It is difficult to make concrete the effects of the overhaul of health in which the Minister of Health Christian Dubé is committed when the figures persist in giving us the image of a network in distress. The return of bright red in the emergency dashboard, combined with a dark series of surgical postponements and the imminent threat of a breakdown in service in the Rivière-Rouge emergency room, constitute all alarm signals which tell of a fatality which it is difficult to imagine could be broken.
According to a Pallas Data/Qc125/ surveyNews carried out at the end of January, nearly two-thirds of Quebecers doubt that the Dubé reform — and its trump card, the creation of the Santé Québec agency — could change anything in the current disgraceful situation. Their pessimism is shared by many observers. And for good reason: the megalaw made up of some 1,200 articles imagined by the minister is a restive mammoth that the rigidity of the public network risks stinging if we don’t throw some ballast at it.
However, there will be some ballast given the lifting, a few days ago, of a lock surrounding travel between units, hospitals or health establishments within the largest union in the health sector. Basically, Quebec wanted to make travel compulsory “in all directions” and “unconditionally”. He’s glad he didn’t go there.
Health care workers have had a taste of “breaking” arms with the explosion of “mandatory overtime”. It is documented that this coercive approach prematurely wears out teams while fueling the shortage it is intended to alleviate. It is not for nothing that the minister is committed to putting an end to it: it is a serial killer of vocations.
In contrast, the incentive agreement concluded with the union members of the Federation of Health and Social Services (FSSS-CSN) demonstrates that the proverbial “flexibility” fiercely contested by the two parties can be achieved for the benefit of all with a little willpower. In exchange for voluntary travel, employees will be offered a lump sum of $50 or $100 per day, in addition to mileage reimbursement. Better still, beneficiary attendants and nurses will now be able to self-manage their schedules if such a formula suits them. This is all the more important since we know that it works where it has been tested.
Another central obstacle lifted by the agreement with the FSSS-CSN concerns the seniority of employees who have been on the move. The government has undertaken to recognize them for up to five years of seniority. Its primary goal is to bring back into the public fold the thousands of active forces who have exiled themselves in private employment agencies without losing too much in the process. But this recognition will also be granted to union members who have left one public establishment to work in another. Until now, these saw the counter restart from zero. It’s significant.
Remember that the Legault government has given itself until 2026 to eliminate the use of private agencies. The tide looks set to be difficult to reverse. Data compiled by colleague Jean-Louis Bordeleau in The duty show that the number of employment agencies, all job categories combined, has continued to quadruple in Quebec since 2020. Monday, THE Montreal Journal still recorded more than 340,000 shifts at agencies in nine months. It’s pachydermic.
The movement towards the public is, however, well and truly underway. The Association of Private Healthcare Personnel Companies of Quebec has even begun to denounce an “aggressive” strategy on the part of certain public actors in The Press. Certainly, there are more elegant ways than others to go about raiding, and blackmail is not one of them. The fact remains that the agencies only have their greed to blame: the rules have been stated frankly, it is now up to them to reinvent themselves.
Quebec must also fiercely resist any temptation to go back. Because he will have to inject a lot more ballast. Hence the importance of doing what is necessary to solidify these initial achievements, knowing that the questions of travel like that of seniority remain points of dispute in the negotiation which is continuing hush-hush with the Interprofessional Health Federation of Quebec (FIQ) and in that which must resume shortly with the Health Federation (FSQ).
The Legault government has considerably improved our tools for measuring the vitality of ministries in recent years. It would benefit from developing a similar tool for its reforms in health and education, sectors where the problems are so great that they systematically screen out progress, even the most considerable. A dashboard would not only allow Quebecers to get the facts right, but also, through the band, to encourage emulation, another key factor in taming this great mammoth with its naturally rebellious nature.