The longer the pandemic drags on, the more it brings to light the multiple dysfunctions that, for years, have undermined our health and social services network, which is riddled everywhere like Swiss cheese. Hence the inevitable question.
Could the pandemic also be serving as “permission” to further reduce the basket of health services? See the new “hospitalization prioritization guide”, presented by the Minister of Health, Christian Dubé, and the Dre Lucie Opatrny, assistant deputy minister, she poses.
While the Omicron wave is breaking over our mega-hospitals built with billions, it is difficult to see otherwise the announcement of a “guide” aimed at reducing the “minimum” threshold of the care offered there.
Not that the Prime Minister does not despair like us of having to wait for the proverbial “light at the end of the tunnel”. Not that Christian Dubé is not eagerly looking for solutions.
However, it remains to be seen whether, given the extreme fragility of the network, they are not likely to be worse than the proposed remedy.
According to the Dre Opatrny, this “contingency” plan – welcome to the festival of euphemisms – would aim to offer quality care “B” instead of “A+”. To believe that the “A+” was already the norm… Let’s be serious.
The plan also proposes to relieve caregivers – exhausted, we agree – by calling on families and caregivers. For those who can, always go. The reality, however, is that after 22 months of the pandemic, many caregivers are also at their wit’s end.
Flexibility, you say?
Beware, moreover, of those who see it as a guarantee of “flexibility” propelled by the pandemic. Except for a few good ideas, in many cases this could end up in permanent reductions in care.
Above all, this plan again betrays the old hospital-centric reflex of the network. While we try to save the hospital soldier, the famous first line, whose access to home care and to family doctors or specialists, still suffers from major deficiencies.
On this account, one wonders to whom the patients less well treated or fired from the hospital will then be able to turn. All this despite the $52 billion in health care spending this year – or 43% of the Quebec state budget.
Considering the body of work as a whole, the worry of seeing this new leveling down taking hold little by little is therefore not entirely far-fetched. Worse still, in an aging society. Because is it not a question here of new disruptions in services, even in oncology, orthopedics, etc.? ? As Stéphane Laporte writes so well, when we speak of “shedding”: “in reality, we stop treating people who need to be treated. Treatments are suspended. These patients are not relieved, they are neglected. Mistreated. »
It is indeed rare to see utilities that are leveled down and magically come back up the slope afterwards. Ask the public schools… And the worm in the apple, it is precisely there.
A temporary or permanent plan?
In an interview with Paul Arcand, the Dre Opatrny made no secret of it: “We absolutely must use this crisis to question what we are doing and how we are doing it, to carry out a long-term reform”. That is clear. Meanwhile, faced with the health emergency, the 3e vaccine dose is lagging behind. The non-vaccinated clog hospitals, but the government refuses to impose the same vaccination on them, which precisely helps to reduce the risk of hospitalization and death.
The Public Health Act yet gives it the power to do so legitimately and legally.
Unlike other states, our public health also refuses to recommend the wearing of N95 type masks. Even though they are proven to be more effective than medical masks. Public schools waiting to be mechanically ventilated to help them fight aerosol contagion? They are told to open the windows as if it were Emilie Bordeleau in her schoolhouse.
It is sure that it is easy to play the “managers of stage”. However, this does not mean that these growing concerns, expressed among others by renowned experts and independent of the government, do not deserve its attention.