By Christian Dubé’s own admission, there is no invention in the plan he presented on Tuesday. And that’s good. The challenge is execution, he said. In fact, successive governments in Quebec have not distinguished themselves in this regard.
For more than 30 years, commissions and reports on the reform of our health care system have piled up; the 79-page document made public by the Minister of Health and Social Services lists them. Many of their most important recommendations have gone unheeded.
But the pandemic has cast a harsh light on the network’s serious shortcomings. Above all, Quebecers were able to compare its ability to withstand the waves of COVID-19 to that of the health systems of other provinces and other countries. Quebecers were able to see collectively just how fragile their health network was.
On the other hand, the pandemic showed that the network could do things differently, as shown by the success of the vaccination campaign and the rapid implementation of telemedicine.
The reform plan, which spans three years, is lacking in financial details and precise timelines. These are principles and orientations that are set out, which are moreover very valid, and which are inspired by the key recommendations of the various reports. The patient must be at the center of the system – the minister talks about improving the “patient experience”, which is reminiscent of the catchphrases used in marketing. Easier said than done: we find in this plan the eternal objective of financing hospitals, no longer on a historical basis, but according to patient demand.
The other main axis of this plan is the concern for the satisfaction and well-being of the staff, heavily tested during the pandemic, and even before. Christian Dubé wants the health network to become “an employer of choice” and that “compulsory overtime” is no more than a last resort expedient.
In addition to the orientations that are based on a desirable mobilization of all staff and managers, two concrete measures target electoral commitments that the CAQ government has not managed to respect.
Instead of offering all Quebecers a family doctor, a first-line access point is being set up, using a multidisciplinary approach that has produced good results in the Bas-Saint-Laurent. By the end of the summer, half of the 945,000 so-called “orphan” patients who are on the waiting list for a family doctor will be able to obtain an appointment within 36 hours if their case requires it. , promises the minister. More needs to be done: negotiations are continuing with the Federation of General Practitioners of Quebec for patient care.
The other promise not kept is the reduction to 90 minutes of waiting time in emergency, this illusory commitment. The Minister sees in the “command centre” set up at the Jewish General Hospital in Montreal a way to improve the situation. In addition, as the pandemic has highlighted the lack of beds in hospitals, he promises to provide access to 4,000 additional beds, which will allow Quebec to reach the Canadian average in this regard.
A large part of the reform is based on the collection of data, their computerization and their pooling. It’s kind of the trademark of the minister, who tabled two bills to that effect. “We will measure. What gets measured can get better,” he said. On the agenda is the decentralization of the health network, to make it an organization that is both more humane and more efficient. But we won’t know until Deputy Minister Dominique Savoie’s team completes its review and comes up with a plan this summer. The department is also called upon to step back from business management to focus on direction setting and performance measurement, another longstanding recommendation.
With regard to home care, the Legault government has mandated the health and well-being commissioner, Joanne Castonguay, to review the ways of doing things in this area. This review is the prelude to an important shift that has been postponed for too long.
Certainly, the opposition is right to point out that the plan lacks details and that it is part of the electoral platform. But it is essential. The plan is ambitious, the reform is comprehensive and it will take time. Acting as a revealer, the pandemic has convinced the CAQ government and, it must be believed, all the players in the health system that drastic changes are more necessary than ever, both for patients and for caregivers.