This text is part of the special section Unionism
Since its tabling in the spring, Bill 15 has continued to provoke reactions from unions representing workers in the health and social services network. The Alliance of Professional and Technical Personnel in Health and Social Services (APTS), which represents 65,000 professionals and technicians from the system, is particularly alarmed by the privatization and centralization of care in the province, if the reform gets the green light.
“As soon as the bill was released, it aroused great interest on our part, in order to know the government’s vision on the health and social services network to make it more efficient. Now, well, for us, there is one thing that is certain, it is that he misses the target,” estimates Émilie Charbonneau, social worker serving as vice-president of the APTS.
Tabled last March by Minister Dubé, Bill 15 has the main objective of improving the efficiency of the health and social services system, by reviewing its governance through the creation of a new agency, Santé Québec, which would take care of network management. For meme Charbonneau, the reform would only weaken the system, a fragility which was especially highlighted during the pandemic, she recalls. “With this bill, more than ever, we are opening the door to the privatization of the health and social services network. The bill is inspired in particular by the case of Alberta. To reduce waiting lists and to have better access to care, this province has redirected many interventions to the private sector,” explains the unionist.
After studying the Alberta case through a report published last May, the APTS concludes that “if waiting lists are shorter, accessibility to quality care is greatly impacted . Recourse to the private sector means that we have a revolving door syndrome. When cases sent to the private sector become more complex, these people are rehospitalized in the public sector,” explains the vice-president, who adds that the hospitalization time in Alberta is, ultimately, higher than in Quebec.
Far from the network
The APTS is also concerned about the centralization of the health and social services sector, if the bill were to move forward. “It would be such a great centralization that we will weaken the network. People no longer recognized themselves in the megastructures created by the last Barrette reform. This is what causes our people to leave the network,” laments Mme Charbonneau.
According to the social worker, centralization would contribute to the “disconnection” of workers from the health and social services network to the system. “By creating the Santé Québec agency, people will no longer have a say. Those who provide care would not be involved in the construction of this care. Workers will find themselves completely dispossessed by their workplace,” she denounces.
In order for the network to be more “resilient”, Émilie Charbonneau believes that it is by “decentralizing” it that it will become so, particularly in relation to issues of health and safety at work. “Centralization would also have harmful impacts on the occupational safety and health of workers. Already with Bill 10, this was an area that had been affected. It was difficult to treat and they were barely able to meet legal obligations for prevention. So, how can a super agency be close to its workers and present upstream to resolve problems that are sometimes very concrete and very focused on the field? » she asks.
According to the vice-president of the APTS, for a reform to be truly effective, it must first achieve “consensus”. “The best way is to ensure that people adhere to it and that it is not imposed. However, the only thing that there is consensus about in Bill 15 is that there is no consensus. For it to work, we must consult people who are in the health and social services network and who are also providers. There is no miracle solution,” she emphasizes.
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