It is difficult to blame the Government of Quebec directly for the thousands of deaths, which occurred in excess here, at the height of the pandemic.
The botched centralizing reforms, which were unprecedented in the world, very little discussed in current surveys, largely explain the excess mortality among our vulnerable people. Since 2015, health leaders have been appointed centrally and blindly follow, regardless of local needs, the directives of the MSSS. Our health network has since been placed without real representation of its users, nor constructive criticism. These reforms have enshrined staff mobility, the loss of local management, the loss of the sense of belonging and the loss of pride of employees and volunteers.
Bureaucratization
The hyper bureaucratization of the system has shown that it is difficult to accomplish normally simple tasks like buying a printer or a trash can. It is also difficult to attract employees with poorer working conditions than in restaurants and retail. It has obviously become rare to find gestures of accountability in the current system.
Our health network is complex and failing, with a low capacity to adapt, where wall to wall is king, rather than tailor-made. Thus, we cannot do without an independent public inquiry commission, even in this pre-election year, because lives are at stake. Critics say that there are ongoing investigations. However, they contain a partial, anecdotal and even contradictory picture.
This future commission cannot be entrusted to civil servants. For example, in the construction file, we have seen faulty and even malicious officials. Let’s not be naive, health accounts for more than half of the state budget. This is important for business lobbies, often outside Quebec, looking for good deals. Obviously, we would never have mandated municipal officials to lead the Charbonneau Commission.
It is of little use to describe the failures of the system which are already well documented (Herron, Liverpool, Ste-Dorothée …). Faced with the aging of the Quebec population, we need all the resources that can be mobilized: those of the public, the private and the community. However, clinically clear contractual rules and effective support measures are needed. Indeed, if an environment closes because of the inaction of the State, it is the public sector which must take charge of the users, unfortunately to be uprooted from their environment at great expense.
A Ministry of Long-Term Care
The public health system, already heavily mortgaged with many difficulties, cannot turn a deaf ear to the establishment of national standards in accommodation and long-term care (ratios, salaries, etc.). Likewise, a salary decree applicable to all employees in the private and community sectors is essential to reduce mobility, strengthen safety and ensure equity between people.
In addition, the creation in each region of Quebec of an independent establishment with the sole mission of care and accommodation is required. In addition, we must enshrine a Ministry of Long-Term Care like in Ontario, rather than a title of responsible minister with too little power.
For the same need, a resident must benefit from the same quality of service and the same level of resources, while respecting the taxpayers’ ability to pay, regardless of the place of his accommodation, especially if he is under the responsibility ( reference) of the Quebec State.
André Prévost, Lecturer at ÉNAP, former director of CHAU Hôtel-Dieu de Lévis and former political advisor to seniors at the MSSS
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