A project for a specialized medical center that will eventually make it possible to perform more than 16 surgeries and 28 endoscopies per day on patients in the public health network has been waiting for more than a year and a half to obtain its permit from the Ministry of Health. Faced with these long delays, the construction work for the vast 30,000 square foot building located in Saint-Jérôme was put on hold.
Only a handful of construction workers were busy Monday in the three-story building, built a stone’s throw from the Saint-Jérôme hospital. “We started, but we stopped the site”, says the Dr Antoine Turcotte, orthopedic surgeon in Saint-Jérôme involved in the project with his colleagues, Dr.r Patrice Makinen and the Dr Matthew Carrier.
Last week, the Minister of Health, Christian Dubé, showed signs of impatience in the face of waiting lists for surgery which have not diminished in Quebec since the pandemic. As of December 31, 20,649 people had been waiting more than 12 months for surgery. This level was around 3000 before the health crisis. “I can’t operate for them,” the minister said last week of the surgeons.
This assertion startled the orthopedists of Saint-Jérôme. “We have been working hard for a year and a half on this project. But we are still waiting. »
PHOTO CHARLES WILLIAM PELLETIER, SPECIAL COLLABORATION
The Dr Antoine Turcotte and the Dr Patrice Makinen
We are at the rendezvous. But we can’t issue our own permit.
The Dr Antoine Turcotte, orthopedic surgeon
“There is a knot in the system. But where ? We don’t know,” said the Dr Turcotte.
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In recent years, several projects have been put forward in the Laurentians in order to maximize the number of operations that can be carried out in the public facilities of the network, from Mont-Laurier to Saint-Eustache, assures the Dr Makinen. “We optimized the technical platforms of the region before thinking of making a CMS [centre médical spécialisé] he says.
The pandemic has seriously limited the volume of operations that can be performed. Waiting lists have exploded.
Currently, 10,113 patients are waiting for an operation in the Laurentians, including 1,514 for over a year. Before the pandemic, the waiting list had 7,000 names, of which only 30 had been waiting for more than a year.
In September 2021, the CISSS des Laurentides issued a notice of intent to set up a CMS. The establishment, managed by the private sector but receiving patients from the public, had to carry out orthopedic, bariatric and general interventions, in addition to performing endoscopies while awaiting the end of the expansion work on the Saint-Jérôme hospital, planned by the end of 2028.
Shortly after, the Saint-Jérôme CMS project received a favorable opinion from the Ministry of Health and Social Services (MSSS) and construction began. The physicians involved in the project applied for an official CMS permit from the MSSS a year and a half ago. But since: nothing. “The needs are there. We see them every day, ”says the Dr Makinen.
The Federation of Medical Specialists of Quebec (FMSQ) confirms that some of its members “complain about delays in granting permits” from CMS. The organization ensures that medical specialists will always be present to work in the operating theaters of the public network, but believes that the CMS are part of the solution to accelerate catch-up surgery.
A shortage of nurses
Since the start of the pandemic, around twenty CMS have signed agreements with the government to operate on patients. These agreements allow the completion of approximately 80,000 procedures per year.
But in November 2021, Radio-Canada indicated the government’s desire to put a brake on the development of new CMS in the hope of keeping as many nurses as possible in the public network. However, the Saint-Jérôme project was to be excluded from this moratorium.
Still, the shortage of nursing staff is significant in the Laurentians as in several regions of Quebec. Of the ten operating rooms at the Saint-Jérôme hospital, only seven are currently open.
By opening their CMS, do the doctors of Saint-Jérôme not risk cannibalizing the resources of the already mortgaged public network?
CHARLES WILLIAM PELLETIER, SPECIAL COLLABORATION
The Dr Antoine Turcotte and Le Dr Patrice Makinen
It is a joint project. We don’t want to rob hospital staff. We operate there ourselves! We join the hospital.
The Dr Patrice Makinen
The Dr Patrice Makinen explains that he wants to recruit health workers “who no longer want to work in the hospital for various reasons”. Or retirees.
The Dr Turcotte reminds that only less complex cases can be operated in a CMS. With current waiting lists, these patients are often among those who wait the longest to go under the knife. The orthopedists of Saint-Jérôme deplore the fact that they have to postpone the operation date of several of their patients every day, often considered to be of lower priority than cases of oncology or trauma, for example. “We are being asked to do more. We did it. But it is stagnating. We would like things to move, ”says the Dr Makinen.
At the MSSS, it is indicated that the processing delays in CMS permit applications are “in particular linked to the pandemic and all the repercussions associated with it”. “Since the issuance of permits can have a direct impact on the network, particularly in terms of staff migration and medical availability, the MSSS has ensured that the situation is stable before starting to issue new permits,” indicates spokesperson Marie-Claude Lacasse, who assures that “all CMSs that have applied for a permit should receive a response in the coming weeks”.
Minister Dubé’s office asserts that the CMS “are part of the solution” and we “wish to use them more and perpetuate our agreements with them”.
“We must grant permits more quickly, particularly for clinics that specialize in surgeries for which the needs are the greatest,” said the minister’s press attaché, Antoine de la Durantaye. If CMS meet the criteria and are ready to contribute, we are ready to hear them and work with them. »