At a crossroads
The Minister of Health doesn’t seem to understand, despite the alarm bells going off on all sides that he can never get his reform to succeed without establishing meaningful dialogue with the different stakeholders in the network, with all the friendliness, respect and listening required for this type of exercise. And even if he has to resign himself to it, he has to realize that the transformations that he is putting into operation are obviously diametrically opposed to the solutions that should be applied.
There is no doubt, taking the expression used by the authors of a letter published in La Presse =, that we are at a crossroads when it comes to the reform of the healthcare network. Never, that can be remembered, has a Minister of Health gone so far in his ambitions for controlling the Québec healthcare system. Moreover, I do not remember either such a consensus of the stakeholders in the network in denouncing the proposed changes.
What the healthcare network needs the most is a strong, diversified front-line. All the indicators and the evidence-based data highlight the necessity to switch to a vision in which the healthcare professionals can fully carry out their field of practice and remain employees of a public network. Furthermore, it seems clear to us that the network must offer services that are close by, rooted in the needs which vary greatly from one place to another.
Thus, the mission of the CLSCs (for those that still exist) should be preserved, and the FMGs need to adapt their management and their organization of work to promote the full and complete autonomy of the healthcare professionals working in them. The Minister of Health should also accept the idea that new publicly funded models of care can be created, models which take the contribution of the healthcare professionals into account more.
Unfortunately, Mr. Barrette is stubbornly imposing a vision which limits access to front-line care and services by making them go through the medical prism. We have seen this in particular with his directive on transferring a part of the services provided in a CLSC to the FMGs and the private clinics. He is going to continue his momentum, without talking to anyone and by discrediting everyone who doesn’t think like him along the way. And in the end, he will fail to take better care of the patients, because he will not have been attentive to those who carry the weight of the healthcare network every day on their shoulders.