Special consultations on Bill 15 ended last week, but criticism continues to be heard. For Dr. Steven Grover, who has worked as a researcher for more than three decades, the Dubé reform will have no impact on access to care.
“It is quite clear that, if the law is adopted in its current form, it will be a major change for the structure of our establishment, but it will do nothing at all to improve patient care,” he decides. in interview.
The Dr Grover is an epidemiologist and expert in biostatistics at the Research Institute of the McGill University Health Center (RI-MUHC), in addition to being a professor in the Department of Medicine at McGill University. He says he wants to express a very personal opinion on the expected reform of the health system.
In an op-ed on Bill 15 sent to The Canadian Presshe judges that the bill “is unlikely to respond to the growing challenges we observe in our hospitals and communities”.
Supporting data, the doctor maintains that the Quebec health system is under pressure from two forces, namely the accelerated aging of the population and the shortage of manpower aggravated by resignations and retirements.
The Montreal region would be particularly disadvantaged, according to the Dr Grover, while waiting times in metropolitan emergency rooms are two to three times longer than in Toronto.
Once again, the lack of staff could explain this backlog, as barely 70% of Montrealers have access to a family doctor, compared to approximately 85% of Canadians on average. The other regions of Quebec are also better off than Montreal in general.
“The problem of access to a family doctor, the waiting time in emergencies, it’s extraordinary! And the new law does nothing about all that. We don’t even recognize the problem,” he insists in a telephone interview.
In order to remedy this problem, the Dr Grover calls for the end of the quotas imposed by the Regional Medical Staffing Plans (PREM) for family doctors and the Medical Staffing Plans (PEM) for specialists. Under the current version of Bill 15, these two measures will remain in place.
The purpose of these two plans is to distribute medical resources across Quebec by limiting the number of new physicians who can establish themselves in each region.
“Baby Boomer Tsunami”
Beyond doctors, the labor shortage also affects the entire range of healthcare professionals. According to the Dr Steven Grover, the very high mortality rate in Quebec during the first waves of the COVID-19 pandemic has highlighted the glaring lack of investment in long-term care.
Here again, he criticizes the Minister of Health Christian Dubé for not having planned anything in his reform to improve home or long-term care in order “to take charge of the tsunami of aging baby boomers”.
“Bill 15 does not respond to too many of these issues to be considered a serious solution by our elected officials, hospital managers and professional orders,” writes the man who knows the machine very well from the inside. by virtue of his numerous involvements within committees.
Based on data from Statistics Canada, the doctor points out that only Alberta and the territory of Nunavut spend less than Quebec on long-term care. The province is also the one with the fewest available beds, with the exception of Nunavut.
Centralization
Dr. Grover also believes that the creation of the Santé Québec agency to take over the operations of the health network could have the effect of aggravating the problems by centralizing powers and reducing the responsibility of local managers.
The epidemiologist even goes so far as to hope that the entire bill will be withdrawn. He would like to see the Ministry of Health adopt an approach based on collaboration between professionals in the field rather than a centralization approach.
He believes that the effectiveness of the health network depends on greater flexibility of action at the local level and not on the micromanagement of a large state corporation.
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