The Dubé reform presents an “undeniable risk” for the continuity of patient care and for care in remote regions, because of the increased mobility that it will require of personnel, judges the FIQ.
The Interprofessional Health Federation, which represents 80,000 nurses, nursing assistants and other healthcare professionals, delivers this sharp verdict in the brief it sent to the health and social services commission which is studying the bill. 15 filed by Minister Christian Dubé.
Moreover, the FIQ and the FIQP (private) consider that “under the guise of laudable objectives”, the bill “endangers the universality, accessibility, equity and quality of care as well as the union democracy,” she says.
The FIQ agrees with the Minister: the status quo is no longer acceptable; we need a change of culture, local management and greater efficiency of structures.
Problems with mobility
Since there will be a single employer — Santé Québec — and since Québec wants there to be a single seniority per professional for all of Québec, and not per establishment, the FIQ concludes that the nurses will have to demonstrate “increased mobility and unlimited” to meet the needs of the agency.
And this phenomenon worries him. “Is it reasonable to believe that a school health nurse can work with seniors or in intensive care, overnight? »
“It is also possible that mobility within the network has negative impacts on access to care in certain regions far from major centers or in certain care sectors, whether CHSLDs or hospitals, for example. Care settings known for their problematic work organization could in particular be abandoned in favor of more attractive settings,” the FIQ judges.
As for the risks affecting the continuity of care, the FIQ again explains its fears by the increased mobility expected of the personnel. “Not only is nothing in the project put in place to ensure the stability and adequate staffing of the care teams, but if it were adopted as is, it would destabilize and further weaken the care teams by allowing excessive mobility. “, she writes.
She gives the example of CHSLDs which experienced enormous difficulties at the height of the COVID-19 pandemic. “Staff mobility has a negative impact on the quality of care offered in addition to contributing to the spread of infections and viruses. »
Too much private space
The reform also places too much emphasis on the private sector, particularly in specialized medical centres, “the big winners of this reform”, judges the FIQ.
The bill “must not become a Trojan horse that will mark the end of the public network born of the Quiet Revolution, by allowing the private sector, for profit or not for profit, to replace the State in some of its fundamental missions with the most vulnerable people, in home care and mental health, in particular”.
Too centralized
The Dubé reform also provides for an overly centralized network, which loses its ability to adapt to local realities and whose local managers will in reality enjoy little room for manoeuvre, apprehends the FIQ.
“Bill No. 15 will only accentuate this loss of contact with the field, particularly in terms of management”, considers the trade union organization.