New Quebec health plan promises better access to care, improved working conditions for nurses

Quebec unveiled its plan to heal its beleaguered health care and social services system over the next three years, with a focus on accelerating access to front-line health services, reducing emergency room wait times and improving working conditions for nurses.

The plan, outlined in a 90-page document called “Human and Efficient — Plan to implement necessary health changes,” highlights some solutions to the system’s challenges made worse by the pandemic, including lack of personnel, rising costs, and an aging population.

Health Minister Christian Dubé and Lionel Carmant, Quebec’s junior health minister, rolled out the details of the plan Tuesday morning.

Dubé said one of his key objectives is to ensure all Quebecers have “the best patient experience and that they are proud of their health system.”

Among the 50 proposed measures, which were leaked in a document obtained by Radio-Canada last week, are eliminating mandatory overtime for nurses, hiring of 3,000 new clerks by the end of the year to take on some of the paperwork, more home-care services for seniors, modernizing access to medical data and the creation of electronic health records accessible to patients.

Many measures are aimed at creating a “more attractive work environment” for health-care professionals, particularly for nurses.

To that end, the government is promising to overstaff the system, to enable it to handle absences without relying on forcing nurses to work overtime. The plan is to undertake a “massive” recruitment campaign, including hiring more than 1,000 nurses from abroad.

Each establishment would also be allowed to manage its own schedules, with input from staff.

The government also wants to reduce the system’s reliance on private agencies to provide temporary nurses and nurses’ aides. Right now many hospitals and long-term care homes rely on those agencies to fill positions when they are short-staffed, at a higher cost.

The new health plan document doesn’t include costs, but Dubé pointed to a budget increase of 6.3 per cent for the health system in the coming year.

Last week, Finance Minister Eric Girard said that increase will be put toward the upcoming revamping of the system.

But money is only part of the solution, Dubé said.

“It takes more than money — it takes a willingness to work differently.”

One-stop service for Quebecers without family doctors

Quebec is also planning to change the way family doctors are paid, from a per-act to a per-patient basis, in an effort to get those doctors to take on more patients.

There are some 945,000 Quebecers who are still on the waiting list for a family doctor, according to the document.

Dubé said the government is still working on reducing the number of people on that list, but it is backing away from a promise made in 2018 to get everyone a family doctor by the end of the CAQ government’s first mandate this year.

The plan now calls for stepping up alternatives for front-line care, including giving nurse practitioners, paramedics and pharmacists more power to treat patients.

Under the plan, Quebecers will call a phone number which would act as a one-stop service, where a nurse would direct patients to the appropriate medical service, whether that’s seeing a doctor or lining them up with some other method of care.

“It’s not only theoretical. It’s already started,” said Dubé, who pointed to a pilot project in the Lower Saint-Lawrence region.

Dubé said he hopes that “the majority” of people without a family doctor will be able to use the one-stop service by the end of the summer.

The hope is that under this plan, fewer Quebecers would need to go to a hospital emergency room for health issues that could be treated elsewhere.

However, there are also proposed reforms to how emergency rooms would operate, with an aim to reduce the wait time in every emergency room to no more than 90 minutes, the document states.

Every hospital would have a “command centre” that would tackle reducing wait times. The center would be staffed by workers from different sectors, including the at-home care team and mental health professionals.

The center would aim to discharge patients as soon as their condition is no longer critical but would ensure the patient “continues to benefit from services outside the hospital if their state of health requires it.”

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