Health network overhaul plan | Three years to undertake the re-establishment of the network

Massive recruitment of personnel, better access to data, construction of new hospitals and accountability: the Minister of Health, Christian Dubé, presented Tuesday morning in detail his “Plan to implement the necessary changes in health” which “will inscribed on the horizon of 2025”.

Ariane Lacoursiere
The Press

The main lines of the plan had already been presented piecemeal in recent weeks by the government or had been fanned by the media. With this plan, Minister Dubé says he is relying on the many expert reports produced over the years on improving the health network, including that of Michel Clair produced in 2001 and on which The Press came back recently.

“The time is no longer for assessments or expert reports, but for action,” writes Mr. Dubé in the introduction to the document.

The plan presents 50 measures to offer “care on a human scale and effective” in Quebec. The first: massively recruit personnel by hiring 1,000 nurses abroad and implementing accelerated training programs, among other things.

Quebec also wants to better retain its health care workers by eliminating mandatory overtime and implementing a self-management schedule system. While the population is aging at breakneck speed, health needs are increasing just as rapidly. For Quebec, “the status quo is unsustainable”.

The end of the fax machine and modern hospitals

The pandemic will have revealed that the health network is lagging behind when it comes to access to data. Fax is still used throughout the network, and around 10,000 different information systems are used, complicating data collection. “Yesterday’s network had become bureaucratic, cumbersome and technologically outdated,” the minister writes in his plan. The latter wants to give every citizen the possibility of having access to their health information. He wants to implement a single digital health record and improve data collection to better manage the network. This change will notably go through the adoption of Bill 19.

Mr. Dubé also wants to quickly modernize health infrastructure. In addition to building seniors’ homes, we want to renovate several hospitals and CHSLDs. New hospitals or expansions are planned, notably in Gatineau, Vaudreuil, La Malbaie, Chicoutimi and Montreal. New beds will thus be added to the network. These additions will help reduce emergency room waits. Quebec is also counting on the creation of “command centers” in each hospital to allow more fluid management of beds and reduce waiting times in the emergency room. The shift towards patient-based funding of healthcare institutions and no longer based on historical values ​​will accelerate. We are also betting on an increase in federal health transfers.

The doctor, not the only gateway

A great deal of energy will be put into improving access to first-line healthcare. The front-line access counter, deployed in Bas-Saint-Laurent, will be extended throughout the province. This call line allows appointments to be made to orphan patients in a given region.

Rather than just making the family doctor the gateway for patients into the network, the Ministry of Health wants to involve more professionals and relies on interdisciplinarity. Specialized nurse practitioners, community pharmacists and paramedics will be even more involved. Family physicians will also be encouraged to modify their remuneration by opting more massively for capitation. This method of remuneration encourages the care of patients “in a group and in an interdisciplinary approach”.

To improve the management of the network, Quebec is counting on the “decentralization of the health system” to “bring the operations of the network to the regions and reframe the mission of the Ministry (Editor’s note: of Health and Social Services) on the strategic orientations ” .

The private and the elderly

As announced earlier this month, Quebec wants to make more room for private health. Among other things to reduce waiting lists for surgery. However, there is no question of charging the patient for this care. For seniors, a massive shift towards home care will continue to take place. However, we are awaiting the conclusions of the Health and Welfare Commissioner, who is currently examining the performance of home care and its financing. More support will be offered to caregivers and community organizations offering home support.

Still marked by the CHSLD Herron scandal that occurred during the pandemic, Quebec wants to acquire increased investigative powers in private residences for seniors, private CHSLDs and intermediate resources.

To be ready if a new virus hits the planet, Quebec plans to create a national strategy to prepare for a next pandemic. There are also plans for “significant reform” in public health. The outlines remain vague. But the COVID-19 pandemic will have “shown the importance of having clear governance in public health, based on the independence and transparency of the work and recommendations of experts” and “brought to light the need for more greater efficiency and greater consistency between jurisdictions,” the plan reads.

To ensure that the measures provided for in the plan are actually applied, the government plans to publish several times a year a “national and regional scoreboard on the achievement of the objectives of the strategic plan and priorities”.