On March 29, the “Plan to implement the necessary changes in health”, henceforth called “Plan Dubé”, was tabled. The Minister of Health and Social Services, Christian Dubé, affirms that he is betting “on relevance, efficiency and the creation of values, in accordance with the principles that are dear to me, and that are dear to our society. : universality, accessibility, equity and quality of care. These principles drive us and guide our own work, as well as our activism. They must serve as a beacon for any health policy decision, big or small; it is about our common humanity.
The announced reorganization contradicts these fundamental principles. As the election campaign begins its home stretch, it appears that they are not guiding the orientations announced by the CAQ in terms of health either.
Universality, accessibility, equity and quality? Let’s see…
Among the shortcomings, it is clear that nothing is planned to guarantee the universality of care for adults, whose migratory status is precarious. It is true that with the adoption, a year ago, of Law 83, children can now access the health system. But what about their parents, whose health is in danger, because they are not entitled to health care, or when these children turn 18? The regularization of all precarious migrants would solve the problem of universal access to health care.
Prime Minister Trudeau instructed his Minister of Immigration to create a program giving permanent resident status to undocumented people; the Government of Quebec should support and promote this initiative by facilitating the granting of permanent residence to all precarious migrants.
The CAQ’s obstinate denial of the presence of systemic racism does not exclude its existence in Quebec. The Dubé Plan and the CAQ’s election commitments do not mention any of the recommendations put forward by the Atikamekw nation to put an end to the injustices experienced by Aboriginal people within our health system.
It was in a Quebec where systemic racism exists that Joyce Echaquan died, a victim of it, and this silence is yet another violence. Recognizing Joyce’s Principle and applying it in any reform of health and social services must go without saying.
Although the Dubé Plan recognizes the importance of “reducing social inequalities that have an impact on health”, it does not propose anything concrete to reduce them. Currently, marginalized populations do not receive dignified and adequate care, including LGBTQA2S communities, racialized communities, women and men in prison, homeless people. Will people with functional limitations finally receive decent and adequate health care at home?
Privatization v. the principles that are dear to us
Future generations will pay the price for the dismantling of the public system, already well underway under previous governments, and the CAQ proposes to continue to weaken it.
Our public health care system is no longer the ideal dreamed of during the Quiet Revolution. It is a victim of two decades of neoliberal management, chronic underfunding, centralization and senseless bureaucratic reforms. He suffers from the lack of respect and consideration for his workers, who work there with all their heart and skills.
The CAQ’s announcements towards greater privatization in health will have disastrous consequences on the universality, equity, accessibility and quality of health care in Quebec. From its own experience with cost overruns, the government knows that relying on the private sector to replace public sector personnel is neither economically viable nor socially acceptable. A look south of the border is enough to be convinced.
The population deserves a 100% public system and this requires solving the shortage of healthcare personnel, particularly nurses, by investing in the public sector first and not in the private sector.
Far from the democratization of health
Although article 2 of the LSSSS guarantees the participation of the population in its own health, physical as well as mental, nothing is proposed to work with neglected and marginalized communities in order to learn how to make health care truly accessible. The way Plan Dubé considers community organizations is also eloquent in this regard, counting them as part of its own resources, while they are autonomous.
In addition to offering the public a response other than that of the network, community groups allow citizens to participate in decisions that influence their health. The democratization of health should be at the heart of decisions and of any reform, in particular by ensuring the autonomy of community groups and the continuation of their activities, as well as by giving decision-making power back to communities and health care personnel, for example, as at the origin of CLSCs.
A shot within a shot
To these examples of inconsistencies between what the CAQ envisages for its next mandate and the values advocated by the Plan Dubé are added announcements that will have consequences on the right to health. From the announced tax cuts to the reluctance to welcome more than 50,000 immigrants, the CAQ’s commitments will harm Quebec society in general and the funding of public services in particular.
Rather than stopping the demolition of the public health and social services system, a CAQ government will make a major contribution to it, in defiance of the societal choice that has been ours for a very long time.