One could have imagined that after 10 years of existence offering free health care without appointment in Lower Town of Quebec based on a unique and essential model, the SABSA clinic would no longer have to fight to finance its activities. activities. Well, that would be overestimating the crass numbness of our system. It is perhaps a little more accepting of models of care that go beyond the traditional mold, but not to the point of including them in the government’s official funding scale.
SABSA, do you know? For 10 years, our journalist Isabelle Porter has followed the fascinating and essential activities of this cooperative clinic, originally started around 2011 to treat vulnerable clients suffering in particular from hepatitis C and HIV. The acronym SABSA, for “low accessibility threshold services”, reflects the nature of its clientele — the most deprived in society, the excluded and the reclusive, citizens who, sometimes, do not even have a card. health insurance. The SABSA cooperative opens its doors to them, and offers the care that specialist nurse practitioners (NPs) and psychosocial support staff can provide.
In addition to an intervention component focused on hepatitis C, HIV and other STBBIs (sexually transmitted and blood-borne infections), nurses can respond to several common front-line problems, from otitis to pneumonia or cystitis, and offer pregnancy follow-ups, renew medication prescriptions, and can prescribe certain diagnostic tests. In short, they can respond to several of the most common problems encountered in a medical office, once an appointment has been made.
The beauty of SABSA, according to patients encountered there over the years by our journalist, is precisely that no appointment is necessary. In January 2015, here is what Jennifer confided to Duty : “I like coming here because I can come anytime,” says this ex-drug addict. “I’m not good with dates. »
The cooperative opens its door, among others, to drug addict clients with grandiose health needs, but who often find themselves excluded from traditional entry points. The former PQ Minister of Employment and Social Solidarity Agnès Maltais, now president of the SABSA Foundation, recalls that SABSA’s entry into the field was disturbing at the start. “When SABSA arrived, it shook everyone up, but now, the clinic has become essential in the network. » Today, this award-winning clinic, cited as an example, has become a reference for the traditional health network, which very often secretly sends it patients it cannot serve.
We read all this and we cannot help but salute the hard work of these complementary community networks, whose feet are firmly anchored in the very concrete aspects of life in all its ramifications, the beautiful ones, but also the very ugly ones, give them a precious, beneficent and essential status.
Would such a portrait lead us to believe that after 10 years of such medicine for humanity, the SABSA cooperative is sailing on a cushion of stable financing? Nay! As our reporter reported on Saturday, a decade after its opening, SABSA is still pulling the devil by the tail. Supreme irony: the clinic is not eligible for a program launched in 2022 by the Quebec government to finance nursing clinics, even though it offers a “real” walk-in service and prides itself on not to turn anyone away. Her success is such that she has extended her tentacles into Charlevoix and has been named responsible for a file as important as supervised consumption monitoring.
If it is from its uniqueness that it owes its extraordinary success, it is also unfortunately because of this that it still apparently has to endure its greatest worries, namely the fact of not being able to count on stable and lasting financing which allows it to to serve its customers. SABSA and its cooperative model, you see, does not yet fit neatly into the boxes. Quebec has promised a reference framework where a precise procedure will be provided for the originals like SABSA. It will be ready… within two years? It makes no sense.
We must recognize gigantic advances since the time when SABSA was interesting with its unique model, but disturbing, because it announced a form of revolution by not employing any doctors. The Minister of Health at the time, Gaétan Barrette, did not completely turn his nose up at the model, but he seemed to fear like the plague the creation of a “parallel network”. Minister Christian Dubé is not of this opinion and seems allergic to sterile resistance, especially if the good of patients is at stake. There is still some sarcasm in rereading the fears of parallel networks, when we see that today Today it is difficult to find nurses who are deserting a disreputable public network to conquer the private sector.
Between free co-op and paid private, where should our heart swing?