The Legault government favors the privatization of large sections of the health system, believes the president of the CSN. Having recently been operated on in a private clinic at public expense, Caroline Senneville deplores the creation of a parallel system which leaves complications to the public network.
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At the end of last summer, the president of the Confederation of National Unions (CSN) had to have a metal plate removed from her ankle a year earlier, after a bad fall. The Department of Health sent her for surgery at a well-known private clinic, Rockland MD, all paid for by health insurance.
“It wasn’t my choice,” laughs the woman who represents some 120,000 union members in the public health and social services network.
First surprise, Caroline Senneville recognizes the doctor who is about to operate on her: it is the same one who had carried out the first surgical intervention, in a hospital. Installed in the public, the plaque will therefore be removed from the private sector.
However, when a serious infection appeared in the wound, the clinic no longer offered service. Instead, the union leader had to wait for twelve hours in her hospital emergency room.
The president of the CSN, Caroline Senneville, after her first operation in September 2021.
“The first thing they make you sign when you get back to Rockland MD is that once the surgery is over, you’re going anywhere in the universe except to them. For them, they completed their call for tenders, they carried out the operation and then it was: Goodbye Charlie Brown“, says Ms. Senneville, while specifying that she received good care during the operation.
The private network, she says, “does what’s easy, what doesn’t cause problems.” “But all that overflows is [pour] the public network,” observes the president of the CSN.
Health Quebec
If Caroline Senneville recounts her misadventure, it is to illustrate her apprehensions regarding the partial privatization of the health system. The phenomenon did not start with the Legault government, but the reforms of Minister Christian Dubé are accelerating it, believes the union leader.
Indeed, the new agency, Santé Québec, will now be able to call on the private sector to take care of cases for which the wait exceeds reasonable time limits.
Moreover, public and private networks are now in competition with the aim of obtaining day surgeries at the lowest possible cost.
At the same time, doctors in the public network can now offer telemedicine services to the private sector, without disaffiliating from the Régie de l’assurance santé, whereas it was until now prohibited to practice in both networks at the same time. It will therefore be the sun card for a clinic appointment and a bank transfer for a telephone consultation, illustrates Mme Senneville.
The example of 1D line
With this approach, the president of the CSN fears the creation of two parallel systems, a bit like is the case in education, where private schools recruit the best students, relegating difficult cases to the public network. The observation also applies to private seniors’ residences, she says, which close their doors when the business model is no longer profitable.
The experience has not been more conclusive for the first line in the health network, where GMFs (subsidized private clinics) have replaced CLSCs over the last two decades, notes Mme Senneville.
These “open and close whenever they want”, without too many constraints. “It is because of the failure of this first line that we find ourselves in the emergency room,” says the union leader.
Intensive raiding in sight
The creation of a single employer, with the arrival of the new Santé Québec agency, will lead to a major struggle between the various unions in order to recover the thousands of workers now grouped under the same accreditation unit.
Currently, the CSN, the FTQ, the FIQ and the APTS share the field with around a hundred accreditation units, distributed according to the establishments. The Dubé reform will reduce them to just six, within a single organization.
This means, for example, that 83,000 employees will find themselves in category 1, i.e. nursing and cardiorespiratory care; a windfall for the union that will represent them.
“It left my Kiki. Thank God we finished the public sector negotiations beforehand,” says Caroline Senneville.
Mandatory training
Beneficiary attendants, construction workers, non-legally qualified teachers: the accelerated training and accommodations put in place by the Legault government to compensate for the labor shortage are useful, recognizes the president of the CSN.
But these workers should be required to participate in continuing education in order to eventually obtain their diploma in due form.
Currently, they can count on better qualified and experienced colleagues to support them. But they will leave their jobs gradually. “There must be a second stage, otherwise we will have a loss of expertise,” says Caroline Senneville.
“We should do a second wave of training,” she insists.