the policy adopted in 2003 by the provincial government, called At home the first choice. It “remains the flagship vision of home support in Quebec”.
However, it is an open secret, the current health system does not allow the home to be favored as the first choice “at all stages of intervention, in respect of the will of the people”, as mentioned.
And there are very good reasons for that. One of them concerns the sinews of war: money. One-fifth of long-term care spending in Quebec is devoted to home care and support services.
In some countries where the system works significantly better than ours, it is “around half”, the report points out, citing Denmark, Norway and Belgium.
That does not mean that increasing the budgets will make it possible to achieve our objectives overnight. There are major structural problems to be solved.
Several are noted in the report. For example, the fact that there is insufficient data to make informed decisions – what a surprise!
Or the fact, also, that it is still very difficult to properly assess, quickly, the needs of Quebecers who would like to have access to home care services – it is terribly embarrassing.
Another major problem: doctors are still too little involved in the home care ecosystem.
A specific example comes to mind: Radio-Canada recently looked into the “palliative home care lottery”. More specifically on the case of a resident of Sainte-Julie who needs an injection, on an ad hoc basis, to avoid ending up in the hospital.
The CLSC that serves its territory informed him that there is no doctor assigned to home support. Among the options that were suggested to him: move to Longueuil!
One more (aberrant) example that demonstrates that seeking home care too often turns into an obstacle course.
This, in a nutshell, is the fundamental problem that the office of the health and welfare commissioner is tackling.
He will try this year to bring out the elders from the blind spot. It will be necessary to ensure that its recommendations – which will be known by the end of the year – do not end up on a shelf.