Urgences-santé is under the microscope of Quebec. The Minister of Health, Christian Dubé, will appoint an independent auditor in the coming weeks to examine “in depth the organization of work and the use of budgets” of the public pre-hospital services company, which covers the territories from Montreal and Laval. He announced this to the president and CEO in a letter he sent to him on Tuesday and of which The duty got a copy.
In his two-page missive, Minister Christian Dubé reports to the CEO of Urgences-santé, François Charpentier, that his team noted a “significant disparity” between the “authorized service hours” and the “service hours” delivered.” “The situation reports that you submitted to the office of the Deputy Minister, Mr. Daniel Paré, on January 26 and April 9, 2024 show a significant difference of 111,913 hours of service interruption, thus representing 20% of your service hours authorized,” he wrote.
Under a new service contract concluded in July 2023 with Quebec, the province’s 53 ambulance companies are required to submit their audited financial statements to the Ministry of Health and Social Services (MSSS) each year. The MSSS particularly wants to check the number of “hours delivered” to measure their performance.
According to a government source, these companies “deliver 99 or 100% of the hours authorized” by the MSSS, compared to 80% at Urgences-santé. “When we compare your organization with the rest of Quebec, the number of hours of services delivered by Urgences-santé is much lower,” underlines Christian Dubé in the letter.
The minister adds that a series of decisions taken by Urgences-santé raise “certain questions”, including: a call for tenders to use independent labor while the government is trying to wean itself from it; a 47.06% increase in “managerial staff” between April 2019 and December 2023; a 19.64% decrease in emergency medical dispatchers during the same period; as well as a “questioning of the participation” of a representative of the MSSS at the negotiating table of paramedic ambulance technicians from Urgences-santé.
Christian Dubé also indicates that a “draft management and accountability agreement” is on the table and that it must be signed “no later than April 30”. He states that he has “more specific expectations” regarding, among other things, reaching the time to get back on the road between the release of the stretcher and the ambulance getting back on the road (“lower or equal to 25 minutes, zero seconds) and the delivery of a “maximum hours of services authorized in the organizational plan”.
“More transparency, performance and accountability”
Questioned about this letter, the office of the Minister of Health recalls that Urgences-santé is committed, like other ambulance companies, to putting in place measures “for greater transparency, performance and accountability” .
“In recent weeks, we have learned that despite Urgences-santé’s commitment, a significant number of hours of service had not been delivered this year,” we write. An independent analysis is therefore necessary “to paint a fair picture of the situation”. “When it comes to taxpayers’ money, there is no compromise,” the firm says. What matters to us is patient service. If there are fixes to be made, we will do them. »
Asked to react, the CEO of Urgences-santé replied that he “will collaborate fully” with the MSSS and the independent auditor. “As an emergency service, our top priority is to ensure the safety and well-being of all members of the community,” says François Charpentier in a written statement sent to the Duty. This collaboration with the MSSS demonstrates our commitment and will also highlight our particularities and the challenges that we will have to take on in the years to come. »
François Charpentier assures that his organization will report “transparently and completely” on its “human and financial resources”. “The goal of this exercise is to achieve efficiency gains to better serve the population,” he continues.
Remember that the CEO of Urgences-santé made a public outing last January to plead in favor of a “nationalization” of pre-hospital services in Quebec. He then estimated that with the billion dollars invested annually by the Quebec government in the prehospital sector, the system could “do much better and be much more efficient.” He emphasized that the Urgences-santé budget amounts to approximately $200 million for 38% of calls in Quebec.
The reactions were quick. The Corporation of Ambulance Services of Quebec (CSAQ) and the Federation of Paramedic Cooperatives of Quebec (FCPQ) had rejected its nationalization proposal, emphasizing that Urgences-santé is far from being an “exemplary model” and that it needed to improve its performance in delivering its services.
“When he talks about nationalizing, it is to compensate for the lack of labor, the poor management or use of the resources that there are on the territory of Montreal and Laval,” he said. Duty the president of the CSAQ, Dr Sébastien Toussaint, who notably represents 28 ambulance companies.