When you want to lose weight, you start by stopping the fast food. And when you want to restore the credibility of the health care system, you start by stopping making promises you can’t keep.
Posted yesterday at 6:00 a.m.
Since the start of this campaign, we have seen the Liberal Party and the Coalition avenir Québec make promises that simply cannot be kept.
From the first hours of the campaign, the Liberal leader, Dominique Anglade, promised a family doctor for all Quebecers, exactly the same promise – not kept, and today abandoned – of the CAQ during the last election campaign. The only nuance being that Mr. Legault had promised that it would be in his first term, Mr.me Anglade speaks rather of “at least one mandate”.
Except that, by the admission of the PLQ itself, the number of Quebecers who do not have access to a family doctor has almost doubled in four years to reach nearly 1 million. The challenge is therefore even greater than it was for the CAQ four years ago.
To do this, the PLQ proposes to train more doctors, to better distribute them throughout the territory and to ensure that doctors spend more time in the clinic rather than in the hospital.
Just to train more doctors, the challenge is colossal. We need more places in universities, so more professors, more laboratories and other equipment and more internships in hospitals, where there is already a shortage of places.
In any case, doctoral studies in medicine take four or five years, to which must be added the residency which can be spread over two to six years. An investment today that will only “pay off” in several years.
These are things that cannot be changed just by increasing budgets. Promising it knowing that we cannot succeed will only increase the cynicism of the population and damage the credibility of the health system.
The same is true of the CAQ’s health commitments. Having broken its teeth with its promise of a family doctor for all, the ruling party is now proposing to hire 27,000 more health care workers within four years, if retirements in provide.
We would like to train 600 new doctors. And there are also plans to hire some 1,000 nurses abroad. Which had already been announced last February and, before that, in the fall of 2021.
But what is truly distressing is to see the method chosen by the government: we are going to invest 400 million dollars, as if the money would settle everything.
It means not understanding the dynamics of the labor shortage, which is not a temporary phenomenon and which must profoundly modify the ways of managing personnel, in governments as elsewhere.
For example, we can no longer isolate the health sector thinking that it will have no effect on the rest of the world of work. Today, nothing is easier than changing jobs and finding working conditions that are much less restrictive than life in a hospital.
We see it elsewhere. The simple announcement of extended work on the Louis-Hippolyte-La Fontaine bridge-tunnel between the South Shore and Montreal has already caused a wave of resignations among teachers at certain school service centers in Montreal.
To improve the situation in the health sector as elsewhere, we must rethink the way governments operate. It is no longer enough to throw in a few hundred million and hire more staff to fix the problems.
Quality of life is beginning to weigh much more heavily than collective agreements.
But it seems quite difficult to understand, beyond words, by this government of accountants and managers.
Unfortunately, it seems much easier for the ruling party to continue with the old ways and dip into state coffers than to adapt to the new labor market realities, which would be less onerous and much more efficient.
The next challenge in the public service is not cost control, it is staff retention. When we know that today there are more than 13,000 fewer employees than last year in the health network, we understand the magnitude of the challenge.
***
On a completely different subject: There is a lot of talk about the toxic climate of this election campaign. To understand how political discourse has drifted in the United States over the past 30 years, read The Destructionists by Dana Milbank, a columnist for the washington post. He tells the story of the Republican Party from Newt Gingrich to Donald Trump and shows how the deeply toxic political debate is increasingly violent. And it is important not to think that these methods are not crossing the border…