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Fueling challenges
Emergencies overflowing. Difficult access to a family doctor. More than 145,000 people awaiting an operation. Shortage of personnel everywhere in the network… The list of projects that the Minister of Health and Social Services, Christian Dubé, will have to tackle in the coming months is strong. But the main interested party is far from worrying about it.
“It’s like giving someone some kind of trouble candy dish.” But he likes that, the problems… ”, he said.
Appointed on June 22, 2020 to succeed Minister Danielle McCann, Christian Dubé left the Treasury Board to take the reins of the Ministry of Health, which Prime Minister François Legault described as a “monster”.
Upon taking office, Christian Dubé spends most of his days managing “the urgent”: the COVID-19 pandemic. But members of his team have never stopped taking care of other “important” health issues.
Even if the pandemic is not yet behind us and the Minister insists that many Quebecers must get their second dose of vaccine to avoid a fourth wave in the fall, Christian Dubé can devote a little more of his energies to the routine management of health. To tame “the monster”, what.
Data obsession
Christian Dubé has set himself five priority projects: emergencies, surgery, home care, human resources and access to the first line.
To achieve his goals, this minister from the business world wants data. All the people who know him near or far say it: he is obsessed with numbers. “I need this information to manage properly,” he says.
Recruited from the Treasury, Marc-Nicolas Kobrinsky was appointed Assistant Deputy Minister in the General Directorate of Strategic Planning and Performance at the Ministry of Health. The minister nicknamed him the “king of data”. He is working with the firm to refine a dashboard where unique and reliable data and indicators from the entire network are available in real time.
PHOTO EDOUARD PLANTE-FRÉCHETTE, THE PRESS
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I don’t want to debate whether we have the right figures. It takes someone who says: between the cabinet, the Ministry and the network, there is only one set of figures.
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Christian Dubé, Minister of Health and Social Services
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Mr. Dubé explains that with the pandemic, access to data has been accelerated in the health network. The imposition of emergency measures will fall in September in Quebec. “But I will make sure that I will have a transition period to be able to continue to have these figures,” said the minister, who wants to draft a bill for a permanent solution.
The wind of accountability
With the arrival of this results-oriented minister, the leaders of the health network feel a wind of accountability blowing. During the past year, two CEOs were dismissed from their positions: the CEO of the CISSS de Lanaudière, Daniel Castonguay, lost his title after the death of Joyce Echaquan at the Lanaudière Regional Hospital Center. And the CEO of the CISSS de la Montérégie-Ouest, Yves Masse, has given way to Lise Verrault, appointed by interim.
Minister Dubé confirms that accountability is essential for him. But he also wants to make the CEOs of CIUSSS shine, many of whom are “creative, on the boat, proud…”. He quickly appointed several, including Sonia Bélanger (CIUSSS du Center-Sud-de-l’Île-de-Montréal), Sylvain Lemieux (CIUSSS de l’Est-de-l’Île-de-Montréal) and Lynn McVey ( CIUSSS of the West Island of Montreal). “These are people who want to find solutions. And they’re not afraid of numbers, ”he says.
In the health network, Minister Christian Dubé has a rather good reputation. Many speak of a field minister: he tries to visit one hospital per week.
While some underline its ignorance of certain health topics, others praise its great effectiveness and its ability to apply innovative solutions. Such as the signing of agreements with specialized medical centers which made it possible to carry out 50,000 operations during the pandemic.
A strategist in the medical community describes Minister Dubé as a man “with a vision, respectful, loyal and honest”. “He knows how to impose respect in a changing world,” said this source, which nonetheless underlines that the minister’s next challenge remains important: to manage a ministry which will no longer operate in emergency mode. “He trained the lion. But he hasn’t watched him yet … ”
The opposition remains critical
On the political side, the opposition believes rather that Minister Dubé can not boast about the management of the health crisis. “We are one of the most bereaved societies in the world. We have a catastrophic record! The number of deaths during the second and third waves is as high as during the first, ”says MP Marie Montpetit, Liberal Party spokesperson for health.
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Mme Montpetit notes that if “the vaccination campaign is going”, there were major problems. “I don’t want to rain on the parade, but I think we have to put things into perspective,” she said. There were less good moves. How many debates did it take at the Salon Bleu for the chronically ill to be vaccinated as a priority? ”
PHOTO EDOUARD PLANTE-FRÉCHETTE, ARCHIVES THE PRESS
Marie Montpetit, Liberal Party Health Critic
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Christian Dubé has committed “a lot of mistakes” since taking office, “because of his stubbornness”, according to her: expanded access to N95 masks in CHSLDs has been delayed and rapid screening tests are almost unused , for example. She recalled that the government said it was resisting the third wave, but that it had to do an about-face a few days later and recognize that it was finally hitting Quebec.
