Legault Government's Anti-Social Restructuring of Health Care
False Claims that Privatization Complements Public Health Care
The present crisis in health care is the result of several decades of the neo-liberal anti-social offensive. One of its characteristics is to deny society's responsibility to its members and the role of government as defender of the public good. The situation requires a redefinition of what is the public sphere. The simple fact that the notion of public is associated with a "sector" -- the other being private -- is in itself a problem. A redefinition of what is public is the order of the day, by those directly involved — health workers, all workers and the population as a whole.
Privatization, such as the building of mini-hospitals recently
announced by the Quebec government, is presented as being complementary
to public health institutions, with the aim of "reducing emergency ward
overcrowding," and "shortening the waiting lists." In 2018, the
president of the Quebec
Chambers of Commerce, in an article entitled "The private sector, a
partner to the public and universal health system," speaks of the
unending waiting lists, "in spite of the billions of dollars of
investments given by the Treasury over the years." This statement in
itself is part of the false
claims that the public system is not effective. He does not even take
into account that just three years prior to this, the Quebec government
cut back millions of dollars in health care with its centralizing
reform, from which the system has never recovered. He speaks of a
"close and clearly
advantageous collaboration" which, according to him, has evolved
between the public sector and private enterprises, and states that it
would be a misinterpretation of the spirit of the Canada Health Act to see such complementary services as a violation of the principle of universal health
care.
Quebec Premier François Legault made similar statements when he announced his new mini-hospitals project. After having stated that the question of privatizing the supply of health care was a "touchy subject for Quebec," he added that one should not speak of privatization as if one were speaking of the devil. Such demonization is resorted to by governments when workers demand wages and working conditions acceptable to themselves for the work they do. This is precisely what Doug Ford did when he responded to the demands of Ontario education workers by declaring that they were demanding money which is supposed to go to schools, health care, public transit and infrastructure, "vital services hardworking people of the province are counting on."
In an open letter dated September 22, speaking on behalf of the Board of Quebec physicians for a public system, resident physician doctor Élise Girouard-Chantal points out: "Let us not be fooled: the immediate aim of private companies is profit, even in health." She explains that the financing of the Groups of family medicine (GMF) is public but the management is private. She says that this financial arrangement is more costly to the state, since doctors who practice in these centres receive, for each service, a fee which is 35 per cent higher to cover the operating costs of private management. A significant proportion of GMF's are made up of corporations making substantial profits at the expense of tax-paying Quebeckers, she says.
She also points out that privatization schemes such as those put forward by the CAQ deprive the public system of its capacity to tend to patients. To illustrate this, she says, we just have to look at private hiring agencies, which were very active during the pandemic. The workers with these agencies were themselves public health care workers who left the system to be rehired by agencies, then are sometimes assigned to the same hospital they used to work in. For the same worker, the government pays more because the agencies pocket a generous profit.
Dr. Girouard-Chantal adds that privatization is often presented as a miracle solution for providing better care and reducing waiting lists. In fact, data shows that a private parallel system does not ease the public burden and can in fact make waiting lists even longer. In long-term care, studies have shown that private institutions provide lower quality of care, and have a higher death rate. The myth of the superiority of private management in Quebec was completely shattered during the pandemic in private homes for seniors.
Some of the recommendations she puts forward are very similar to those of the Quebec Federation of Nurses and other unions: improve nurses' working conditions by abolishing mandatory overtime, pass legislation to establish safe staff to patient ratios, block contracting-out to private manpower agencies, block for-profit GMF's, private medical centers managed by private investors as well as public-private partnerships.
In the case of private CHLSD's (long-term care homes) and seniors'
homes, numerous reports -- including the one by the Quebec Coroner
Géhane Kamel on the death of older or vulnerable persons in these homes
during the first wave of the COVID-19 pandemic -- have denounced the
handing over of
the health of our seniors to private institutions whose aim is to make
money on the backs of the elderly. The number of cases was overwhelming
and showed that these homes are not properly equipped in human and
material resources to care for illnesses and problems frequently
experienced by the
elderly, nor to take basic epidemiologic measures, let alone to face a
pandemic.
Some families whose loved-ones were victims of these tragedies are still going to court to obtain justice. The most recent is a civil lawsuit by two families claiming damages from the Quebec government for the alleged abuse of their parents during the COVID-19 pandemic. A member of one of the families has pointed out that it is important that justice prevail, our elderly having been sacrificed, and hoped that a ruling in favour of the families would force the government to improve care for the elderly and make sure such a tragedy never happens again. The families fear that the report by Coroner Géhane Kamel on the deaths in long-term care homes will be forgotten and ask themselves why, during the electoral campaign, parties did not talk about the catastrophic situation in the CHSLD's, stating that we cannot pretend that it does not exist.
In her report, the Coroner stated that the tragedy in the CHLSD'S reflects a " breach of the moral and societal contract." These words are actually a good description of the present overall situation since for several decades we have witnessed a definite breach of the civil society moral and societal contract. The very notion of society and the responsibility of governments as defenders of the well-being of the population is a thing of the past. In the face of the dismantling of the public health care system which leaves many behind, and in the face of devastating attacks on our physical and mental well-being, who but the public themselves -- made up of health workers and of workers and the population as a whole -- are in a position to defend the care needed by the population and which belongs to it by right? Who else can put its collective strength into play and rally everyone around a public health program whose content is clearly emerging and has, as a top priority, the improvement of the working conditions of those who deliver the care as well as of the protection of their health and security?
This article was published in
Volume 52 Number 56 - December 7, 2022
Article Link:
https://cpcml.ca/Tmld2022/Articles/D520561.HTM
Website: www.cpcml.ca Email: editor@cpcml.ca