“We cannot take care of our elders if our health system itself is sick. It is on this somber note that the representative of the Union of Nurses, Respiratory Therapists and Auxiliary Nurses of Laval (FSQ-SIIIAL-CSQ), Me Amy Nguyen, presented her recommendations on Tuesday to the coroner’s inquest into the deaths in CHSLD during the first wave.
She pointed to the Barrette reform of 2015, which created the organizational megastructures that are the CISSSs and the CIUSSSs. To the coroner, Ms. Nguyen said that the conclusions of her report “should touch the very core of the health system, its operation, its management”.
With regard to CHSLDs, “everyone is responsible for something, and therefore no one is responsible: there is always someone to whom we can throw the ball,” added Me Sophie Brochu, who represents the Alliance of Professional and Technical Personnel in Health and Social Services (APTS). She also thinks that “it is the whole system that has failed, systemically”.
Over the past week, several government officials have come to testify before coroner Géhane Kamel, most without accepting responsibility for the carnage.
Those at the top of the pyramid “have the luxury of distance”, reacted Me Brochu, while the members of the APTS, who were sent to care settings for seniors without sufficient training or supervision, “will live all their lives with what they have experienced in CHSLDs”, many having even suffered post-traumatic shock.
This bureaucratic imbroglio, as well as the long distance between the decision-makers and the field, has cost the lives of many residents, argued the lawyers, arguing for proximity management, where the decision-makers on the ground could take decisions themselves. quick decisions adapted to their environment.
Nguyen cited directives sent by the Ministry of Health, which were often misunderstood, such as the order to limit transfers to hospitals, which ultimately prevented sick seniors from receiving care in the emergency room. She also raised the fact that “the directives took so long to arrive that the ministry had already had time to modify them” even before they arrived in CHSLDs.
“Poor child of the health system”
“How many patients would still be alive if we had enough staff? wondered Me Nguyen. And not just staff, but healthy workers, in sufficient numbers and above all not sick and contagious with viruses? », a reference to some testimonies of nurses who had been forced to work despite their symptoms.
Improving working conditions is for her the key to success, since “if nothing is done for health personnel, there will be fewer and fewer workers who want to stay in this field”.
This vicious circle was, according to her, created upstream, while the environments for seniors are “the poor child of the health system”, where “we have always made the minimum investment”.
Not only “we have not invested enough upstream”, but the CHSLDs have also “been in the blind spot of the first wave”, added Me Brochu, saying that the alarm bell has only been sounded. in “late February, early March”, when it should have been in January.
The lawyers also both asked that, in the future, the precautionary principle take precedence, particularly with regard to the wearing of protective equipment.
The context of the investigation
The coroner’s inquest is looking into deaths of elderly or vulnerable people that occurred in residential settings during the first wave of the COVID-19 pandemic.
During this initial wave, from February 25 to July 11, 2020, Quebecers aged 70 and over accounted for 92% of deaths from COVID-19, according to data from the National Institute of Public Health of Quebec. 5211 of them then succumbed to the disease.
The investigation is limited to events that took place between March 12 and May 1, at the height of the crisis. Its purpose is not to identify a culprit, but to make recommendations to avoid future tragedies.
Six CHSLDs and a private residence for seniors were designated as a sample. One death was reviewed for each facility, then the coroner considered the provincial management of the crisis.
This week’s hearings focus on recommendations from various interested parties.