Posted at 2:00 p.m.
On January 18, 2022, it was a tired Minister of Health who spoke of the end of the rope. Its Deputy Minister, the DD Opatrny, is in reflection with a working group in order to review our approach and our care for patients.
In his Guide for prioritizing and managing short-term hospitalizations in the context of the COVID-19 pandemic, we talk about the compromises made necessary to treat the greatest number to the detriment of the quality of care. It is specified that this radical change will be temporary. Never in our recent history have we seen the health care system so on the edge of the precipice.
This apocalyptic vision is an outright capitulation of the system unable to think “outside the box”. Today, we will have to be imaginative to design more original and creative solutions.
More than ever, we will have to establish intermediate scenarios before thinking of the worst and signing an armistice with the virus and abdicating on “the quality of care”.
An outdated healthcare system. A broken healthcare system. But a health system capable of recovering!
Many had mentioned it even before the pandemic: our health system is hospital-centered. The context of the global COVID-19 pandemic has demonstrated this intensely. The health system is like a vast field of monoculture that must be sprayed with ever more pesticides and herbicides for declining yields. In two years, what has the government done to decentralize and thus reduce our dependence on Quebec hospitals? Does the system have a safety net, a plan B? An outpatient contingency plan? Is the system capable of preventing the occurrence of serious cases? It is precisely outside hospitals that the solution can be found.
Underused CLSCs
It was in 1970 that the first CLSCs were inaugurated. Today, they are spread all over the territory. These local community service centers are primarily local service centres. They have never been exploited to their full potential. The government, through Public Health, has been busy recalling the barrier measures and establishing an effective vaccination process, but once the citizens are infected, what happens? Do they have medical advice or even care before going to the nearest hospital? Where are we with home care services? It is obvious that today, it is necessary to hasten the step on this file.
Moreover, during the various epidemic peaks, have we put the family doctors who are dedicated to primary care to good use?
They can be essential allies to reduce hospital traffic, as several studies show. The economies of scale that will be generated will not only be calculated on a column of figures, but also in terms of human resources. The Covid context is certainly no exception.
The Scandinavian countries restructured their network in the early 1990s. Their reforms enabled real coverage of primary care throughout the territory and an effective deployment of home care. Finland has a very low death rate per million from COVID-19 with a vaccination rate of almost 75%. In sweden, cataract surgery is handled in the equivalent of our CLSCs. Their cataract waiting list has been minimally affected by the global pandemic. It is clear that their health systems are more resilient than ours. The trick is in a decentralized system.
We will need more than courage and a well-crafted communication strategy to face this danger, we will need the audacity to think otherwise. To the politicians: in this troubled context, the best way to get re-elected is to work without thinking about your re-election. We will need to increase our resilience. We will never have to give up in the face of the virus. It’s never too late.