(Quebec) The Legault government plunges the North Shore health network “into a precipitous” and “unprecedented” crisis with its law to put an end to the use of placement agencies, denounce doctors in the region. A third of the beds will have to be closed by Sunday and patients moved to Quebec. Activities in emergency rooms and operating theaters will be reduced.
“It’s more than a reorganization of care, here, we are going to transfer people who are sick, vulnerable almost everywhere in Quebec, depending on the availability of hospitals […] We are being told about a contingency plan which is a catastrophe,” laments the Dr Youssef Ezahr, president of the council of doctors, dentists and pharmacists of the CISSS de la Côte-Nord.
“It’s a failure of care and it’s not the fault of the management of the CISSS de la Côte-Nord […] The Ministry pushed us to this level,” he adds.
In a letter sent to The Press, 20 doctors in the region are sounding the alarm: “Today we are witnessing an unprecedented crisis in our regional health system. This time, it is indeed a crisis precipitated by our government,” they write.
The CISSS de la Côte-Nord announced Monday a vast reorganization to compensate for the departure of employees from private employment agencies. Starting May 19, a “sharp reduction” in services is expected, such as a reduction in home care and a slowdown in services for routine care.
In Baie-Comeau and Sept-Îles, emergency capacity will be limited to available stretchers, meaning there will be no space for overflow. Half of the operating rooms will no longer be used, while around forty hospitalization beds will be closed on the North Shore. In Baie-Comeau, we will also close the nursery and pediatrics.
This exceptional situation would result from the entry into force of the provisions of the new law to put an end to the use of independent labor in the health network and the application of a mammoth contract standardizing practices across the country. province-wide.
Since April 14, Quebec has capped the rates paid to agencies per job title. The government has also tightened rules surrounding the award of contracts by mutual agreement. This leaves little room for maneuver for establishments in remote regions, such as the CISSS de la Côte-Nord, where dependence on agencies is enormous. The Press went there in April 2022 when we were already anticipating the effects of the coming law.
At a press conference on Monday, the CEO of the CISSS, Manon Asselin explained that the new obligations relating to salaries make the North Shore less attractive for agency staff. “We are going through a transition between the different contracts. We hope that the situation will stabilize in the coming weeks,” she said, according to comments reported by Radio-Canada Côte-Nord.
These rules “erase most of the advantages of our independent workforce, which will then stop coming to work in our region,” the doctors emphasize.
The CISSS de l’Abitibi-Témiscamingue also announced on Monday a major reorganization of its services for the same reasons.
On the North Shore, independent workers occupy more than 60% of positions, write the doctors. This equates to approximately 600 employees. In addition, the establishment is seeking to hire around a hundred beneficiary attendants and around forty nurses.
“Inapplicable and dangerous” measures
“On May 19, the North Shore essentially becomes a huge Quebec territory without a functional health network capable of taking care of the needs of its population. And this population will have to go into exile hundreds of kilometers away to receive appropriate care, adding additional stress to other establishments,” deplore the signatory doctors.
“A child who has gastroenteritis […], we won’t even be able to keep him in Baie-Comeau, we will have to transfer him for his rehydration. It is a disaster ! », says the Dr Ezahr.
This means that patients will be moved to the National Capital and major centers. Sept-Îles, for example, is more than 600 kilometers from Quebec.
The signatories support Minister Christian Dubé’s desire to wean the health and social services network from independent labor to reintegrate it into the public system. But they deplore that the measures do not take into account regional realities. On the North Shore, for example, agency staff mainly come from outside the region.
PHOTO EDOUARD PLANTE-FRÉCHETTE, LA PRESSE ARCHIVES
The Minister of Health, Christian Dubé
“These measures aim to reintegrate professionals into the network, but they are inapplicable and dangerous on the North Shore. Nurses and other workers will reintegrate the network close to their homes, leaving a gaping hole in the essential services of the North Shore,” they write. Quebec must put in place incentives for this workforce to settle in the regions.
In the meantime, we need independent labor to operate our hospitals. This is an unavoidable reality. This crisis is unnecessarily accelerated by political decisions and a lack of listening to our regional reality.
Around twenty doctors from the North Shore
The network must “stick together”
In a statement sent to The Press Monday evening, Christian Dubé recalls that “the entire network must pull together in order to put an end to our dependence on resources from independent labor”.
“We have taken an important first step in ending the independent workforce with the imposition of maximum rates. Several agencies responded to the call for tenders at the new maximum rates, but are not providing the requested staff. There are therefore temporary service reorganizations on the North Shore and in Abitibi-Témiscamingue, but we will take the appropriate measures and we are doing everything we can to restore the situation as quickly as possible,” indicates Mr. Dubé’s office.
Quebec hopes to abolish the use of independent labor across the entire network by 2026. Three targets have been set depending on the region. The North Shore is part of the last wave.
- October 20, 2024: Montreal, Laval, Montérégie, Capitale-Nationale and Chaudière-Appalaches
- October 19, 2025: Saguenay–Lac-Saint-Jean, Mauricie and Centre-du-Québec, Estrie, Lanaudière and Laurentides
- October 18, 2026: Bas-Saint-Laurent, Outaouais, Abitibi-Témiscamingue, Côte-Nord, Nord-du-Québec, Gaspésie–Îles-de-la-Madeleine and Nunavik
Last August, network managers affirmed that this transition was “too abrupt” and that it risked causing service disruptions and “destabilizing” employees’ working conditions.