Through its speech and its decisions, the Legault government has contributed to normalizing the path of pragmatism in health. Again on Thursday, the Minister of Health insisted on the need to move away from “dogmatism”. The private sector has its place in complementarity with the public, argued Christian Dubé, inviting both to “just work better together”. Very good, but what kind of private are we talking about, exactly?
In The duty Last week, reporter Sarah R. Champagne lifted the veil on a dubious practice that casts a shadow over the good understandings that we have the right to hope for. Through the employment agency Groupe AMS, immigrants without work permits were paid well below the minimum wage, at $10 an hour, to clean hospitals or serve food in shelters. long-term care. This illegal practice aroused general ire in the National Assembly.
The affair affects at least four integrated health and social services centers. The Labor Standards Act provides that the client and the agency bound by contract share responsibility for unpaid salaries. Impossible, in theory, to escape. The practices described in our survey illustrate the limits of certain triangular relationships, which the network is not about to get rid of with a restructuring plan that places such great emphasis on complementarity.
Even more so with management cast on this complementary private-public mold at Santé Québec.
Certainly, Minister Dubé has put an expiration date on the controversial use of independent labor (MOI), which is at the heart of this sad affair. Realizing that the transition can only take place over a very long period of time, he capped the prices in order to put a stop to the bidding wars which are costing the State a lot. All of this is well and good, but in the meantime, we expect Quebec to monitor more closely the probity of companies invited to act in complementarity with the public.
In April, six private health agencies were blacklisted by the Public Procurement Authority. Last year, almost a third of agencies, all specialties combined, which were the subject of an inspection by the Commission for Standards, Equity, Health and Safety at Work were found to be non-compliant . A compliance investigation is also underway for the AMS Group. We should increase the number of these inspections to have a fairer portrait of this fiercely competitive environment.
We should also take advantage of these examinations to take the exact measure of the effects of the private sector on complex environments, youth centers, for example. There, the use of MOI has seen a prodigious jump, reporter Marie-Eve Cousineau told us. Minister Lionel Carmant may well have taken offense at the term “carceral” used by the president of the Alliance of Professional and Technical Personnel in Health and Social Services to illustrate the extent to which the use of MOI can distort a model of intervention, the question remains oh so relevant.
At what point does the imbalance end up affecting the quality of care offered? This applies to ME, but it especially applies to all other forms of care, organizations and private services that will arise in the future. We have very little data to measure the effects of this complementarity that we build in mid-flight, to use an expression dear to Prime Minister Legault.
On the other hand, almost every week there are public outings denouncing a slippage here, an abuse there.
The private sector that the caquistes sell to us is efficient, competitive, pragmatic. He occupies the place we want to leave him, without abusing his privileges or destabilizing the public. The private sector, which regularly makes the headlines, is a completely different matter. At a time when complementarity is about to shift into second gear, it is essential that Quebec draws more transparent and firmer lines.