End of use of agencies postponed | “I want room to maneuver,” says Dubé

(Quebec) In an unexpected turnaround, Christian Dubé is pushing back the weaning of independent workers in the health network. The minister is abandoning his first target and granting a six-month deadline to establishments in major centres to abolish the use of agencies.

This is a major about-face by the Legault government in its standoff with labour placement agencies. The Minister of Health has decided to postpone until March 2025 the end of the use of independent labour in the first establishments targeted by the measure.

“I want room to maneuver,” Christian Dubé says in an interview. “I’m not stubborn. I’ve achieved my goals, we’ve managed to hire 3,800 people [des agences]but if we give ourselves a little more time, we will have more flexibility [dans le réseau] ” he adds.

Initially, the ban was to come into effect in Montreal, Laval, Montérégie, the Capitale-Nationale and Chaudière-Appalaches starting October 20. The withdrawal is planned to take place over three years, in three different waves. For now, the other targets remain unchanged.

However, it was the labour crises on the Côte-Nord and in Abitibi-Témiscamingue that helped make the minister reverse his decision. Christian Dubé did not want to compromise the loan of staff from establishments in major centres to remote regions. And the flying team – which has had a difficult start – does not yet allow him to do without this workforce.

“There is a domino effect,” illustrates the minister. For example, the CIUSSS de la Capitale-Nationale is sending teams of caregivers to lend a hand on the Côte-Nord, where the tightening of government rules on the use of independent labor is causing significant turbulence.

Furthermore, the minister is not going back on the imposition of maximum rates for agency workers, which is particularly problematic in remote regions. “This is our greatest success,” he says.

Uneven weaning

Last Friday, the Fédération des médecins spécialisé du Québec and the Collège des médecins asked the government to postpone the October 20 deadline. These statements also weighed heavily in his decision to review his commitment, Mr. Dubé confirmed.

The minister assures that most of the establishments targeted by the first wave are on track to meet their target for reducing the independent workforce. “I would like to remind you that I did not have to [repousser la date] because I was in a bad situation in my big regions. I just want to be sure that they can continue to help others,” explained the minister.

Some establishments have more difficulty, he admits. “The challenge is that not all of my regions are the same. I have regions that have been more successful and I have a few regions, for example in Montérégie-Est,” where it is still difficult, maintains Mr. Dubé.

The Press reported last week that the Suroît hospital in Salaberry-de-Valleyfield would have to close 36 additional hospital beds to meet the government’s objectives by October 20. Data revealed by The Press also demonstrated that establishments were far from the targets.

Unexpected and welcomed turnaround

Just last week, the Minister of Health wrote on the X network that he was maintaining the course. “The agencies hope that the government will back down. We saw it when we implemented the maximum rates last May, the pressure to back down was strong, but we succeeded in this important change,” he indicated.

On Thursday, the College of Physicians and the Federation of Medical Specialists of Quebec (FMSQ) praised the minister’s “flexibility.”

“This should reduce the direct impact of staff shortages on patients in certain regional hospitals, ensure better continuity of care and give caregivers some respite,” the professional body said.

“We welcome the Minister’s decision to adjust the timetable to end the use of agencies in urban areas. This […] demonstrates the importance of consulting caregivers who know the reality on the ground for whom safety and access to care are priorities,” indicated for his part the president of the FMSQ, Dr.^r Vincent Oliva.

For the Association des entreprises privées de personnel soignant du Québec – the largest group of placement agencies – this is “an admission of failure for the minister and an undeniable illustration of the importance of our contribution within the network,” maintains its president, Patrice Lapointe. According to him, Quebec is “giving in to pressure” from the FIQ, with whom the government “failed to meet the necessary conditions to guarantee the sustainability of the network without the service [des agences] “.

Negotiations between the government and the nurses’ union have reached an impasse after more than 500 days. In its press release, Quebec also emphasizes that “collective agreements concluded to date provide for the recognition of seniority for staff of private agencies and other measures to make the public network more attractive.”