(Quebec) The health network suffers from an “extremely strong structural dependence” on labor placement agencies, particularly in the supply of home care, concludes the Institute for Social Research and Information -economic (IRIS), in a new study. Quebec will have to “completely review its model” if it wants to reach its targets and make home care a priority.
Posted at 5:00 a.m.
It is well known that the use of placement agencies has exploded in recent years in Quebec, particularly since the pandemic. What is less so is that it is the home support services (SAD) that suffer the most.
They are indeed worth nearly 30% (27.2%) of the total hours offered by agencies throughout the health network in 2020-2021, reveals IRIS on Wednesday. “There is a huge rate there,” argues Anne Plourde, researcher and author of the study. This has “well-known harmful consequences on the quality of services”, she adds.
Surprisingly, this rate was 27.9% the year before the health crisis, in 2019-2020.
It surprised us, but home care may have been less directly affected by the pandemic, unlike various sectors where more intensive use of agencies has been made.
Anne Plourde, researcher and author of the study
Quebec will therefore have to raise the bar if it hopes to wean itself off private agencies, believes IRIS. The MSSS has its sights set on reducing the “rate of recourse to independent labour” to 2.27% for all hours worked in the health and social services network (RSSS) by 2021-2022.
The measure, which is part of the MSSS’s 2019-2023 strategic plan, was adjusted due to the pandemic with the “starting measure” being the rate as of March 31, 2021, which was 2.56%. Throughout the pandemic year (2020-2021), the use of agencies has reached 5%, says Mme Plunder.
Hard-to-reach targets
“What we’re arguing is that it’s going to be difficult to achieve the targets for the network in general if we don’t see what’s going on in one of the sectors where we use the most labor- self-employed: the home care sector,” she says.
While accommodation environments have been damaged during the pandemic, the Legault government promised in November a “big shift” towards home care. Quebec has given the Health and Welfare Commissioner the mandate to examine best practices to “make the right choices”.
The growth in the use of agencies is also almost twice as fast in the DCS sector (81%) than in the rest of the network (48%) from 2015-2016 to 2019-2020. The financial benefit of using independent labor for DSS also dropped from $13 per hour to $4 per hour for those same years.
Regional disparities
According to the researcher, “the use of agency services is a political and managerial choice, as evidenced by the significant disparities in the use of placement agencies from one region to another”. IRIS relied on data from all CISSSs and CIUSSSs in the province to draw up its findings.
His study reveals that the use of independent labor for home services varies from 22.56% to 49.07% only in the greater Montreal area. In other regions, such as the CIUSSS de l’Outaouais, the rate of hours worked in home care is barely 0.98%.
This therefore demonstrates that the issue is not always the shortage of personnel. “In the same territory, as in Montreal, for example, we do not see how there would be great disparities in terms of the availability of personnel […], it gives the impression that there are managerial choices that have been made, ”she illustrates.
Despite everything, she suggests deploying emergency training programs, as the Legault government did for beneficiary attendants, to quickly increase the number of health and social services auxiliaries.