Quebec is giving a new boost to health spending and is devoting $5.2 billion over 5 years to its plan to “restore” the network, including $1 billion for new measures that will be announced “soon” by the health Minister.
A total of $8.9 billion in health spending is planned over five years. In 2022-2023, $1.3 billion will be allocated to “restore the health and social services system” and “enhance care and services to the population”, particularly on the front line.
The budget exercise presented on Tuesday also announces an increase in health spending of 6.3% for 2022-2023, before a slowdown of 4.5% next year. The increase in expenditure for the year is mainly due to the entry into force of new collective agreements, which in particular make permanent bonuses.
Taking into account the sums disbursed last year due to the health emergency, the growth in expenditure fell by 4.1% this year. In 2021-2022, the various measures related to the fight against COVID-19 reduced the health budget by $7.2 million. For 2022-2023, Quebec reserves 1.6 billion for “COVID-19 support and recovery measures”.
Focus on network restoration
The Girard budget allocates 904.7 million this year to the “recovery” of the network, including 196 million (1 billion over 5 years) to establish “decentralized management” and direct the system “towards the needs of the patient”. In all, 604 million must be used to “change the culture of the organization of work”. A series of examples, such as self-management of schedules, the arrangement of atypical schedules and the increase in working hours in a week are listed in the budget.
The government also wants to eliminate the “abusive use of overtime”, without, however, eradicating this practice completely. “The idea now is to say that it must become an almost non-existent use, which boils down to cases of exceptional situations that everyone is capable of understanding — and not [être] a way to compensate for the lack of personnel,” commented the President of the Treasury Board, Sonia LeBel.
The ratio projects, expected year after year by the members of the health network, are not included in the government’s plans. “You always have to make sure you have enough staff, so we’re going to work on that component first,” explained Minister LeBel.
The Alliance of Professional and Technical Personnel in Health and Social Services and the Centrale des Syndicats du Québec respectively denounced the lack of measures to “address the issue of the lack of personnel” and to tackle the labor shortage. The Fédération interprofessionnelle de la santé du Québec also recalled that it wanted Quebec to invest “in stable and dedicated work teams through the implementation of safe ratios”.
The expanded Bas-Saint-Laurent project
The government is also allocating $394.2 million in 2022-2023 to “enhance care and services for the population”. Of the 83.9 million dedicated to the accessibility and quality of services, 27.3 are devoted this year to access to the first line. As expected, Quebec is reviewing its promise to allow all Quebecers to be followed by a family doctor to instead commit that they can “have access to a health professional within 36 hours “.
It also undertakes to deploy, “gradually” and “throughout Quebec”, the access window project established in Bas-Saint-Laurent. The triage service, often cited as an example by the Minister of Health, Christian Dubé, is used to direct orphan patients to various health professionals who, most often, are not doctors.
The government is also continuing “its shift in favor of home support”. It improves its refundable tax credit for home support for seniors so that it increases to 40% in 2026. Quebec also allocates 128.5 million over 5 years in order to “harmonize public and private CHSLDs”. It plans to contract about twenty private CHSLDs that are not, or to integrate them into the public network.
The budget also allocates 1.5 billion over 5 years for seniors’ homes. From 75 million in 2022-2023, operating costs will increase to 501 million in 2026-2027. Quebec plans to open 2,640 places in 33 seniors’ homes by September 2022, and a total of 3,480 places in 46 homes by 2023.