March 17, 2021

The Fédération interprofessionnelle de la santé du Québec-FIQ and FIQP | Secteur privé respond to the Rapport de l’enquête conjointe CMQ-OIIQ-OIIAQ on the quality of medical and nursing care and on the La Presse investigation on Vigi Santé institutions. In finding that several residential centres are incapable of fulfilling their responsibilities to a vulnerable clientele, they demand that all residential centres in Quebec, whether public, private or private subsidized, be held to all of the obligations set out in the Act Respecting Health Services and Social Services (ARHSSS). They are putting pressure on the Health Minister to deploy all control mechanisms to enforce compliance, which is currently not the case for private CHSLDs.

As recommended in the report, CIUSSSs and CISSSs must obtain all required powers of intervention to oblige uncooperative residential centres to provide care that meets the norms and standards set out in the ARHSSS. They must be held accountable for the outcomes of the services offered in their territory. These powers could have been used to intervene well before the pandemic at the Herron or Vigi, and prevent the atrocious events reported at these institutions.

The pandemic highlighted major failings that endangered the health and safety of seniors residing in both private and public CHSLDs. Minister Dubé must take note of this in the recommendation follow-up he committed to yesterday.

“The report from the professional orders should serve as a catalyst to create deep change in the care and practice conditions for healthcare professionals. The recommendations must be echoed throughout the entire health network. To ensure that seniors’ right to receive safe, dignified, and attentive care is respected, we must first see to the implementation of mechanisms that are applied uniformly at all times. Though most of the recommendations were already known, it is still urgent to apply the solutions.  Private CHSLDs can no longer remain our collective blind spot and avoid control mechanisms set out in the law.”

Nancy Bédard, President, Fédération interprofessionnelle de la santé du Québec-FIQ

Nursing administrations in all care settings and safe ratios

The care needed in CHSLDs is complex. The report highlights the obstacles to efficient organization of work that would support clinical practice. In the Herron residence’s case, for example, no nursing administration had been set up. The healthcare professionals working there had no management to turn to, nor any restraint protocols. As set out in the ARHSSS, healthcare professionals must refer to protocols and a management framework that establishes the practice’s norms and standards.

To guarantee the safety of seniors in residential centres, the Federations insist, once again, that the government tackle the work overload and workforce shortage. The government’s refusal to seriously address these issues is absolutely inexplicable following all of the Ombudsperson’s recommendations during the pandemic, those that are in the report by the professional orders and the investigation on Vigi Santé.

“Safe ratios are a prerequisite not only for safe, quality care, but also for proper practice conditions. Further measures—especially regarding staff mobility, complaint processing, reserving personal protective equipment, and healthcare professional training in these institutions—would facilitate the resolution of residential care quality problems within a short time. What’s more, it is imperative that the process for granting private CHSLD permits be reviewed.”

Sonia Mancier, President, Fédération interprofessionnelle de la santé du Québec | Secteur privé-FIQP

The end of the code of silence would signal improved care and services

The Federations demand that the government come up with a global strategy for seniors’ care, home care and residential care, and that it inject the necessary funds to ensure that Quebec seniors have access to quality care. It needs to take immediate steps to make sure that the situations denounced daily by healthcare professionals never happen again.  

As the Federations see it, breaking the code of silence in the health network would be the only measure that would prove the reforms are underway. It would mean that healthcare professionals would no longer need to denounce the horrible consequences resulting from the neglect of seniors’ care.