Before getting to the heart of the matter, allow me to quote a few figures, just to set the scene. Not what happened in CHSLDs. The social, human and economic challenge that awaits us now.
Posted at 5:00 a.m.
I quote the report of coroner Géhane Kamel.
In 2020, “more than 315,000 people aged 65 and over required support for autonomy” in Quebec.
This number will increase to 500,000 in 2035 – in just 13 years. Then to more than 600,000 in 2050.
Already, our CHSLD network is in a state of disrepair and chronic underinvestment. Deadly sometimes.
It was not the CAQ that created it, it was a political sedimentation of all the previous governments.
But I draw our attention to this. If the network is in this state, what will it look like in 15 years, when the needs will have almost doubled?
It will go largely unnoticed, but that’s probably the most important thing about this report that re-examines 2020: the pandemic has made us “run into the wall”. But another wall stands in front of us: aging. It will take something other than “concrete” to get through, as the coroner says.
Those who wait for a punch are going to be disappointed, guilty question. They won’t even be the ugly owners of the Herron private CHSLD. Nor Marguerite Blais. Not even “the government”.
It wasn’t the coroner’s job to find a culprit, of course. But in the tragedy that was the CHSLD Herron, where 47 people died in six weeks, a strong presumption of negligence hung in the air. Criminal negligence, even suggested Prime Minister François Legault.
Indeed, this establishment was poorly managed, it lacked employees and the management was not competent to take care of sick elderly people. He was also very poorly supervised. While reading 5060 of my colleagues from The Presswe understand how even the worst establishments always find “customers”: we resign ourselves to sending people there, for lack of space.
Except that for this tragedy in particular, the State had taken charge of Herron, long before the journalist Aaron Derfel exposed the carnage, on April 10, 2020. The managers of the CIUSSS were on site, at the request of the owners of Herron, overwhelmed by events and the escape – understandable – of employees. It was only after the article was published in The Gazette that a CIUSSS official called 911, as if she had just discovered the horror. While they had been managing the disaster for 10 days. But for media appearances, this call “covered” the CIUSSS…
When Herron’s bosses wanted to send very sick patients to the hospital, the CIUSSS blamed them. Everyone knew, however, that Herron was incapable of providing care for these patients. But the directive was clear: leave these patients in CHSLDs… even Herron.
We are therefore far from the image of owners who hid from everyone what was going on. We are also far from a surprise, when the horror of these abandoned people was spread out in the newspaper. The CIUSSS knew very well what was going on there.
The culprit designated to the government was obviously Marguerite Blais, responsible for Seniors and Close caregivers. Far from blaming her, coroner Kamel believes that she has delivered the most credible testimony on pandemic preparedness – although politically “formatted”, as has been compared to interviews given to journalists.
What emerges from this is already widely known. Faced with the imminence of outbreaks, we “emptied” the hospitals and filled the CHSLDs. The official logic was that CHSLDs are “used” to managing outbreaks. We were especially afraid that the hospital system would crack.
“She tried to make herself heard”, but the basic orientation was decided: hospitals had to be saved.
We knew pretty quickly that the decision, and the way we made it, was not good. But the coroner recognizes that in these circumstances of absolute, unprecedented crisis, these decisions were made in good faith.
The fact remains that Quebec had the worst record during the first wave, with regard to deaths in CHSLDs and RPAs. It must be said that Quebec has the record number of residents in these establishments.
Nevertheless. Several troubling findings call for action “for the next time”.
Obviously, the general lamentable state of the CHSLD network.
But also the important problem of circulation of scientific information so that the best decisions are made. The National Institute of Public Health of Quebec was not listened to quickly enough. The “best practices” in British Columbia and Washington State should have interested policy makers here. Not to mention that the national director of public health, who has the rank of deputy minister, suffers from a lack of independence from politics. All of that needs to be changed.
Let’s not forget that it took the army…
“The army’s success has demonstrated that to optimize the efficiency of actions, a clear, rapid and coordinated chain of command is necessary,” she writes.
The coroner, by the way, cites the example of the CHSLD-Chinese Hospital of Montreal, which managed the pandemic admirably. “A model that is completely reproducible in Quebec establishments, as long as we put the effort into it. »
This report, which insists a lot on the need for home care, wants to prepare us for a next pandemic.
But even without a pandemic, what is coming requires strong action.