The deployment of home support services in Quebec has been “slowed down” for 20 years by the absence of a clear plan, reveals a new report at a time when the Legault government is promising a major shift in this area.
This is the conclusion of the third volume of the investigation led by the Commissioner of Health and Well-being, Joanne Castonguay, into the home support policy At home: the first choice.
After carefully examining the entire system in the first instance, then measuring its effectiveness in a second, the commissioner returns, in this third report, to the genesis of this policy, adopted in 2003, and its deployment since then. two decades.
However, if the policy had an “ambitious vision”, 20 years later, its results are “mixed”, concludes Joanne Castonguay.
Indeed, in the absence of a “real implementation plan” and in the context of “successive structural reforms” in the health system, its objective of making home the first choice for treating Quebecers “does not has not emerged as a real priority,” she writes.
“At the time, it was very avant-garde, but unfortunately, we did not implement it,” explained the commissioner in an interview on Thursday. “The result is that it was not implemented as we would have liked it to be. »
A poorly adapted system
Consequently, the current home support system, which results from the policy adopted in 2003, is “complex”, “poorly integrated” and “demanding” for users and caregivers.
Some brief observations:
- With equal health needs, not everyone has access to the same services.
- The pathways to home support are not easily readable.
- User evaluation practices are heterogeneous.
- There is no common quality standard.
- The sharing of roles is problematic.
For example, different community organizations offering home support services have different criteria for assessing who can access them. These criteria sometimes also differ from those of CHSLDs.
What’s more, a recent government update presented this year and which was supposed to dust off the policy “does not propose new measures likely to bring about the necessary improvements”, judges the commissioner.
Worse, this new update “is even more centralized”, estimates Joanne Castonguay, which “even further limits the room for maneuver [des établissements] to improve what is there locally.
At the start of his second term, François Legault promised to bring about “a real revolution” in home care. In its first mandate, the Legault government invested an additional 2 billion in its shift towards home care. The latest Girard budget provides for new sums of 103 million this year for 963.5 million in new money within five years.