With the passage of Bill 15 under a lockdown order, the government now has a free hand to move forward with the Santé Québec Agency in 2024. This umpteenth reform of the huge healthcare network will bring “a lot of chaos and instability” in 2024, believes researcher Anne Plourde from the Institute for Socioeconomic Research and Information (IRIS). Less than ten years after the controversial Barrette reform, the Dubé reform will take shape next year.
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A gigantic state-owned company
Minister Christian Dubé wants to remove his ministry from operational decisions about the health system and leave management to the Santé Québec authority. But according to Anne Plourde of IRIS, we shouldn't underestimate how enormously maneuverable the new liner will be.
The new state-owned company will have more than 300,000 employees and 1,500 facilities (hospitals, CHSLDs, CLSCs). In comparison, Hydro-Québec, which serves as an inspiration to the minister, employs 22,000 people.
Ms Plourde sees this as an “even more advanced” centralization of the network. “However, during the pandemic it has been very clear to everyone that this centralization creates serious problems in the organization of services and the ability to provide them effectively,” she wonders.
However, Minister Dubé promised that his reform would make decisions more down-to-earth.
Archive photo, Stevens LeBlanc
“The potential is there,” believes Nadia Sourial, assistant professor at the University of Montreal’s School of Public Health. But what authority will these local managers have who can sign checks for equipment purchases?
employees wanted
Despite the best intentions with his reform, Minister Christian Dubé must, above all, find staff if he wants to restore the network to health.
The period before the holidays was marked by overcrowded emergency rooms and dozens of hours of waiting for stretchers due to a lack of staff. Not to mention the strike by civil servants demanding better salaries and working conditions within the network.
Photo agency QMI, JOEL LEMAY
IRIS estimates that the network would need an additional 100,000 workers in addition to improving staff retention.
For her part, Nadia Sourial adds that family medicine must be promoted as quickly as possible to improve access to the first line.
Slide to “Private.”
Last year, the government spent hundreds of millions of dollars on private clinics to perform surgeries that the public couldn't afford.
This increasingly clear opening of the government to the private sector in the health network worries the two experts, who do not see an end in 2024.
Archive photo, Chantal Poirier
“The private sector is clearly contributing to the draining of resources from the public network. It is not because we are opening private clinics to perform operations because we will suddenly have more employees in the network,” notes Anne Plourde.
“There is the idea that the private sector will help us, but we are only impoverishing the public network,” emphasizes Nadia Sourial.
Waiting lists are getting longer and longer
At the end of the year, more than 160,000 people were still waiting for surgery in Quebec. This time last year the number was virtually the same.
The year 2023 did not allow the government to catch up and reduce its waiting lists in several areas.
More than 820,000 Quebecers are waiting to see a specialist. Of these, 107,000 people are still hoping for a consultation with a dermatologist.
And around 21,000 seniors are still in need of primary home care services, while 4,500 are waiting for a spot in a CHSLD.
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