Health | A priority perpetual mandate

The electoral result leaves little doubt that there will be no commission of inquiry into the management of the pandemic. That is. But beyond reports specific to the response to COVID-19, are there not scientific and social lessons to be learned before starting another cycle?

Denis Soulieres
Hematologist and Medical Oncologist, University of Montreal Hospital Center

A lesson seems essential to me. We cannot let nature take its course and assume that there will be normalization. In fact, it is one more episode in the history of medicine in this regard. Society, with all its quirks and inconsistencies, is the best bulwark against oblivion and the loss of the weakest.

In terms of physical integrity, the recognition of diseases and our effort to eradicate them is the element that stands out the most in our commitment to forming a society. Thus, an efficient and secure health network must prevail, impose itself, as the main civic value. I would dare to add: while economists have been decrying for 40 years the share of public spending granted to health, it has been very well demonstrated that these sums are insufficient when a crisis occurs.

Without the robust backbone of the health network, the rest of the social, economic and cultural activity is irreparably compromised. Moreover, we must also deduce that the funding historically granted is too limited to predict the next major public health problem, prepare for it and prevent its impacts.

From one crisis to another

But heck! This next problem is already here! Even if we hardly talked about it during the election campaign. Not another wave of mutant COVID, but a surge of health conditions left behind during the pandemic and which today deserves the term epidemic, coming to bog down emergencies and various consultation sites.

The worst thing is that the current crisis, linked to cases of cancer, mental health and loss of autonomy will not find a remedy in a vaccine with almost miraculous and spontaneous virtues.

To counter these problems, it would have been necessary – and it will be necessary – for a “healthy” health care system benefiting from an appreciable leeway to curb them in a timely manner.

Because four observations stand out:

• The population is increasing, in line with all demographic projections, and as a result, health infrastructures must also benefit from an increase which has not, however, taken place since the hospital closures of the 80s and 90s, at least significantly not in proportion to population growth;

• The population is aging, which was also predictable demographically, requiring an adaptation that has not taken place to provide the quantity of care and the technical platforms adapted to achieve this;

• The population is changing, more multi-race and multi-ethnic, sedentary, exposed to harmful environmental factors. Care dogmas must mold themselves to these new imperatives, offer more, offer better, to everyone, in a timely manner;

• Technological progress gives access to diagnostic and therapeutic advances that must be integrated to promote the stabilization or even improvement of life expectancy and the quality associated with it.

It is rare that general, founding, absolute objectives are declaimed by our leaders. We are talking about access to data, home care, organizational charts. It is good to mention them and to implement them, but these are only tools that the people of Quebec must have at their disposal in order to aim and oblige themselves to, for example, reduce the incidence and mortality of cancer, to the increase in the functional autonomy of the older population, the control of pathological variations linked to the psychological and psychic state in each stratum of society, and security in the face of an upcoming pandemic risk.

“Never allow someone to be your priority while allowing yourself to be their option. Mark Twain clearly expresses here that social issues, such as health in particular, transcend political programs after more than 60 years of establishing a public system.

A priority requires substantial funding and the political humility to trust professionals and managers capable of proposing objectives and constantly adjusting plans to achieve them.

And also to allow security for the rest of social and personal activities. This is essentially what is expected of the minister or ministers who see to the destinies of health. And this both in 2022 and in 2035.

For increasingly vulnerable patients. For committed health professionals who are losing their vocation.