At the time of the first wave of COVID-19, the Legault government justified the imposition of severe public health measures by the need to “protect our seniors who built Quebec”. Today, Quebeckers are being asked to make sacrifices to “protect the health care system”. A system which, apparently, is at the end of its resources and energy.
In his most recent text in Press1, Marie-France Bazzo rightly suggests a global reflection “on the way in which the health system manages Quebec”: “It is the number of available beds that ultimately dictates the number of people who can come together around a turkey, what will we do, if there will be a curfew, which business will have to close. ”
How is it, in fact, that our health system is fragile to the point where the addition of a few hundred COVID-19 patients brings us to the edge of the abyss?
One of two things: either this network lacks resources, or these resources are poorly managed.
I do not have the expertise to decide between these two hypotheses. But I am amazed, when I study statistics, to hear about a shortage of money or of personnel.
According to the Canadian Institute for Health Information, in 2011, so 10 years ago, the government of Quebec was investing $ 29.7 billion to operate the province’s health system. By 2019, that figure had risen to 42 billion, an increase of over 12 billion (42%).
Yes, there were the so-called “austerity” years under the Couillard government (2014 to 2018). During these five years, Quebec health spending has increased (not decreased!) By an average of 4.7% per year.
Staff shortages? Let’s see. According to the College of Physicians, Quebec now has 22,150 active physicians. In 2011, this number was 18,924. There are therefore 3,226 more physicians than 10 years ago, an increase of 17%. According to the Order of Nurses of Quebec, this year there are 78,240 nurses working in the health network, 6,000 more than 10 years ago.
Of course, Quebec’s population is also growing, but this growth is much slower than that of budgets and staff.
The fundamental question
All of these figures bring us back to the basic question: given the sharp increase in spending and the number of caregivers, why is the healthcare system so fragile that an increase of a few dozen patients suffering from COVID-19 is causing a panic worthy of the last minutes of the sinking of the Titanic ? One of the answers surely comes from the fact that while the population of the province as a whole has not grown much, the number of seniors has increased sharply (+ 39% over the past 10 years). However, who says the elderly means increased demand for care.
Is this the only answer to the riddle?
When a disaster strikes in Quebec, Civil Security implements a plan that has been prepared for a long time, and things go smoothly. Why is the Department of Health not able to do the same?
Admittedly, by its magnitude and duration, this pandemic is unprecedented in recent times – I emphasize recent – but was it not probable that one day a pandemic would occur and congest hospitals? Why, despite the obvious competence of the Prime Minister and his Minister of Health, do we not have the impression that the emergency plans are being implemented in a prepared and coherent manner? Why do we have to beg Quebeckers to protect a system that should protect them?
Once the pandemic is behind us, the government must set up a commission of inquiry whose mandate will not be to find the culprits, but to conduct a fundamental reflection on the management of the health system. Quebec does not have the means to spend more on health. So we have to do things differently. Better.