For too long now, many questions have been regularly raised in the public space regarding the services offered to our seniors living in private CHSLDs in Quebec. As key players in the health network, institutional pharmacists, that is, those working in our hospitals and our CHSLDs, have often expressed their concerns about the quality of care provided in private CHSLDs. Of course, the public network also faces certain challenges, particularly with regard to the lack of personnel, but it must be admitted that the problems are even more glaring in the private network. The COVID-19 pandemic, especially during the first wave, reminded us of this sad reality.
More recently, coroner Géhane Kamel’s public inquiry shed light on the circumstances surrounding the deaths of 53 people during this first wave. On May 16, the coroner released her report, in which she made an observation that could not be clearer: “Private CHSLDs are unfortunately an unviable solution if we want to offer a quality of care worthy of what the elderly deserve”, she mentions in full. The coroner’s remarks therefore corroborate the observation made by the APES for a long time. In order to remedy this situation, Mr.and Kamel recommends that the Quebec government convert all private CHSLDs into private CHSLDs under agreement.
In the opinion of the APES, this proposal by Coroner Kamel remains insufficient. We believe that the government must go further and convert all private CHSLDs into public CHSLDs so that these establishments are placed under the governance of CISSSs and CIUSSSs, which is not the case for private CHSLDs under agreement. Switching all establishments to the public network would have several advantages for more adequate follow-up of patients, particularly in terms of pharmaceutical care.
Let us cite, among other things, clienteles common to hospitals and accommodation facilities, i.e. mostly vulnerable elderly people, and the need for CHSLDs to have existing resources in hospitals, such as professionals working in interdisciplinary teams, expert variety, a safe medication circuit and care protocols based on best practices.
In addition, if hospitalization is necessary, the fact that the CHSLDs and their caregivers are part of the health establishments helps to coordinate care and services, in addition to ensuring their continuity when returning to the residential environment. For pharmacists present in CHSLDs, direct communication with the CISSS or CIUSSS pharmacy as well as access to the expertise of peers in specialized sectors (e.g.: infectiology, geriatrics, cardiology, etc.) can facilitate the obtaining answers essential to the care to be provided.
In 2022, we have a collective duty to provide Quebec seniors with the safe care they deserve. Minister Dubé’s Health Plan offers the government the chance to make the necessary decisions, and this begins with the standardization of care in CHSLDs in Quebec, by integrating them all into the public network. Remember that the private CHSLDs under agreement, like the private CHSLDs, must at all costs produce positive financial results.
However, in a pandemic situation or in any other exceptional circumstance, budgetary concerns must be set aside to prioritize patient care. For the good of our seniors, let’s not create two classes of housed patients.