(Quebec) Ceiling rates, demarcated areas and risk of penal offences. Minister Christian Dubé grants himself a series of powers to “supervise and prohibit” the use of private employment agencies in the health network. He gives himself until 2026 to get rid of it.
This is the first Bill 10 introduced by the Minister of Health since the start of his second mandate. It is the Minister of Cybersecurity and Digital Transformation, Éric Caire, who is now piloting Bill 3 aimed at increasing access to health data.
“It’s an important day,” said Minister Christian Dubé, saying that this new bill is a “key element” of his health plan, tabled a year ago.
We must free ourselves from the agencies
Christian Dubé, Minister of Health
The legislative text, tabled Wednesday at the Blue Room, gives the Minister of Health the power to “frame and prohibit” the use of independent labor with various “levers” which will be determined by regulation. The option to proceed by regulation will give him more flexibility, the Minister explained at a press conference.
With Bill 10, the Minister of Health will notably be able to set a maximum hourly rate per job title, as he had done by ministerial order during the pandemic. Moreover, most of the content of these orders will be taken up by regulation. One example is the 90-day buffer period imposed on a health care worker who leaves a facility before returning for an agency.
The Minister will also be able to “delimit the sectors” for which the use of labor will remain permitted. It should be remembered that regions such as Abitibi-Témiscamingue or the Côte-Nord suffer from a significant dependence on agencies. The Minister also retains the power to “extend the period” during which the agencies can be used.
Quebec is also giving itself until 2026 to completely free itself from agencies, especially in remote regions where dependence is greater. We aim to wean ourselves off of them in urban areas, which includes Montreal and Quebec, as early as 2024. We want to bet on a transition to gradually eliminate the use of agencies. The targets by region will be established in a regulation.
It could also be that the elimination targets are different in the same region if there is a particular problem in an establishment, for example.
Penalties for the network and agencies
The Minister of Health gives teeth to his bill by providing for the imposition of “administrative measures and criminal offences” in the event of non-compliance with the future law and regulations. These financial penalties will range “from $1,000 to $25,000, in the case of a natural person, and from $3,000 to $75,000, in other cases. In the event of a repeat offense, these amounts are doubled.
And it is not only the agencies that will be liable to penalties, but the health establishments as well, said Mr. Dubé. The Minister also grants himself “powers of inspection and investigation” to ensure that the rules are respected.
Public establishments, private CHSLDs under agreement, private residences for seniors (RPA), intermediate resources, palliative care homes and religious institutions that provide care will be covered by Bill 10.
On Tuesday, the Minister of Health argued that he wants to operate “a change of culture”.
Quebec has not been hiding for several months that it aspires to wean the health network from private agencies, whose use continues to increase. On Tuesday, the FTQ revealed that the Quebec state had spent nearly $3 billion from 2016 to 2022 to hire independent workers.
Data provided Wednesday by the Ministry of Health and Social Services (MSSS) show a 380% increase in the use of agencies from 2016 to 2022.
No small task
A survey conducted by the largest group of labor placement agencies among more than 2,000 of their employees revealed on Wednesday that for eight out of 10 health care workers, it is “unlikely” to return to the public sector by retirement.
The Press reported the results of this survey on Wednesday, where we also learn that 70% of the employees surveyed “would probably have reoriented their careers in another field instead of remaining in the public network” if the private labor agencies “n ‘did not exist’.
The task will not be small. Quebec launched a call for tenders last December – which has since been suspended – for 8 million hours of work to be carried out by independent workers in all health establishments in the province.