Health care reform on right track
Premier Legault’s proposed health care reform is a cause for optimism. The plan addresses several major failures. The only note for caution is that though Health Minister Dubé has stated that decentralization will be a major component of the plan, the government must be held to that with decision-making responsibilities devolving to local health agencies and hospitals.
But Dubé seems serious about what the government has termed an ”historic” reform.
He’s not approaching the funding of the plan incrementally. That always fails. As former President of the Treasury Board, he and the Premier got the Board to free up some $8.5 billion to help achieve the realization of the solutions they propose.
The plan is 80 pages long with some 50 measures, but there are several that are critical and the success of the reform will be judged by their success.
The plan promises to limit ER wait times to no more than 90 minutes. It proposes to do this by setting up “command posts” in every hospital that will connect ERs with all departments in the hospitals and immediately have information flow and availability of beds, doctors, and nurses in every department. What patient can be seen, by whom and when can tests be done, results obtained and the patient admitted if necessary.
This “command post” model exists in the CIUSS West-End at the Jewish General Hospital. It works.
The JGH has achieved the goal of 90 minute wait time. The essence of its success is that the structure was developed from within.
It was a bottoms-up approach. It is to be hoped that Quebec will follow that model and not try to impose a top-down one-size-fits-all approach. That would be bound to fail.
The plan also proposes a target of hiring 1,000 more nurses. Among the measures will be salary raises and an end to forced overtime. These are two things that nurses’ unions have been asking for from before the pandemic. The past two years have seen a catastrophic loss of nurses leaving the public sector. More money and no mandatory overtime should be just the prescription to get many back. Hopefully, the government will not attach any conditions for those nurses who want to come back and benefit from the new working conditions.
The third major reform will be to expand our health care capabilities and reduce the backlog of elective surgeries by relying on private-sector solutions. It was both surprising and refreshing that Minister Dubé publicly stated this and recognized the need to utilize capacities that exist. It will not mean that people will pay any money. What it does mean for example is that licenses for orthopedic surgical clinics and cataract clinics will be extended and expanded.
The plan also calls for giving more powers to healthcare professionals such as pharmacists in as many jurisdictions in North America. Pharmacists have already given more than 3 million doses of flu and COVID- 19 vaccines and they can do more.
The planned reform also proposes to improve the treatment of family doctors. Currently, over 900,000 Quebecers have no GPs. Doctors are leaving in droves and are not attracted to the discipline.
The plan calls for an end to caps on how many patients a GP can see and to pay family doctors more for every patient they do take in. To help in this, the plan calls for expanding telehealth services and paying doctors for their time on tele-health as they are paid for in-person visits.
Beryl Wajsman is the Editor-in-Chief at the Suburban newspaper.