On March 22, 2022, following an unprecedented mobilization of 28 associations and professional orders1 With the quality of life of Quebecers at heart, the National Assembly unanimously adopted a motion in favor of health prevention. More specifically, this collective statement by elected officials called on the Government of Quebec to place the prevention of diseases and injuries at the heart of the transformation of the health care system and reiterated the desire to apply the recommendations of the Commissioner for Health and Well-being be from Quebec. Among these is a major reinvestment in public health, particularly in terms of prevention and health promotion.
If the government’s intentions to give prevention a more important role have been reiterated several times since, actions are rare. And the urgency remains more than ever with our healthcare system which is overflowing and the proposals which follow one another, but do not resolve the situation!
A strategic plan to reduce the number of Quebecers who will have recourse to the health system, whether hospital or extra-hospital, is more than necessary. The sustainability of our healthcare system depends on it.
Its scope is also economic: a sick Quebecer is a worker absent from his workstation or a fellow citizen who cannot go about his daily business. Prevention is therefore a strategy of choice. The longer we delay implementing preventive policies, the longer the effects will take time to appear.
In this sense, the Organization for Economic Co-operation and Development (OECD) recently published a report that reminds us that prioritizing prevention is essential to building a resilient health system in the face of potential crises, whether it is the increase in chronic diseases associated with aging, the consequences of climate change or the emergence of another pandemic.
Today, a year later, what progress has been made? Has the required emergency plan been drawn up to quickly make a major and gradual shift towards greater prevention? Have we identified on the scoreboard the indicators that will enable the government to demonstrate the exceptional added value of preventive actions if it invests sufficiently in this sector? It seems not.
The reform of the health system is coming. It is to be hoped that the terms of its refoundation, announced as revolutionary, will make room for prevention and the promotion of health. Public health must be given due recognition as an integral part of health and as a possible solution.
However, much more than a question of value, it is the social responsibility of the government to do so, because it has the power to spare the population unnecessary suffering and to reduce the workload that medical professionals can no longer hold on.
The government has in its hands an effective, although not exclusive, strategy to reduce its largest expenditure item, the cost of health care. According to Berwick in 2008 and Bodenheimer in 2014, improving the health system should have four objectives: better health of the population, reduction of costs per person, improvement of the patient care experience and well-being. to be health workers. These objectives are closely linked to preventive actions. It is still necessary to have the will to implement them.
Investing in prevention is bold
Recognizing those involved in prevention as alter egos of caregivers means making enormous progress in the place of prevention within the health system. And to do this, we must combine the strong and unanimous commitment of the National Assembly with a clear and costed plan for prevention.
Messrs. Dubé and Girard, our request is not only pragmatic and realistic, it is also and above all essential to avoid the point of no return for the sustainability of our healthcare system. It’s one to midnight.