Have we already forgotten it? In her annual report tabled in September 2021, the Ombudsperson, Marie Rinfret, urged our departments and public bodies to “redouble their humanity and empathy” towards those they serve. Weakened by the pandemic, we all needed extra kindness. But the headlines are stubborn: it is the opposite that is observed, with a regularity that betrays the breathlessness of our public services.
Last January, the cry from the heart of Michelle Bourassa, whose mother, Andrée Simard Bourassa, died in indignity, opened a huge breach. The violated rights of the widow of former Prime Minister Robert Bourassa made their way to the National Assembly. Rebelote with the letter from Micheline Lanctôt, last week, which caused another dike to yield. The actress, director and producer recounted the heartbreaking death of her spouse, the victim of a system “out of whack” to the point of having become “inhuman”.
There is great and good news every day in our public services, but these stories are not anomalies. Every year, the Québec Ombudsman identifies a litany of them. And in the wake of these two powerful speeches, many tongues were loosened. Citizens and caregivers have taken to the keyboard to testify to the lack of resources or the frustration of knocking in vain on double-locked doors. The refrain is well known. For decades, Quebecers have been hanging around in the emergency room, almost as much as they conceive of the granting of a family doctor as a game of lotto whose rules still escape them.
Whether they bear the signature of Côté, Rochon, Couillard or Barrette, the major reforms have produced little fruit and many bitter glitches: exacerbated bureaucracy, growing disempowerment, generalized demobilization, inflexibility erected into a system. The shadow of galloping austerity does not hang over people’s heads as it has long done in Quebec. It is no longer a question of timing or rationalizing each intervention until failure. The Toyota method dear to Bolduc has been shelved, the Barrette reform disavowed.
Shortages are still glaring, but positions are opening up. If they are not filled, it is because attracting candidates and retaining them has become an almost insurmountable challenge. At the head of an ambitious overhaul plan, Minister Christian Dubé has his hands relatively untied; its means are counted and not restrained beyond reason. Its dashboard is not yet stellar, but we see clearings: the red “crisis” is no longer as uniform.
However, the distress bursts from everywhere, unchanged, if not exacerbated by places. “It is not the lack of resources that is in question,” wrote Michelle Bourassa, it is “the lack of compassion and respect for the fundamental rights” of patients, which goes so far as to create places of care “where the human and dignity have been forgotten”. “I lost the person who was dearest to me in the world, and in conditions unworthy of his great soul,” echoed Micheline Lanctôt.
In a letter to Duty, experienced nurse Hélène Denoncourt proves them right. Yes, the network is weighed down by its well-documented evils, but the dehumanization that we denounce does not find its only source there. We must, she says, be “wary of this ‘take me as I am’ which allows us to deposit our fatigue and our individual revolt on the other”. An evil that echoes another electric shock, in education this one, delivered by a screaming teacher on whom we have closed our eyes for too long.
The basis of all good practice, continues Mme Denoncourt is civility. And that is what is withering away in our public services. In his annual report tabled in September 2022, the ombudsman, Marc-André Dowd, prescribed more “humanity” and “empathy” in detention centers. He also recalled the need for the Department of Youth Protection (DPJ) to take the actions expected “in a humane way”, even when the emergency imposes its law.
The misfortune is that we were all cut off, and on both sides of the fence. Signs everywhere remind patients that the staff is not there to answer their questions and that, if they venture to insist on what annoys, worse to raise their voice, we will not tolerate it. This institutional reserve almost raised to a law of silence, caregivers suffer just as much. It is imperative to bring the human forward.
Three years ago, the late colleague Jean-Robert Sansfaçon noted here the failure of our quasi-universal model, calling for making accessibility and quality the “absolute standard”. “For the moment, he wrote, Quebec is a beggar on horseback who justifies its mediocrity by defending a model entangled in corporatism. Despite some clearings, the evil is still there, aggravated by a creeping incivility that we accept as inevitable, when we can — and must — stop feeding it as such.