Earlier this month, hundreds of doctors from across Quebec signed an open letter asking the provincial authorities to decentralize certain aspects of health care administration. Known by the acronym RQMDSS, physicians in the collective come from a wide variety of backgrounds, regions and specialties.
When you get into the weeds of their specific demands, you get the feeling that they’re really not asking for too much. They seek to reinstate a local administrator at each hospital and health care facility, a local director of professional services at each hospital centre, a Council of Doctors, Dentists and Pharmacists for each hospital and a local directors table that would bring together all the department heads in a hospital.
This would bring things back a little closer to how they were prior to Bill 10, the former Liberal government’s . . .
enormous restructuring of the province’s health care system back in 2015. Even before the legislation was put into force, many in the health care sector were calling on the government at the time to reform their reform.
These calls have continued steadily over the years, but this latest push is the largest and most organized by far. Though there is no official count at this point, several doctors from the Pontiac have added their signatures. As the group points out in their demands to current Health Minister Christian Dubé, these changes could be implemented under the current law, without tipping the system on its head a second time.
Local administrators are under an incredible amount of pressure and in the case of the Pontiac, they have the enormous responsibility of serving a population that’s one of the most elderly and unhealthy in the entire province. However, they lack almost any decision-making power which is a recipe for inefficiency in the best of times, let alone during a public health crisis.
Several elected officials have also voiced their support for the movement. When asked by this newspaper if he thought there had been mistakes in the reformation of the health care system, Pontiac’s MNA André Fortin said that, “The follow up is what’s important when you make big changes.”
There’s inevitably going to be tweaks and reconsiderations with any enormous piece of legislation, but perhaps some could have been avoided if the government at the time (in which Mr. Fortin served) had listened to the folks on the ground in the first place. There was no absence of outrage when Bill 10 came into force and now five years on, the critics have been proven correct, though it is cold comfort.
Decentralization of health care management is a part of the CAQ’s platform, but it’s something that doesn’t seem to be a priority. In addition, at the time of this column’s writing, Minister Dubé had refused to even grant the RQMDSS an audience.
The current pandemic could be seen as a catalyst for change or a barrier to any further restructuring, depending on where you’re seated. It might be easy for the CAQ to announce shiny new hospitals (to be built within the next decade they promise!) the difficult work lies in addressing pre-existing problems, like the hyper-centralization of management or the long-festering labour shortage.
Health care workers are about as essential as you can get, they literally have our lives in their hands. The government should at least pay attention to what they’re saying.
Caleb Nickerson
