Chris Lowrey
CAMPBELL’S BAY Dec. 13, 2017
A report compiled by advocacy group Santé Outaouais 2020 is highly critical of the health network amalgamation that took place in 2015.
The authors of the report held a press conference in Campbell’s Bay that was attended by local officials and stakeholders.
The amalgamation was the result of the passage of Bill 10 in 2015 which aimed to centralize the health network in the province.
As a result of the amalgamation, the local Pontiac centre de Santé et services sociaux (CSSS) was merged with the other four CSSS’s in the region to form the centre Santé et services sociaux en Outaouais (CISSSO).
The report’s three co-authors include former Mayor of Hull Michel Légère, Gilbert Langelier and Paul-Émile LeBlanc.
The report was compiled after interviewing 15 people with experience in the healthcare sector in the Pontiac ranging from frontline healthcare staff, to former local politicians and CISSSO representatives.
The report, entitled: “The Barrette Reform in the Pontiac: A Model System Dismantled” concludes that the population of the Pontiac has suffered as a result of the reforms by Quebec Health Minister Gaétan Barrette.
“It has resulted in a loss of proximity to institutions and of flexibility in service delivery,” the report reads.
The report says that the old system “was well-integrated. It was flexible, based on the values of rural solidarity and a population dispersed over a large territory.”
Many of the managers in the old system had to wear many hats, so to speak. They were responsive enough to deal with many different issues that emerged.
Under the new system, the report says that managers are now hamstrung by being forced into “bureaucratic silos” that limit their responsibilities.
One of the main criticisms in the report is the excessive bureaucracy that has resulted from Bill 10.
The report states that the population regularly complains about being unsure which service centre to contact and being transferred from one service to another.
“Callers are put on hold two to three times per call since supervisors must be consulted,” the report said. “[callers] do not know what services are available in the area.”
Assistant to CISSSO CEO Jean Hébert, Benoît Gauthier, admits that the system in place pre-reform was more flexible and that residents would not give the new system the same level of satisfaction as the previous one.
The report also criticizes the fact that there are no local representatives from the Pontiac on the CISSSO board of directors.
However, CISSSO argued that the board has no regional representatives.
Gauthier said that the board members are appointed by Minister Barrette.
“Geography is not a criterion,” Gauthier said in the report.
One of the major issues of the reforms that came out of Bill 10 is the fact that many people in the region now have to travel to Gatineau for medical appointments. This results in two-hour drives becoming the norm for people looking for routine healthcare.
“The distance that people in the Pontiac must travel to seek care in Gatineau is a heavy burden,” the report said.
The report also says that access to specialists remains an issue. Many Pontiac residents have to travel to Gatineau to see such specialists.
“People are shown to do better when they’re treated in their own community,” said Dr. Thomas O’Neill, one of the interviewees for the report.
“You have to say ‘how about all these people who are seeking care from a urologist, a gynecologist; even if these specialists come up once per month, it still gives access in the community,” O’Neill said.
Additionally, the authors note that 42 per cent of the population aged 15 and over speak only English. When these people go to Gatineau, they must be greeted in French.
The report says this language discrepancy doesn’t take into consideration the wording of the bill that specifically says that the reform will take into consideration “the recognition of cultural, linguistic, local and historical specificities of certain institutions.”
The authors of the report also argue that the large wait times at the hospitals in the city are causing more and more people to make the trip up Hwy. 148 to Shawville.
“It is estimated that 40 per cent of users are from Gatineau,” the report says. This puts increased stress on staff and management.
Four proposals were made by those who were interviewed by the report’s authors:
· A local budget
· A director general for the Shawville Hospital Centre
· The recovery of certain management positions
· The relocation of certain services from Gatineau to the Pontiac.
In the report, CISSSO said that it would not be opposed to relocating some services to the Pontiac but collective agreements with healthcare worker unions would not allow that.
One issue the report takes with the system’s amalgamation is the fact that there is no local purchasing policy. All purchases must go through one of three major procurement offices – which slows the process down.
The report also notes the important role the healthcare sector plays in the local economy. The healthcare system in the Pontiac employs somewhere in the neighbourhood of 500 people – including doctors.
The report also examines the socio-economic impact of the elimination of management positions at the Shawville Hospital Centre.
Not only does the report say the relocation of managers to Gatineau has led to a negative impact on accessibility of decision makers, but it also eliminated the management payroll of around $1,500,000 – most of which was spent in the local economy.
When interviewed after the report’s release, Barrette said that he considered the report an “opinion piece” and said it was not done impartially.
