A few weeks ago, the government announced its intention to overhaul the health and social services network. The pandemic has demonstrated beyond any doubt that the organization of the network must be reviewed both to meet the needs of the population and to curb the distress of the personnel.
In 2017, a coalition bringing together the Fédération de la santé et des services sociaux (FSSS–CSN) and the Fédération des professionnèles (FP–CSN), representing employees of all categories of staff, as well as the Alliance des patients pour la Santé, the Quebec Medical Association and the Association of Senior Health and Social Services Executives, proposed 15 potential solutions. The COVID-19 crisis has shown that these solutions are more relevant than ever to improving and sustaining the health and social services network.
Decentralizing the health and social services system is much more than scattering a few management positions here and there in the establishments. The organization of the network must be reviewed and the situation of services for seniors and youth protection services must be tackled as a priority. The CHSLDs and youth centers are drowned in the megastructures that are the CISSSs and CIUSSSs, within which the hospitals are heavyweights.
Decentralizing the network also means giving back a voice to those who provide services as well as to those who receive them. The overhaul of the network must allow for greater participation in decisions on the part of staff, relying on their expertise and professional autonomy and those of the population, particularly within the boards of directors.
After two years of pandemic, the staff is at the end of its tether. Work overload and mandatory overtime (TSO) must end. The best way to attract the next generation is to provide better working conditions, starting now, by opening up dialogue between the government and the labor organizations, as was done during the 5and wave of COVID-19. There is only one target to aim for and that is to rediscover the pride of working to attract young people to their career choice.
Reinvest to erase the ravages of austerity
The network is still struggling to recover from the austerity of recent years. Not only have these cuts undermined its operation, but this shortfall has never been made up. An overhaul of the network appears impossible without the investment of the sums necessary to achieve it. Just think of the cuts in public health, which made it impossible to prepare and adapt the national strategy when the pandemic hit. They would explain the carnage experienced in CHSLDs, according to the health and well-being commissioner. In addition, a reinvestment in mental health is absolutely crucial.
Strengthening home support is not only a necessity for the quality of life of citizens, but also a completely coherent budgetary choice. In this respect, Quebec has a huge gap to catch up with compared to comparable states and other provinces. There must therefore be funds devoted to physical and mental health care at home.
Investing better where it matters is not so much a question of available resources as of political choices. Two measures alone, such as the introduction of universal prescription drug insurance and a review of the mode of remuneration of physicians, would make it possible to allocate significant sums to these structuring priorities.
Will the government have the necessary courage to carry out a real overhaul of the network, in particular on these three priority areas that we are proposing? This is no longer the time for fine words. We must intervene. It is urgent to act!