Posted yesterday at 1:00 p.m.
Decentralization
One of the most promising areas of Minister Christian Dubé’s project is that of decentralization. Bringing the decision closer to the place of action can only benefit the customer by making the system more agile. At the same time, it will be his greatest challenge because his immediate entourage, the administrative machinery of the ministry, will do everything to ensure that this does not happen. Several attempts at decentralization have been carried out in the last decades in the world of health and, unfortunately, they have all come up against the discreet but effective resistance of the “machine”. Why would it be otherwise? No bureaucracy has any advantage in working against its own survival. Minister Christian Dubé will need to put his great talents of patience and persuasion to good use in a very short time. Because, as the employees of the ministry repeat in the intimacy: “The ministers pass, but the civil servants remain. »
Andre Carrier
Chances of succeeding
Yes, this reform has a chance of succeeding: it includes all health professionals in the front line; the doctor will no longer be the main entry point (the physiotherapist, the pharmacist, the nurse clinician, the social worker will be involved); triage will be more efficient – if it works in Rimouski, it should work elsewhere. It brings back the administrative assistants on the hospital care units, which already existed in the past and made the task of the nurses more attractive. Home care should include both physical care and home maintenance, in collaboration with social economy enterprises. It is not compulsory for every Quebecer to have a family doctor, but every Quebecer must have the care required in situations that lead to a deterioration of his health. FMGs and CLSCs will have to collaborate. And the single computerized file quickly accessible for all these professionals should be a priority. There are many nurses who have left the network: let’s repatriate them by offering adequate working conditions. We must blow up the preserves.
Jean Marceau, retired doctor, Saguenay
Prevention is better than cure
In Mr. Dubé’s plan, there are several interesting measures. However, it is doomed to failure. The health system is almost solely a care system. With an aging population and increasingly sedentary young people, we are heading into a wall with such a philosophy. Rather, the opposite approach should be adopted: aim to have fewer patients. Targeted interventions with health workers such as kinesiologists and nutritionists. Give at-risk patients programs with interventions and follow-up to prevent type 2 diabetes and other metabolic diseases that cause enormous financial strain on the system. It is much cheaper to prevent the disease than to cure it.
Nelson Rioux, Boucherville
Clean slate
How to improve the health system? It’s quite simple: we have to wipe the slate clean of this centralization. First, place a competent manager in each hospital and trust him. Second, to value the judgment of nurses in nursing. Third, increase technology, there are too many papers lost.
Michele Juneau
Do not limit yourself to the electoral calendar
Having worked in the health and social services network all my career and observed changes in orientation with each new minister, it would be desirable for the network to be able to develop in continuity and not in constant rupture according to the electoral calendar. Each time a minister arrives with his vision and his reforms, the network wastes a lot of time adapting. Meanwhile, it is the services to users that suffer and the staff that burns out. So if it’s a good plan and it’s based on the results of several reports, it should be implemented, regardless of who is behind it, whether minister or party in power.
Andree Deschenes
Concrete solutions
Here are my solutions: reduce the salaries of medical specialists (especially radiologists) and use the money saved to add clinical nurses; increase the number of beds and staff; and improve technology.
André Pichette
Waste of funds
First of all, the Minister should secure the work teams for all sick clienteles. Then, eliminate many administrative levels: there are plenty of people doing the same tasks. Having been in the health sector for 34 years, the waste of public funds is extremely repugnant to me! It’s time to straighten it all out!
Diane Arseneau
too much paperwork
I am a nurse and will be retiring in December 2022. I believe there are far too many managers. My smartwatch vibrates two or three times a day for appointment messages (directors or otherwise)… There is too much paperwork and not enough people in the field.
Chantal Boivin, nurse
Politicized health, doomed system
Another reform that will not change the problem of our health system with a bureaucracy and a technocracy too heavy for change. Especially since health has become politicized for too many years. Adding beds, adding places in accommodation, adding professionals, adding doctors… realistically, all of this would take a lot more time and money. We have long since lost this capacity for flexibility and performance by imposing too many rules, management frameworks and unnecessary paperwork. And what about the overall productivity of this system at all levels. Too many chiefs and not enough Indians…!
Jacques Desroches