Health mammoth snakes

The investigation by coroner Géhane Kamel on CHSLDs took on the appearance of a master class on the many ways to escape from one’s responsibilities, when one is warm at the top of the pyramid of a ministry.



Me Kamel is investigating the death toll of the first wave of spring 2020 in CHSLDs, focusing on the following Centers: Herron, des Moulins, René-Lévesque, Yvon-Brunet and Sainte-Dorothée).

At the top of the mammoth ministry of health, there is the minister and the deputy ministers. Regionally, care is administered by other bureaucratic monstrosities, the CISSS and the CIUSSS.

These are headed by presidents. “Establishment presidents”, according to the jargon, CISSS and CIUSSS being referred to as “establishments”.

At the start of 2020, who was responsible for preparing CHSLDs for this worrying virus from China, which was starting to spread?

This is, among other things, what Coroner Kamel is trying to find out.

She therefore calls witnesses and asks questions. Who knew what and when? What actions were taken by whom, when? It’s a classic coroner’s inquest. The goal: to establish the facts and make recommendations to avoid loss of life in the future.

It is the number of fatalities that detonates – 4000 – in the network of CHSLDs and RPAs, in the first wave.

The senior officers of the ministry at the beginning of 2020 are Minister Danielle McCann and Deputy Minister Yvan Gendron. As early as January 2020, did they testify at Me Kamel, the Ministry of Health informed “the CEOs of establishments” – the CISSS and the CIUSSS – that it was necessary to prepare to face this virus which came from China in January 2020.

Small problem: there is no trace of that.

The Network Management Committee brings together the CEOs of the CISSS and the CIUSSS, Minister McCann, Deputy Minister Gendron and the Director of Public Health, Dr.r Horacio Arruda. It reunited well in January. No trace of this directive.

It was only on March 9, 2020 (remember this date) that we noted in the minutes of this Network Management Committee that it was necessary to “update the pandemic plan developed for the H1N1 and add an annex dedicated to COVID ”.

Of course, the whole world was caught off guard by this virus at the start of 2020. The loopholes in many states have been exploited by the coronavirus in a thousand ways, starting with Italy.

No, what irritates me supremely is the denial of responsibility of the top of the pyramid, on the part of Mr.me McCann and Mr. Gendron.

Not only did they falsely affirm to the coroner that the Ministry of Health advised the CISSS and the CIUSSS to prepare to face the virus as early as January, but the former minister and the former deputy minister also affirmed without laughing that the protection of hospitals and CHSLDs, well, it was not the responsibility of the Ministry of Health, but that of the CISSS and CIUSSS …

* * *

Let us recall here a fact conveniently obscured by Mme McCann and M. Gendron before the coroner: the CISSS and the CIUSSS are creatures of the Ministry of Health. I repeat: the CISSS and the CIUSSS are creatures of the Ministry of Health. The CISSS and the CIUSSS ARE the Ministry of Health.

Question: How do the CISSS and CIUSSS receive their orders from the Ministry of Health?

By smoke signals?

By secret non-verbal signs?

By telepathy ?

No.

Mainly, by memos signed by the person who occupies the post of deputy minister of the Ministry of Health. And at the start of 2020, this person was called Yvan Gendron.

If no memo has been sent to the CISSS and CIUSSS telling them to prepare to face the Chinese virus, it means that the Ministry of Health has not advised the CISSS and CIUSSS to prepare to face this virus, early 2020.

* * * *

It has been said over and over again, a thousand times, for decades: the health monster works ” top-down »: The directives come from the top of the pyramid and descend towards the tentacles, like the CISSS and the CIUSSS.

I want to recall a telling example. On Wednesday March 18, 2020, I reported in Press how doctors at a Montreal hospital had started preparing their hospital for this virus that was devastating Italy, BEFORE the health machine woke up and sent out directives.

On Thursday March 12, Premier Legault, remember, put Quebec on hiatus in a dramatic press conference. These doctors, they had started to activate at the beginning of the week, from March 9 (day when the Network Management Committee took note of the virus, as I mentioned above) …

These doctors were talking to their Italian colleagues and they were terrified by what they heard. And they took action here in Montreal upstream. They have made local decisions such as the suspension of certain non-urgent surgeries, the end of hospital visits, the end of outpatient consultations, etc.

What happened ?

Well, the CIUSSS has hit them on the fingers!

On Monday March 16, four days – I repeat: FOUR DAYS – after the press conference where the PM put Quebec on “pause”, the CIUSSS told these doctors that they were going too far and too fast, that ‘we had to wait for the ministry’s plan!

Extract from my column of March 18: “This doctor contacted me on Monday morning because he was absolutely furious: in a conference call, the management had just announced to the doctors that the measures put in place went too far, beyond what the measures of the Ministry of Health provided for. And the management also sent the message to the doctors that they had to respect the hierarchical structure… ”

I repeat: on March 16, a CIUSSS again told its doctors that THEY WOULD GO TOO FAR and that it was necessary to WAIT FOR DIRECTIVES FROM THE MINISTRY.

(Sorry for the capital letters. I scream inwardly.)

In short, even after the PM himself urgently put Quebec on hiatus, the health network was still doing what it always does superbly well: waiting for directives from the Deputy Minister of Health, in comfortable indolence .

That the former Minister McCann and that the former Deputy Minister Gendron try to remake the history of the first months of 2020 is a huge snake that should not swallow the coroner.

* * *

Last week, former Minister McCann and Deputy Minister Natalie Rosebush assured Coroner Kamel that the inspections in CHSLDs, in the first wave, had been documented by… verbal reports. And if there were any reports, they had been destroyed.

Knowing the department’s obsession with paperwork, it was surprising. Ariane Lacoursière from Press then revealed that, no, these reports existed.

Then, this morning, the journalist Thomas Gerbet presented these forms in his report.

A former Minister of Health and a deputy minister in office therefore misled a coroner …

It’s starting to cause a lot of snakes that we try, at Health, to swallow the coroner Kamel.


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