The telephone lines of many first-line access counters (GAP) have been ringing since 288,000 Quebecers received a letter announcing that they were being cared for by a group of family doctors. In Laval, the demand is such that the call system has experienced failures. Montreal, she says she manages to meet the needs “for the moment”. Its five GAPs, which are not fully deployed, take care of 100,000 orphan patients, but will welcome 800,000 from the 1er september.
” It is enormous ! says the DD Ariane Murray, Head of the Regional Department of General Medicine in Montreal, responsible for the deployment of GAPs in the territory. “In September, we are going to open for the entire orphan population of Montreal, whether or not they are registered at the counter for access to a family doctor (GAMF). »
Some 200,000 Montrealers who do not have a health insurance card (asylum seekers, refugees, homeless people, etc.) will have access to it, like the 600,000 other orphan patients in the city.
The establishment of GAPs is at the heart of the reform of the Minister of Health and Social Services, Christian Dubé. The mission of these new counters is to offer orphan clients — registered with the GAMF or with a group of family doctors — the right care at the right time by the right professional.
In the spring, the Legault government promised that the GAPs of all regions of Quebec would be fully deployed by the 1er september. Three weeks before the deadline, many counters are still working on it. According to the health network’s performance dashboard, 54 out of 92 local service networks were served by a “functional” GAP as of July 28.
According to the D.D Murray, the development of the five Montreal GAPs — managed by as many CIUSSS — is progressing well. “There are some GAPs that don’t have all their nurses in place yet,” she says. They have some, but not yet the optimal number to do the job of filtering. »
There is also a lack of personnel at the GAP of the CIUSSS de la Mauricie-et-du-Centre-du-Québec, which nevertheless manages to serve its entire territory. “Currently, 66% of GAP positions are staffed,” we write. Staff will come in reinforcement in September. »
GAPs need administrative agents to handle calls and refer cases requiring care to a team of triage nurses. An appointment may then be offered with a family doctor or other professional, such as a specialist nurse practitioner, pharmacist or social worker.
Their volume quadrupled in the space of a few days. It broke the system [télépho-nique] last week !
At the CISSS de Laval, the counter operates with two-thirds of its workforce. Four employees (out of the twelve that will make up the team) are due to start work soon, and the staff in place are not idle. Since the collective registration letters were sent to orphan patients, the calls have multiplied.
“Their volume has quadrupled in the space of a few days,” says Sylvie Brazeau, director of access to first-line medical services at the CISSS. It broke the system [téléphonique] last week ! »
The manager explains that many orphan patients, taken care of collectively, contact the GAP without necessarily having a specific health problem to solve. “People don’t understand the letter [d’invitation du GAP] or don’t read the letter, she says. They see a phone number and they call. This creates traffic and slows down service for those who have a real need, she laments.
In the Laurentians, the GAP receives more than 200 calls every day. The local CISSS notes a “significant increase” in these. “The waiting time on the line is more important”, says one, without specifying a precise deadline. The CIUSSS de l’Estrie, for its part, recalls that “the volume of calls is higher in the morning”. It prompts patients who are unable to obtain communication to call back at a later time.
Unfilled beaches
In western Montérégie, family doctors deplore the fact that appointment slots granted to GAP patients remain vacant.
Some 4,200 orphan patients were taken care of collectively at the Trois Lacs Medical Center, located in Vaudreuil-Dorion. The GMF books 20 medical consultations every day at the GAP out of the 80 offered at its walk-in clinic. “It is less than 25% of the beaches of the GAP which are filled, deplores the Dr Christian Leduc, doctor in charge of the GMF. A good day is four patients [du GAP] that we receive. »
The medical team has four hours to redistribute the free slots to other patients. She asked the ministry to extend this deadline to 24 hours, which was refused, argues the Dr The Duke. Result: one or two time slots remain unoccupied each day because of this too short deadline, he believes. “Finally, instead of seeing more people, the GAP makes sure that we see fewer people,” laments the Dr The Duke. He specifies that he is in favor of the project, but thinks that it was launched too quickly.
Asked about this, the CISSS de la Montérégie-Ouest notes “currently an increase in appointments”. The health establishment adds that it is “still to make known” the “terms of use” of the GAP to its population without a family doctor. He invites orphan patients to use it.