Will the major reform of the structure of the health system proposed by Minister Christian Dubé in his Bill 15 give the final blow to the CLSC network?
This is what fears the member for Rosemont and spokesperson for Quebec solidaire in terms of health, Vincent Marissal, who tabled a motion debated Wednesday in the National Assembly. The vote for its adoption, however, was postponed until Thursday.
The motion asks the government to commit to “maintaining the entire current mission of the CLSCs in the bill” aimed at making the health and social services system more efficient.
By comparing the text of the bill with that of the current law, we see that the concept of “mission” as well as its content disappear. This withdrawal is also voluntary as can be read in a technical sheet written by the government.
“The bill no longer mentions a mission,” it says. “Classes and types are not included in the bill. Santé Québec may, in its internal regulations, establish the classes and types of centres. »
At the heart of the change is the abandonment of the concepts of “centres” and the missions entrusted to them. The Dubé reform instead adopts an approach based on “services” which must be provided to users, but whose delivery is left to the discretion of the future state corporation.
This means that the Health Quebec agency will have full freedom to abolish local community service centers (CLSC), hospitals, child and youth protection centers, residential and care centers (CHSLD) and rehabilitation centres, as long as it maintains the services provided by these establishments.
While debating his motion, the member for Rosemont said he was “worried” and asked the government not to “put the last nail in the CLSC model” which has already been considered a flagship in Quebec.
“It was a fairly unique model, moreover, which was studied around the world, because it was a model, precisely”, boasted Vincent Marissal, adding that it dealt with “the whole population approach” in each of the communities served by a CLSC.
In addition, the president of the College of Physicians, Dr.r Mauril Gaudreault, told La Presse canadienne last week that the CLSC network should be revitalized. He then pleaded for the formation of interdisciplinary teams whose mandate would be to take care of patients on the front line.
“It was as if abandoned (the CLSCs), but it was a great solution and that was what was being done, teamwork of professionals,” recalled Dr. Gaudreault.
Question of perception?
In response, the Minister of Health, Christian Dubé, proposed an amendment to the motion to remove the word “integrity”, which MP Vincent Marissal rejected.
The minister then sought to reassure the second opposition health critic of his desire to “solidify” them. In his opinion, it would be a “matter of perception” on reading the documents, but that would not be his intention.
He insisted on the government’s desire to offer network managers more flexibility in the organization of services within their establishments.
Mr. Dubé also gave as an example the recent specialized nurse practitioner (SNP) clinics, set up in CLSCs, to support his vision of improving the service offer in these establishments.
However, we will have to wait for the final version of the bill to know whether or not the future of the network of local community service centers will be assured.
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