Surgical catch-up plan | 400 million are lying dormant in state coffers

(Quebec) A key measure of Christian Dubé’s surgical catch-up plan is slow to materialize. A pot of 400 million, which should make it possible to pay overtime to nurses ready to work extra hard in operating theaters, is sleeping in the state coffers, we have learned The Press.

Last May, Minister Dubé and the president of the Federation of Specialist Physicians of Quebec (FMSQ), Dr.^r Vincent Oliva, announced the deployment of a new surgical catch-up plan. Efforts will be made on operations that have been pending for more than a year.

Target ? Bring the list back to the pre-pandemic level, i.e. some 2,500 patients, by December 31, 2024. One of the key elements of the success of the operation: the availability of the workforce .

Quebec thus revealed that a sum of 400 million would be distributed to establishments to offer overtime to staff who wish to lend a hand in operating theaters. The sums come from the Institute for the Relevance of Medical Acts (IPAM).

However, five months after the announcement, these sums are still in the coffers of the Quebec state, confirmed in an email to The Press the Ministry of Health and Social Services (MSSS).

“We committed to making an offer to our staff that we will have to repeat,” admitted Mr. Dubé in an interview on Monday.

According to the minister, “it is almost normal” that the sums have not been spent until now due to the holiday period, when nurses are already in great demand.

The Interprofessional Health Federation of Quebec (FIQ) did not want to comment on the information from The Press.

For its part, the FMSQ indicates that it is “regrettable, at a time of lengthening waiting lists, that the mobilization [des spécialistes] comes up against the inability of the MSSS to implement the conditions required for the proper deployment of the catch-up plan.

The D^r Oliva also signed an open letter two weeks ago in The Press affirming that the surgical catch-up plan “hits a wall”, since the workforce is not there.

The activity rate in operating theaters is 74% on average in Quebec hospitals.

“The money is available,” assures Dubé

The Minister of Health assures that “the money is available” for health establishments which will raise their hands. However, the MSSS explains instead that a committee formed to ensure the distribution of sums in the network has not yet completed its work.

“The amounts will allow the remuneration of network staff who will contribute to the catch-up blitz and the realization of emerging projects approved by the steering committee” made up of the IPAM, the MSSS and the FMSQ, underlines the Ministry, again by email.

The “financing arrangements will be concluded” by the end of the month, we assure. It is planned that the sums will be distributed among the establishments according to “their share of the reduction of the list” of operations pending for more than a year. Each establishment has a target to achieve by December 31, 2024, as well as an interim target by March 31, 2024.

In an interview, Minister Dubé attributes these delays to poor communication of his “offer” across the network. He reiterates that the funds are ready to be spent.

The Legault government hopes to mobilize clinical teams to voluntarily perform surgical interventions in addition to normal activities and during unfavorable shifts.

Progress and challenges

Quebec has managed in recent months to reduce the list of patients waiting for surgery for more than a year. There were 17,512 as of March 31, 2023, compared to 14,296 at the most recent report, published on September 9. Minister Dubé is delighted.

“We are far from having hit a wall […] because I’m early [sur mon volume d’interventions chirurgicales] compared to last year,” replied Mr. Dubé, alluding to the FMSQ letter. In fact, the annual cumulative total reached 177,889 operations carried out, which is the highest volume for the same period since 2020 – the year the pandemic began.

However, the increase in new operation requests darkens the picture. As of August 12, 158,427 patients were waiting to go under the knife in Quebec. One month later (September 9), 163,463 people were waiting.

To date, 25 million have been spent from the MSSS budgets for the implementation of various measures of the catch-up plan, such as better support for establishments, regional tours, the purchase of equipment and the revision of trajectories and planning of surgical interventions.

Quebec did not set targets for operations in general, choosing to first tackle the list more than a year old. In June 2021, Mr. Dubé set himself a series of objectives which were abandoned due to subsequent waves of the pandemic.