For Minister Dubé, the vaccination campaign remains the greatest success of his first year in office. Currently, about 79% of the population aged 12 and over has received one dose of the vaccine and 18%, two doses.
For the time being, Minister Dubé wants to continue to lead the vaccination campaign. “For me, the pandemic and vaccination are far from over. […] I’ll be really happy when we get to September, ”he said.
Mr. Dubé intends to prove to the population that the success of the vaccination campaign, the health network “is capable of doing it with [ses] other problems ”. “The network is being proud. And that’s what I’m most happy with, ”he says. The minister also intends to present a health recovery plan in September. He considers himself “well surrounded” with his senior officials, including Daniel Desharnais, the Dre Lucie Opatrny and Dominique Savoie, to take up the next challenges. “These people thrive on challenges. Me too, important files don’t scare me. ”
The “monster” of the healthcare network
1,218 employees at the Department
Over 300,000 workers
Spending over $ 40 billion per year
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The five priority projects
1- Primary care
The Minister of Health Christian Dubé does not hide it: this file will be “the most complicated” that he will soon have to manage. “The issue is that there is not enough support”, he summarizes. Currently, 81% of Quebecers have a family doctor. The Department of Health and Social Services had committed in its strategic plan that this rate be 83% at this stage.
Last week, Prime Minister François Legault did not hesitate to threaten family doctors to resort to the sanctions provided for in Law 20 if they did not increase their performance. Mr. Dubé says he is “happy that [son] Prime Minister says: “I am ready to go that far if we don’t get along” ”. But he believes that “there is an interim solution to this”.
The Minister notes that only 68% of the citizens of Montreal have a family doctor. In the crowns, we are at 75%. And the vast majority of the 25 most problematic emergencies in Quebec are in Greater Montreal.
PHOTO EDOUARD PLANTE-FRÉCHETTE, THE PRESS
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We must find a solution in Montreal so that people are more supported.
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Christian Dubé, Minister of Health and Social Services
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President of the Federation of General Practitioners of Quebec (FMOQ), Dr Louis Godin did not like the recent exit of the Prime Minister. But he assures us that his relations with Christian Dubé “are good” and that there is “no blockage”. However, he believes that at a time when family medicine attracts fewer and fewer students, outings like that of the Prime Minister, “that does not help”.
Minister Dubé recognizes that the file is “complex”. But he wishes to take it “in pieces”. He wants to reach an agreement with general practitioners that will make more room for “capitation” remuneration, that is to say linked to the care of a population rather than to the act.
However, Mr. Dubé is keen to obtain more data first, in particular on the “productivity” of general practitioners. A word that he himself puts in quotes “out of respect for the professional act”. “People often ask me why I really care about the data is that I want to be sure that I understand the problem. ”
2- Surgery waiting lists
Among the minister’s other priorities: waiting for surgery. Mr. Dubé recently presented his catch-up plan so that the surgical waiting lists, which currently contain 145,000 names, are reduced to 100,000 names before 2023. Before the pandemic, the waiting list was 125,000 people. Quebec.
3- Home care
In home care, the minister is delighted that his government has invested almost twice the sums promised since his election. But the minister now wants to ensure that “the investment we make is reflected in additional hours of service per person and per region”. Once again, he relies on reliable and precise data to document this case.
PHOTO EDOUARD PLANTE-FRÉCHETTE, ARCHIVES THE PRESS
Minister Dubé wants to sit down with the CEOs of hospitals where emergencies are the most problematic and take action.
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4- Emergencies
In recent weeks, the Dre Élyse Berger-Pelletier, deputy director general of prehospital, emergencies and clinical reception at the Ministry, visited half of the 25 most problematic emergencies in Quebec. She will end her visits in September. With these results in his pocket and the data, Minister Dubé then wants to sit down with the CEOs concerned and take action.
5- Human resources
Mr. Dubé believes that the recent agreements concluded with major health unions, including the FIQ, will help improve health personnel shortages. He says he is working with the Minister of Higher Education, Danielle McCann, to find solutions to quickly hire more licensed practical nurses, using much of the same accelerated training model that was used during the pandemic and which made it possible to ” hire 8181 beneficiary attendants in CHSLDs to date (the objective was 10,000. Nearly 550 candidates are currently in training). Mr. Dubé also notes that about 20,000 retired health workers came to help during the pandemic. According to the minister, many of these people may wish to return, but not under any conditions.
With the collaboration of Tommy Chouinard and Pierre-André Normandin, Press
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