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quebec prioritizes access to family doctors in health-care reform plan

the "foundations" of the action plan are broken down into four sections: personnel, access to data, information technology and infrastructure.

stating “the status quo is no longer supportable” for quebec’s health-care system, the government on tuesday formally released its plan to reform the network.

its main priority is to offer all citizens access to a family doctor or other health-care professional to receive quick front-line care. health minister christian dubé recently estimated that as many as 1.5 million quebecers still don’t have access to a general practitioner.

in an 80-page document titled human and efficient, the coalition avenir québec government chronicles the system’s ailments, including a lack of personnel (the government estimates roughly 50,000 workers were missing from the health system in january; of those, 20,000 were off because of covid-19), an aging population, lack of access to rapid care and an outdated medical data system.

the report breaks down its action plan to reform the “pillars of the system” into four sections: personnel, access to data, information technology and infrastructure. last week’s provincial budget estimated the costs of the reform plan at $8.9 billion over five years .

personnel

in response to years of complaints about untenable working conditions for many health employees, the government promises a “new management system based on stability.”
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each institution will have the ability to manage its own schedules, with the input of employees.

mandatory overtime will be abolished by moving from a lack of employees to a surplus. moves have already been made, including training and hiring 9,000 orderlies during the pandemic. three thousand administrative assistants are to be hired this year to help with paperwork in ers, long-term care centres and in youth and mental health sectors.

the main needs are for nurses, auxiliary nurses, nurse practitioners, respiratory therapists and orderlies, as well as health professionals working in mental health and youth services.
educational bursaries of $9,000 to $20,000 are being offered to entice workers into the field.
the government will try to hire 1,000 nurses from abroad.

bonuses of up to $18,000 were given to nurses who either elected to stay in the system or switched to full time.

access to data

the government is promising to modernize access to data and medical records, primarily by making much of it available in a computerized format so patients and health-care workers can have access to it instantly via their smartphones or computers. the government said measures laid out in its bill 19 proposal announced in november are meant to break the information logjam .

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improved systems will give administrators and researchers a clearer picture of the situation within health-care institutions.

information technology

the continued use of the fax machine has become the symbol of quebec’s outmoded information technology system in health care. the government promises an integrated, digitized system that will speed up management, human resources, financing and the issuing of supplies.

infrastructure

with much of the health system’s infrastructure aging or decrepit, the government is promising to renovate older long-term care residences and hospitals, and to build centres for seniors and hospitals that can give more personalized care.

access to front-line care

calling quick access to a health professional its top priority, the government said every quebecer should have access to a family medicine group (or gmf, for groupe de médecine de famille). the pledge is that a variety of health-care professionals will be available to respond to different needs. bill 11, tabled in november, promised better access to a family doctor and an online platform that would direct patients to professionals, but previous attempts have failed.
the government is pledging to alter family doctors’ schedules so they will be more available for appointments or last-minute emergency care.

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there are 945,000 quebecers on waiting lists for a family doctor.
phone and online services that will allow patients to make an appointment with the appropriate health professional — a doctor, nurse practitioner, psychologist, social worker or pharmacist — have been launched successfully in some regions of quebec, the government said, and will be expanded throughout the province. at the same time, telemedicine, which surged out of necessity during the pandemic, will be maintained.

command centres for ers

saying the crowding of emergency rooms is a symptom of “dysfunction in the health-care system,” the government is pledging to create “command centres” within hospitals where patients will be directed to appropriate care instead of going straight to ers. the idea was inspired by a system at the jewish general hospital.

more works by private clinics

during the pandemic, about 14 per cent of surgeries in quebec (85,000 of them) were performed in private clinics, but paid for by the state. the government wants to increase that to roughly 20 per cent to take the load off the public system.

services for seniors, mental health and youth

the government is promising improved at-home services for seniors, more money to update or build seniors’ centres, and increased aid for caregivers.

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an extra $1.15 billion over five years has been earmarked to improve services offered for mental health issues.
following on the laurent commission into youth protection in 2019, and increased needs that came to the fore during the pandemic, the government is promising to increase access to care and services for young people and their families.
rené bruemmer
rené bruemmer

rené bruemmer is a montreal native who covers mainly municipal affairs and social issues for the gazette, with forays into covid-19, health care, haiti and outdoor ice rinks. he has been at the paper for more than two decades.

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