First, two questions and the same answer! First, why have the measures to counter the pandemic been more severe in Quebec than elsewhere? Secondly, why, in March 2020, did you transfer so many patients from hospitals to CHSLDs when the latter did not have the resources to accommodate them, thus sending thousands of people to death? Only one answer: the low hospital capacity of our health network.
Posted yesterday at 1:00 p.m.
Quebec has about 16,500 hospital beds, which gives an average of 2 beds per 1,000 inhabitants. The Canadian average is 2.5. Canada, among the countries of the Organization for Economic Co-operation and Development, ranks 25and rank out of 26 in this area. In the United States, the average is 2.8, in France it is 5.8, and so on. Simply to reach the Canadian average, we would have to add 4,000 beds. These data show how under-equipped we are in hospital capacity.
A few projects are underway, including a 404-bed hospital in the Vaudreuil-Soulanges region. Valued at $1.7 billion, it should be delivered in 2026. There is another possible 600-bed project in Gatineau, but much less advanced than the previous one.
Unsustainable status quo
These projects and a few smaller ones won’t even be able to sustain some form of status quo because the population is growing. Because the population is also aging: in 2020, people aged 70 and over accounted for 13.6% of the population. In 2035, 15 years later, they will account for 20.5%. The demand for care is constantly increasing. So many investments to make before talking about catching up…
At a cost of approximately $450,000 per room, the sums required to prevent the situation from deteriorating are already considerable. Even with the status quo adjusted, we will not be better prepared for the next pandemic.
But should we perpetuate the current hospital model? In France, the United Kingdom, Italy, Denmark, Sweden, in the vast majority of countries in Europe, around a third of hospitals are privately owned, but under contract with the State. The patient pays nothing and can choose the establishment where he will be treated.
In 2019, according to the same data from the Ministry of Health and Social Services, 380,000 patients came out of the emergency room without having been taken care of… That’s more than 1,000 per day. It doesn’t happen in Europe.
One of the important reasons is the mode of financing in force. In Quebec, each establishment, to date, receives a budget based on that of the previous year with some adjustments. So there is no advantage in treating as many patients as possible. A little overzealous can lead to a deficit. In Europe, both private and public, care is paid for on a fee-for-service basis: a patient becomes a source of income. Here, it is an expense item.
But good news, columnist Francis Vailles recently told us that from 1er April 2023, our hospitals will be funded according to the volume of care provided, as is already the case for the most part in Europe and Australia, in particular.
We are thus moving from a funding method based on cost control to another that promotes meeting needs. It’s a revolution!
But now that we have established the cost of each type of care, we should go further. Recently, Mr. Legault was proud to announce the arrival in Quebec of a Moderna plant worth $175 million. Why wouldn’t we try to attract a European hospital company for an investment of a few billion? Minister Pierre Fitzgibbon should get started… If, by a happy coincidence, this company was French, there are already training recognition agreements for 80 trades and professions. It is said that over there, one waits only for a signal to appear.
To get out of its ruts, our healthcare system needs a culture shock. The arrival of foreign companies with their capital, but also with their operational expertise, would force the existing system to improve or wither away. Competition makes better! The patient would gain!