(Quebec) The helping hand from Ottawa allows the Legault government to inject a billion in new money into health this year. The lion’s share goes to Christian Dubé’s Health Plan, which wants to keep the vaccination centers to unclog hospitals and tackle the wait for surgery. Mental health gets “a footnote”, deplores Québec solidaire.
Although insufficient in the eyes of Quebec, the increase in federal health transfers benefits the aims of the Minister of Health, who presented his recovery plan for the health and social services network, damaged during the pandemic.
Quebec will extend one billion more per year for five years in its health network for additional investments of 5.6 billion by 2027-2028.
This is the bulk of the amounts it will receive annually thanks to the increase in federal transfers (approximately 4.7 billion over the next 5 years).
” The sums [du fédéral] are modest on the whole of the financial framework,” nuanced the Minister of Finance, Eric Girard. “These amounts go everywhere because the priorities of the federal government are personnel, home care, data, technologies, surgeries”.
The sums [du fédéral] are taken in terms of income and we have made a considerable effort to deploy our Health Plan.
Eric Girard, Minister of Finance
How much ?
Additional federal funding in health
- 4.7 billion over five years
- 1.01 billion in 2023-2024
Spending growth for the health portfolio – the government’s largest budget item – is also greater than expected at 7.7%.
This increase was initially expected to be around 4.5% due to new federal funds and the upcoming renewal of collective agreements for health care workers. It also takes into account non-recurring expenses related to the pandemic.
Without these “adjustments,” spending growth would be much more modest, at 2.1%. Growth must also stabilize from 2024-2025 when the pandemic should be last.
Health spending growth
- 2022-2023: 5.8 billion + 12% (pandemic year)
- 2023-2024: 59 billion + 7.7%
- 2024-2025: 60 billion + 3.6%
How much ?
To straightenserve the systemth of health
- 5.6 billion over five years
- 1 billion for 2023-202
Improve the “efficiency” of the network
Minister Dubé will be able to count on a new kitty of 3 billion, including 612 million for the first year, to make the health system more efficient. The bulk of the money will be used to “adapt the health sector to post-pandemic realities,” the budget reads.
First surprise: Quebec will extend 272 million this year to keep vaccination and screening centers open, where prevention activities and other front-line services will be added to relieve congestion in the hospital system.
The Minister of Finance mentioned, for example, blood samples, which could be taken in these centers rather than in hospitals or CLSCs. We are not talking here about mega centers, such as the Olympic Stadium or the Palais des Congrès, but about smaller clinics.
We would like to keep at least one per region, we said. The objective would be to keep employees recruited via the Je contribu platform. For the time being, these workers are still on the job at least until the renewal of the collective agreements.
We are also adding 148 million this year to update “the emergency measures plan” and replenish the inventories of personal protective equipment (PPE) to face a new health crisis.
How much ?
To make the network “more efficient”
- 3 billion over five years
- 612.5 million in 2023-2024
Creation of the Health Quebec agency
The Legault government is also injecting 60 million over two years (20 million this year, then 40 million next year) to create the Health Quebec agency, the next major project of the Minister of Health. His bill is expected next week in Quebec.
Christian Dubé promised that his reform, which aims to decentralize the health system to make it more efficient, would “shake” the columns of the temple by modifying the current structures. The announced budgets can be used to hire local managers, in particular.
All operational aspects of the Department will be centralized in this new agency, which will be headed by a CEO. The Department will retain its role of developing policies, the budget, strategies and major orientations in accordance with government priorities.
The Press reported on Monday that the Minister hopes to hire the “top guns” of the industry to carry out his reform, which should come into force in 2024. The amounts announced in the Girard budget will also be used for a “transition period of two years “.
Onslaught for surgeries
Another novelty, Quebec is reviewing from 1er April the healthcare facility funding model to tackle surgical wait lists. That is to say, the establishments will obtain financing on a piece-work basis, according to their volume of surgery.
The network already operates in this way for activities in radiation oncology, medical imaging and colonoscopy/digestive endoscopy. In the radiation oncology sector, Quebec recorded a 26% increase in productivity compared to 2014-2015.
The government thus hopes to boost the “performance” of hospitals and reduce waiting times for surgery. Waiting lists have been at record highs since the pandemic. As of December 31, 20,649 people had been waiting for surgery for over a year.
The goal is to “return” this number to the pre-pandemic level – around 3,000 – in 2024. Last year, Mr. Dubé said he wanted to reach this target by April 2023. The shortage of personnel weighs down catch-up efforts so operating theater activities are still limited.
Addition of IPS clinics
Quebec also plans to create 23 new specialized nurse practitioner (SNP) clinics over the next 5 years, including 6 next year, to increase access to the first line. The creation of these clinics will require total investments of 395 million by 2027-2028.
This kind of clinic has proven its worth in relieving congestion in emergency rooms that were hit by heavy traffic last fall. This is a measure that was identified by the crisis unit created by Minister Dubé to identify solutions.
Last year, six IPS clinics from elsewhere were created. Their number will therefore reach 12 over the next year.
Few additions for sanity
Despite the tragedies of Laval, Amqui and Rosemont which shook Quebec, mental health gets “a footnote” in the Girard budget, lamented Quebec solidaire.
Quebec is investing $40 million more this year to increase access to mental health, homelessness and addiction services. Precisely to respond to mental health issues, the amounts reach 27 million in 2023-2024.
“It’s extremely important,” defended Minister Girard, who recalled that the government has made significant investments since it came to power. “The needs have increased,” he admits.
How much ?
Mental health access, homelessnessand dependsance
- 211.2 million over 5 years
- 40 million in 2023-2024
In short
Home Care
Quebec is continuing its shift towards home care by investing $103 million this year. This is less than the CAQ’s electoral commitment, which provided for sums of 150 million in 2023-2024. The government plans to increase the pace of its investments to reach additional sums of $963.5 million within 5 years. With the 100 million this year, Quebec estimates that it has invested 2.68 billion in home care since coming to power. The Legault government is still awaiting the recommendations of the health and welfare commissioner, Joanne Castonguay, who has had the special mandate to examine the financing of home care. It must deliver its report no later than December 31, 2023. The number of people aged 65 and over will increase from 1.8 million in 2022 to nearly 2.5 million in 2041.
Private CHSLDs
Quebec is giving itself five years (20 million per year) to contract the quarantine of private CHSLDs with the aim of “harmonizing the supply of care”. The Legault government concluded a first pilot project last year which made it possible to contract three private establishments. We learn in the budget that the agreement process has progressed “notably” in recent months in 16 private CHSLDs. Quebec had in its sights to contract about twenty private establishments as of March 31, 2023.
Free vaccine for shingles
Quebecers will be able to get vaccinated against shingles free of charge. The Legault government reserves 124.6 million over 5 years to provide free access to vaccination against this viral infection, which causes a painful rash. Quebec hopes to vaccinate 800,000 people during this period. People who have had chickenpox are susceptible to developing shingles at any age, however older adults or those who are immunocompromised develop it more often.