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home / 世界杯决赛2022

quebec health-care reform prioritizes access to front-line services

health minister christian dubé wants quebecers to have access to critical care within 36 to 72 hours.

by rené bruemmer

mar 30 2022
read time 5 minute read
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while the covid-19 pandemic highlighted many of the deficiencies in quebec’s health-care system, it also showed the system is capable of massive, rapid transformation under duress, and that wide-scale collaboration among its thousands of employees and institutions is possible.
“it was difficult,” health minister christian dubé said. “but at the same time, our network proved during those two years that we were capable of small miracles.” he pointed to the province’s successful vaccination campaign and the health system’s ability to shift to telemedicine as examples.

on tuesday dubé presented his government’s proposal to reform quebec’s health-care system , spurred in part both by its successes during the pandemic and its failings, including an acute labour shortage, inadequate care for seniors and outdated data storage and information technologies.

the main goals are to bring improved health care to citizens “who deserve better,” dubé said, and to improve working conditions for its more than 300,000 employees so that health care becomes the type of profession to which quebec workers flock rather than flee.
chief among the government’s reforms is the promise to provide rapid front-line health-care services to citizens, more than a million of whom cannot find access to family doctors. to do so, the government is promising to expand its fledgling “front-line telephone access portal,” a phone or online service through which citizens can gain access to a health professional at one of the province’s family medicine groups, where doctors, nurses, social workers and mental health professionals are promised to be available.
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citizens should be able to have access to critical care within 36 to 72 hours, dubé said. less pressing needs, like a checkup with a family doctor, should take about two weeks, he said.
pilot projects in rimouski and rivière-du-loup have proved successful, dubé said. the government’s plan is to expand the service so more than half of the 945,000 quebecers on a waiting list for a family doctor will be able to be seen by the summer, he added.
“this is the revolution we are proposing in health care,” dubé said.

premier françois legault, who could not attend tuesday’s news conference because he tested positive for covid-19 last week , said in a facebook post : “we will never solve our health-care system problems as long as we have 50 per cent of patients with mild problems … who have to go to emergency rooms because there are no front-line services.

“these patients must receive front-line services in a gmf (family medicine group) from, among others, family doctors and nurses.”
the coalition avenir québec is also pledging to end mandatory overtime for nurses, cut maximum wait times at overcrowded ers to 90 minutes, digitize medical records so patients and doctors can have better access, and improve access to information technology so that time-consuming elements like fax machines become a thing of the past. it also wants to increase the number of surgeries provided in private clinics but paid for by the state, currently at 14 per cent, up to nearly 20 per cent.

the province has started detailed data collection so it can track its efforts and compare itself with other jurisdictions worldwide. the government earmarked $8.9 billion over five years for the reforms in its provincial budget.

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the announcement was met with disdain by opposition parties, who noted the caq had made similar promises during the last election campaign without following through, but there was guarded optimism from some health-care providers.
“if there was ever a time to try it, it’s now,” said françois marquis, head of intensive care services at the maisonneuve-rosemont hospital. “the last two years have seen a collaboration between workers and departments and institutions that i’ve never seen before, and there is a spirit of wanting to do things together.”
the concept of telemedicine would never have evolved were it not for the pandemic, marquis said. as an icu doctor, a large part of his time and nurses’ time is taken up with trying to find the medical records of his patients. digitizing their records would allow him and his staff to see many more patients.
“with the tools that we have now, we can make sure that people work at the maximum of their capacities,” marquis said.

the quebec college of physicians’ initial reaction, posted to their twitter account , agreed with the government plan to include more types of medical professionals on the first line of patient care.

“many aspects of this plan move in the same direction as our workshop on access to care — compartmentalizing fields of practice, modernizing technological platforms, broadening (the use of) telemedicine and upgrading family medicine.”

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the college also noted that when it comes to the government’s resorting to the private sector in providing services, “we will be able to support measures that will facilitate free access to care and not further drain resources from the public network.”
the association des pharmaciens des établissements de santé du québec said it was open to the government’s plan to see pharmacists play a greater role in the delivery of health-care services, but it added that quebec needs to engage in an “upgrading and integration of its information services as well as automated … drug distribution systems within the network to increase performance in operations.”
dr. marc-andré amyot, president of the quebec federation of family doctors (fmoq), said his group was open to the idea of transferring more services to family medicine groups, but only if the government provides the additional assistance from other health-care professionals that it’s promising.

“thirty per cent of family doctors’ time is spent dealing with patients who have mental health issues, so we would love to have others come in and help,” he said. “ but we can’t keep putting all the weight on the backs of family doctors .”

quebec needs to add another 1,000 family doctors to its current cohort of 9,600 to contend with the extra workload, amyot said.

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the réseau de la santé et des services sociaux (rsss), a grouping of health-care unions, said in a statement it is worried the government’s plan “is nothing but a vast public relations exercise on the eve of the provincial elections.” it is particularly concerned about plans to shift more services to the private sector, which it said could lead to employees leaving the public sector.
rbruemmer@postmedia.com
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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