Health reform in 10 points

Massive recruitment of personnel, better access to data, construction of new hospitals and empowerment: the Minister of Health and Social Services, Christian Dubé, presented Tuesday morning the 50 measures of his “Plan to implement the necessary changes in health which “is part of the 2025 horizon”. Overview in ten points.

Ariane Lacoursiere
The Press

1. More staff

This is the flagship measure of the plan. Because several other actions result from it, such as increasing the number of beds in hospitals. Quebec is banking on hiring 1,000 nurses abroad and implementing accelerated training programs. Quebec also wants to better retain its health care workers by eliminating mandatory overtime and implementing a self-management schedule system. As the population ages at breakneck speed, health needs are increasing just as rapidly. For Quebec, “the status quo is unsustainable”.

2. The end of the fax machine

The pandemic will have revealed that the health network is seriously lagging behind when it comes to access to data. The fax machine is still used throughout the network, and approximately 10,000 different information systems are in use. “Yesterday’s network had become bureaucratic, cumbersome and technologically outdated,” Minister Dubé wrote in his plan. The latter wants to give each citizen the possibility of having access to their health information and to implement a single digital health record. This change will notably go through the adoption of Bill 19.

3. More hospital beds

Mr. Dubé wants to quickly modernize health infrastructure. In addition to building seniors’ homes, he wants to renovate many hospitals and CHSLDs. Approximately 2,000 new beds will thus be added to the network. And the increase in personnel will also make it possible to add 2,000 others, predicts Mr. Dubé. 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.

4. A “revolutionary” counter

As of next summer, the majority of Quebecers will have access to a Frontline Access Counter. This project, already deployed in Bas-Saint-Laurent, will be extended throughout the province. Mr. Dubé speaks of a real “revolution in the patient approach”. By calling a single phone number or having access to a website, patients will be able to speak to a person, quickly receive health advice, book an appointment or renew their prescription. For Mr. Dubé, it is “a single channel where the patient is taken care of by the right professional. Not a number where you are told to go to the emergency room”.

5. Multiply the entrance doors

Rather than making the family doctor the only point of entry for patients into the network, the Ministry of Health wants to involve more professionals and is banking 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”.

6. Decentralize

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 [NDLR : de la Santé et des Services sociaux] on strategic directions. The Deputy Minister of Health, Dominique Savoie, must soon submit a plan on this subject. “The decentralization and organization of work will enable us to ensure the execution of our health plan”, according to Mr. Dubé. The last budget assured Minister Dubé that he will have the means to achieve his ambitions. But for him, “it doesn’t just take money. It takes work organization.

7. Massive shift to home care

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 well-being 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.

8. Prevent the worst

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 to carry out a “significant reform” in public health. 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 greater efficiency and better consistency between the authorities”, one can read in the plan.

9. Take the reports off the shelves

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 written in 2001. At a press conference, Minister Dubé said that many of these expert reports “were of high quality”, but that “sometimes there was a lack of political courage to implement the recommendations”. “It’s over, we have to take action,” he said.

10. Responsible Leaders

In order to ensure that the measures provided for in the plan are actually applied, the government plans to publish as early as May a “national and regional dashboard on the achievement of the objectives of the strategic plan and priorities”. “You know me, we’re going to measure up. Because what gets measured gets better […], says Mr. Dubé. In the medium term, I think we can move the needle very quickly. Mr. Dubé believes that the fact that many important players in the health network are already mobilized and want to change things will allow the plan to be quickly “executed”.