Minister Christian Dubé had promised in the spring that the front-line access counters (GAP), a flagship measure of his plan to reform the public health network, would be fully deployed throughout Quebec by 1er September. The duty learned that this deadline had just been extended by a month.
The Ministry of Health and Social Services (MSSS) is now asking the GAPs in the various regions to be fully functional “in September”. “It could be September 30, depending on the health establishments,” recognizes the spokesperson for the MSSS Marie-Hélène Émond. “We don’t want to create false expectations [dans la population]. »
Launched in June, the GAPs aim to offer orphan patients—waiting for a family doctor or registered with a group of family doctors—the right care at the right time by the right professional.
Increasingly in demand, these new counters have experienced failures in recent weeks. A patient reported having waited four hours on the GAP de l’Estrie telephone line without being able to speak to anyone.
The Côte-Nord has decided to postpone the full deployment of its GAP until September 19 in order to prevent its system from “crashing”, indicates the head of its regional department of general medicine, Dr.r Roger Dube. The region’s GAP is understaffed. A total of three nurses are to be assigned there in September, but one of them must return to her old position for a few weeks to help her ex-colleagues. According to the Dr Dubé, the target of 1er September — a promise he describes as “political” — no longer held water in the context. “I want to respect the deadlines given to me,” he says. But we are going to be human, we are going to respect our world too. »
Despite the date change, the CISSS de l’Outaouais says, for its part, to stay the course on the 1er september.
The CISSS of Chaudière-Appalaches ensures for its part that it will respect the new deadline of September 15. He specifies that four employees are to start working at GAP next month. Four new positions will also be created during the next posting.
Skepticism among patients
The Provincial Regrouping of Users’ Committees believes that the government must stop making announcements if it “is unable to meet its commitments” on the ground. “We are told that we will be supported by a team,” said strategic advisor Marc Rochefort. “We are already short of employees in hospitals, CLSCs, CHSLDs. Where are we going to take them, these psychosocial, medical and nursing staff, to work in the various GAPs? »
According to Mr. Rochefort, patients “do not believe” in this new “gadget” that is the GAP. “It’s as if people have the feeling that they are abandoned behind all this. »
The president of the Council for the protection of the sick, Paul Brunet, believes that the CIUSSS and the CISSS must take advantage of the additional time to correct the problems of their GAP. “Rejected phone calls, unanswered calls, appointments given very far from where the person lives… And above all, the maximum interval of 72 hours not respected [pour un besoin urgent]it’s a promise”, he underlines.
According to him, a single “magic number” will indicate whether the new counters work. “If people continue to go to the emergency room and the number of ambulatory patients does not decrease, that will mean that the system [du GAP] off-putting, impractical, or people failing to see a healthcare professional within 36 to 72 hours as promised,” says Paul Brunet.
For the moment, GAPs have no effect on emergencies, according to the president of the Association of Specialists in Emergency Medicine of Quebec, Dr.r Gilbert Boucher. “There are still many patients who tell us that they have not been able to get appointments or services elsewhere,” he notes.
About half of the approximately 10,000 emergency room visits are less urgent or non-urgent cases, the MSSS dashboard indicates.
Not yet at their full potential
GAPs are still far from having reached their full potential, according to the head of the Regional Department of General Medicine in Montreal, Dr.D Ariane Murray, GAP deployment manager. Currently, patients referred to a professional are often referred to family physicians.
The DD Murray also expects this situation to continue “at the beginning of the first phases of the GAP”. “When you’ve been at the counter for three, four or five years [d’accès à un médecin de famille] and you haven’t had a refill of medication, at some point you need an evaluation by a family doctor,” she says.
She estimates that in an “ideal” world, around ten types of professionals would be easily accessible thanks to the GAP. However, Quebecers will have to be patient for this “innovation” to develop, argues the DD Murray. “It will take a little longer before[que les patients aient] real access, in a meaningful way, to other professionals such as physiotherapists, psychologists, social workers. »