Health network overhaul plan | Three years to carry out the re -establishment of the network

Massive staffing, better access to data, construction of new hospitals and accountability: Health Minister Christian Dubé, presented on Tuesday morning in detail his “Plan to implement the necessary changes in health “that” will be written on the horizon of 2025 ”.

Posted at 9:02 AM
Updated at 9:39 am

Ariane Lacoursiere

Ariane Lacoursiere
The Press

The main lines of the plan have been presented gradually in recent weeks by the government or fanned by the media. With this plan, Minister Dubé said he relies on numerous expert reports made over the years on improving the health network, including Michel Clair’s made in 2001 and where The Press came back recently.

At a press conference, Minister Dubé said some of these expert reports were “of high quality” but “sometimes, there was a lack of political courage to implement the recommendations”. “It’s over, we need to act,” he said.

The plan outlines 50 steps to offer “human-level and effective care” in Quebec. The first and possibly the most central: mass recruitment of staff by hiring 1,000 nurses overseas and implementing accelerated training programs, among other things.

Quebec also wants to better retain its health care workers by eliminating mandatory overtime and implementing a self-management schedule system. As the population is aging at a very rapid rate, health needs are rising at a very rapid rate. For Quebec, “the status quo is unsustainable”.

Increase in overtime hours worked from 2019-2020 to 2020-2021

5.4%

Part of people aged 70 and over in Quebec

1971: 4.2%

2020: 13.6%

Forecast for 2035: 20.5%

The end of fax machines and modern hospitals

The pandemic will reveal that the health network is lagging behind when it comes to accessing data. Fax is still used throughout the network, and approximately 10,000 different information systems are in use, making data collection difficult. “The network yesterday became bureaucratic, complex and technologically outdated,” the minister wrote in his plan. The latter wants to give every citizen the possibility to have access to their health information. He wants to implement a digital health record and improve data collection to better manage the network. This change will notably pass through the enactment of Bill 19.

Mr. Dubé also wants to quickly modernize the health infrastructure. In addition to building homes for the elderly, we want to renovate some hospitals and CHSLD. New hospitals or expansions are planned, particularly in Gatineau, Vaudreuil, La Malbaie, Chicoutimi and Montreal. Approximately 2,000 new beds will be added to the network. And the increase in staff will make it possible to add 2,000 more beds, Mr. Dubé predicts. These additions can help reduce waiting in the emergency room. Quebec also hopes to create “command centers” in each hospital to allow more fluid management of beds and reduce emergency room waiting times. The transition to patient -based funding of healthcare institutions and no longer based on historical values ​​will accelerate. We are also betting on increasing federal health transfers.

Ratio of beds per 1000 inhabitants

  • Quebec: 2
  • UK: 2.4
  • Canada: 2.5
  • United States: 2.8
  • France: 5.8
  • Germany: 7.9

Source: MSSS and OECD

The doctor, not just the gateway

Significant energy will be put into improving access to first-line health care. The front-line access counter, deployed in Bas-Saint-Laurent, will be expanded throughout the province. This call line allows appointments to be made with orphaned patients in a particular region. Mr. Dubé speaks of a real “revolution in patient approach”. By calling a single phone number or having access to a website, patients can talk to someone, receive quick health advice, make an appointment or renew their prescription. For Mr. Dubé, it is “a single channel where the patient is cared for by the right professional. Not a number where you are told to go to the emergency room.” Most Quebecers will have access to this Counter next time summer, predicts the Minister.

Instead of just making the family doctor the gateway for patients to the network, the Ministry of Health wants to involve more professionals and rely on interdisciplinarity. Expert nurse practitioners, community pharmacists and paramedics will be more involved. Family physicians will also be encouraged to change their salary by opting more for capitation. This method of payment encourages the care of patients “in a group and in an interdisciplinary approach”.

To improve network governance, Quebec relies on “decentralization of the health system” to “bring network operations to the regions and redefine the mission of the Ministry (Editor’s Note: of Health and Social Services) in strategic orientation “. The Deputy Minister of Health, Dominique Savoie, should submit as soon as possible a plan on this topic. “Decentralization and organization of work will allow us to ensure the implementation of our health plan”, according to Mr. Dubé. The final budget assured Minister Dubé that he would have a way to achieve his ambitions. But for him, “it’s not just money that’s needed. The organization needs work.

The private and the elderly

As announced earlier this month, Quebec wants to create more space for private health. Among other things to reduce waiting lists for surgery. However, there is no question of charging the patient for this care. For seniors, a major shift toward home care will continue to take place. However, we await the conclusions of the Health and Welfare Commissioner, who is currently reviewing the performance of home care and its funding. More support will be offered to carers and community organizations that offer support at home.

Proportion of home support spending in the budget dedicated to support for the autonomy of the elderly

Quebec: 40.5%

Denmark: 65%

Source: MSSS and Danish Ministry of Health

Still marked by the CHSLD Herron scandal that occurred during the pandemic, Quebec wants to gain greater power to investigate private residences for seniors, private CHSLD and intermediate resources.

To be prepared if a new virus hits the planet, Quebec plans to create a national strategy to prepare for a next pandemic. There are also plans for “significant reform” in public health. The plots remain vague. But the COVID-19 pandemic “demonstrated the importance of having clear public health governance, based on freedom and transparency of work and the recommendations of experts” and “shed light on the need for superiority and greater consistency between jurisdictions., “the plan said.

To ensure that the measures set for the plan are actually applied, the government plans to publish, starting in May, a “national and regional dashboard on achieving the strategic plan’s goals and priorities”. “You know me, we measure. Because what is measured gets better […], said Mr. Dubé. In the medium term, I think we can move the needle very quickly. ”Mr. Dubé believes that the fact many major players in the health network have already moved and are interested in changing things will allow the plan to quickly “execute”.

The refoundation plan briefly

50 steps including:

  • Increase staff training and retention, and recruit hard
  • Eliminate the use of mandatory overtime
  • Adding new beds to the network
  • Installation of front-line access counters throughout the province
  • Massive change towards home care
  • Accelerating patient -based funding

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