Quebec has unveiled its plan to clean up its beleaguered health and social services system over the next three years, with a focus on accelerating access to frontline health services through a telephone service one-stop shopping, reducing emergency room wait times and improving working conditions for nurses.
The plan, outlined in a 90-page document titled “Human and Effective – A Plan to Implement Necessary Health Changes,” highlights some solutions to system challenges compounded by the pandemic, including understaffing, rising costs and the aging of the population.
Health Minister Christian Dubé and Lionel Carmant, Quebec’s deputy health minister, unveiled details of the plan on Tuesday morning.
Dubé said one of his main goals is to ensure that all Quebecers have “the best patient experience and are proud of their healthcare system.”
Of the 50 proposed measures, which were leak in a document obtained by Radio-Canada last week, eliminate mandatory overtime for nurses, hire 3,000 new attendants by the end of the year to take care of some of the paperwork, increase home support services for the elderly , modernize access to medical data and create electronic health records accessible to patients.
WATCH | Christian Dubé explains why Quebecers should trust his government’s plan:
The new health plan document does not include costs, but Dubé pointed to a 6.3% budget increase for the health system over the coming year.
Last week, Finance Minister Eric Girard said the increase would be earmarked for overhauling the system.
But money is only part of the solution, Dubé said.
“It takes more than money – it takes a willingness to work differently.”
One-stop service for Quebecers without a family doctor
Quebec is also considering changing the way family physicians are paid, moving from a per service basis to a per patient basis, with the goal of getting these physicians to take on more patients.
There are some 945,000 Quebecers who are still on the waiting list for a family doctor, according to the document.
Dubé said the government was still working to reduce the number of people on that list, but was backing away from a promise made in 2018 to have a family doctor for everyone by the end of the government’s first term. caquist this year.
The plan now calls for scaling up alternatives for frontline care, including giving nurse practitioners, paramedics and pharmacists more power to treat patients.
Under the plan, Quebecers will call a phone number that would act as a one-stop service, where a nurse would direct patients to the appropriate medical service, whether to see a doctor or to align them with a another method of treatment.
“It’s not just theoretical. It’s already started,” said Dubé, who pointed to a pilot project in the Bas-Saint-Laurent region.
Dubé says he hopes “the majority” of people without a family doctor will be able to use the one-stop shop by the end of the summer.
Deputy Health Minister Carmant stressed that the one-stop shop will be managed at regional level and will be accessible in English.
It is hoped that under this plan, fewer Quebecers would need to go to a hospital emergency room for health issues that could be treated elsewhere.
However, reforms are also proposed on the operation of emergency rooms, with the aim of reducing the waiting time in each emergency room to a maximum of 90 minutes, the document indicates.
Each hospital would have a “command center” that would address wait time reduction. The center would be made up of workers from different sectors, including the home care team and mental health professionals.
The center would aim to discharge patients as soon as their condition is no longer critical but would ensure that the patient “continues to benefit from services outside the hospital if his state of health requires it”.
Improve working conditions
Many measures aim to create a “more attractive working environment” for health professionals, in particular for nurses.
To that end, the government promises to overstaff the system, to allow it to manage absences without relying on forcing nurses to work overtime.
Dubé said his government monitors the frequency with which compulsory overtime is used and pointed to a recent month when it occurred “only 27” times that a nurse was forced to stay on the job because he didn’t work. there was no replacement for the next shift.
“There is a will, a very clear will, not to do it,” he said.
The government plans to undertake a “massive” recruitment campaign, including hiring more than 1,000 nurses from abroad.
Each facility would also be allowed to manage its own schedules, with input from staff.
The government also wants to reduce the system’s reliance on private agencies to provide temporary nurses and orderlies. Currently, many hospitals and long-term care homes rely on these agencies to fill positions when they are short-staffed, at a higher cost.