(Quebec) Due to the shortage, nurses who provide home care services are almost no longer able to work due to new administrative regulations. These employees are now required to own a car.
Posted at 5:00 am.
About thirty Progressive Services employees saw their work hours melt away like snow in the sun when a procedure came into effect in October that changes the way contracts are awarded to home care employment agencies.
“It is not my competence that is in question,” argues Marie-Suzie Paul, a 69-year-old beneficiary carer.
“I have always worked without a car and that has never been a problem […]. We are in Montreal, in 2023 we will have a public transport network that really works, I don’t understand that,” complains the woman who lives in Saint-Léonard. “Nowadays, having a car is a luxury. »
Ms. Paul, a Progressive Services employee since 2008, worked an average of 25 hours per week. She explains that she can visit three to four users a day, some of whom she has been treating for two years, using public transport.
However, the employer, which supports around 2,600 users in the east of Montreal, had to withdraw its user list. The reason ? CLSCs require temporary home care workers to have a car.
The beneficiary carer has therefore only worked three hours in the last two weeks.
I don’t know how to continue. I want to keep working, I still have the strength. They say there is a labor shortage, but the people who are there are being prevented from getting there.
Marie-Suzie Paul, beneficiary
At her age, joining the public network is out of the question for her.
His boss also regrets the situation: “It is such a classic case in which we see that the machine reforms by completely rejecting the human aspect,” says the general manager Patrice Lapointe, who is also president of the Association of Private Health Personnel Companies in Quebec is (EPPSQ).
PHOTO MARCO CAMPANOZZI, LA PRESSE ARCHIVE
Patrice Lapointe, president of the Association of Private Health Personnel Companies of Quebec
The Legault government passed a law last spring to eliminate independent workers in the health network. We aim to achieve this by 2026, starting next year in major urban centers such as Laval and Montreal.
As part of the change, an initial temporary employment contract changed the usual rules in home care.
Previously, a healthcare facility entrusted the care of a certain number of users to a private company that was responsible for organizing the services. With the changes, the company will instead have to “loan” its employees to the CLSC, which will give employees the instructions to follow.
La Presse reported earlier this month on the concerns of user committees and industry fearing service disruptions.
As of September 9, 21,000 Quebecers were waiting for a first home support service.
public transport
In the case of Progressive Services, the company was able to create lists of users to serve based on public transportation because a large portion of its employees do not have cars. When service resumed, the CIUSSS no longer maintained these lists.
“We noticed that the routes sent to the agencies were often reorganized to accommodate the availability of their personnel,” wrote the spokesperson for the CIUSSS de l’Est-de-l’Île-de-Montréal in an email. , Carl Boisvert.
“This had an impact on the stability of the timetables and [main-d’œuvre indépendante] which has served our users,” we add. In addition, “almost all” of the home network employees also have “a vehicle requirement that is necessary for their position,” the facility explains.
We are adjusting these requirements depending on the area, but in certain sectors it still seems difficult to travel by public transport.
Carl Boisvert, spokesman for the CIUSSS de l’Est-de-l’Île-de-Montréal
The CIUSSS claims that “as provided for in the current contract” it is “entitled to request orders involving vehicle use with reimbursement of the kilometers driven”. We also remember that the private companies “bid knowingly”.
The facility ensures that “issues related to travel in the new contract” were never addressed by the agencies.
“Organized in disaster”
Mr. Lapointe, on the other hand, sees the impact of a transition “organized as a catastrophe” and a “hypercentralization in which we will standardize the delivery of care” rather than aligning it “with the reality specific to each person.”
“We are taking services in an area where we could do so using public transport. Now we can no longer do it because it was too complicated from an administrative point of view,” he denounces, affirming that “patients pay the price.”
He reports that in the first weeks of October, the number of calls increased as users and their families struggled to explain the arrival of new caregivers. Some said they did not receive the service or tried to contact the CLSC without success, he lists.
“One of my patients told me that she was not receiving the services she was used to. They are new people or no services at all, they are also in the void,” says Marie-Suzie Paul. La Presse was unable to contact this user.
The CIUSSS ensures that “100% of requests for the transfer of a vehicle are accepted by contracted agencies, which has not and will not result in service failures or special problems.”
According to the institution, on the contrary, the new contract results in “added value in the quality of services for users”, while the CIUSSS itself “manages the schedule of workers by receiving them and providing them with the necessary clinical support”, we write .
In November, the office of Health Minister Sonia Bélanger pointed out that by awarding contracts through outsourcing there was no way to “ensure the quality of the services offered and the qualifications of the staff”.
It then said the “priority” was to ensure the “transition goes well”. A meeting between Ms Bélanger’s office and the EPPSQ also took place in September.
Labor shortage
One of the Legault government’s goals with its law is to bring temporary workers back into the public eye and, above all, to slow their migration to the private sector.
Minister Sonia Bélanger also launched a project to reduce the administrative burden on staff deployed in home care. The CIUSSS de l’Est-de-l’Île-de-Montréal is also participating in the pilot project to improve nursing care.
In a study published in January 2022, the Institute for Socioeconomic Research and Information (IRIS) concluded that home care is one of the sectors where the “structural dependence” on placement agencies is the greatest.
The EPPSQ calls for better monitoring of the use of health referral agencies but opposes their abolition.