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Quebec Government Refusal to Recognize Breakdowns in Health Care Services The Experience of Health Care Workers in Northeastern QuebecNathalie Savard is the President of the Union of Nurses, Licensed Practical Nurses and Inhalotherapists of Northeastern Quebec Workers' Forum: At this time, when health services are at a breaking point in several regions of Quebec, the Minister of Health refuses to talk about a breakdown in services and instead is talking about a reorganization of services. What is the living experience of the residents in the region where your union is active? Nathalie Savard: Indeed, the Minister of Health said at a press conference that on the North Shore and in James Bay, we are experiencing a reorganization of services. The fact is that for a period of time, there was a complete closure of the emergency department in Port-Cartier. There have been closures of services in the clinics. The Minister of Health says that these are not breakdowns in services. He claims that people will continue to have services, except that they will have to go elsewhere to receive them.
Just recently, it was announced that a clinic in Minganie was closed due to a lack of personnel. This summer, several clinics in our region were partially closed. Patient follow-up, treatment, home care have all stopped and only emergency services have been kept. Dispensaries are very important health facilities in the villages. There are also some amongst Indigenous populations and they play a very important role. Actually, we are constantly in a situation of a risk of breakdown of services. We are always on alert. We have staff putting in an incredible amount of hours to continue to provide services to the population and to keep services open. A few weeks ago, there was talk of closing maternal and child health centres in places such as Baie Comeau and Sept-Îles. We have fought for a long time in the regions to have local services, full services, such as specialist care close to where people live. We've experienced the time when major services were only available in the major centres, whether it was Montreal or Quebec City. Those days must not return. We are in 2021. When the government talks about reorganizing services, it is playing politics, it is trying to make itself popular, it's preparing for an election. WF: The Quebec government has announced that it will introduce a health bill in the fall, based on what it refers to as efficiency of services. What is your take on this? NS: It doesn't bode well. The theme of service efficiency is not new. It's a business vision. Managers, for example, make comparisons between the cost of treating a patient in Quebec City versus Sept-Îles. They look at it the way factory owners see their factories. They compare production costs. You can't run a society like that and most certainly not a hospital. For example, there are many Indigenous communities around our emergency department in Sept-Îles with their own problems and difficulties. There are social problems and other difficulties within the communities. We must work with the circumstances in our district, with the community, as they are important partners. There are managers who tell us that we are not efficient, that they have compared us with the emergency department in Quebec City. In large centres, emergency departments have a gynecologist on site, a neurologist on site. In Sept-Îles, when a patient comes in, these specialists have to be contacted, sometimes in Quebec City. At times we also have to transfer patients and have to take the time to do this. The realities are not the same. You can't just compare numbers and conclude that we are not efficient. Talking about efficiency in that manner is to prepare the ground for more closures under the guise of a reorganization of services. We need to put patients back at the centre of decision-making. We must take the time to care for them. And to do that, we must take care of the people caring for them. Managers need to listen to their teams. We need to find on-the-ground solutions to the problems people are experiencing. The health reform of the Liberal Party's [then] Minister of Health, Gaétan Barrette, created mega-institutions that are so big, so cut off from the base, that we are no longer able to sort out the day-to-day problems at the base, to relieve the people who provide services. The work to be done is not so complicated. We have to look at all the departments, analyze the problems in each one of them. We must examine the basic structure and re-establish an adequate basic structure with complete teams in terms of nursing, nursing assistants, attendants, housekeeping staff, etc. In other words, restore all that has been taken away from us over the years by successive governments. We must once again address the problems on the ground, and this must be done by the people on the ground. Services must be close to where the population lives. Respect for health care workers must be restored. Take the issue of mandatory vaccination in the health network, for example. We understand the principle, and since the beginning of the pandemic we have been encouraging our members to get vaccinated. But now our members have gone from being called guardian angels to being called "patient killers." We were sent to war at the beginning of the pandemic with the vaccines coming much later. We were sent to treat people without being given protective equipment, without proper ventilation, having to travel from one facility to another. And now, because around five per cent of our members are not vaccinated, with some of them being off work, they are being called patient killers. It can't work that way. The problems in the health care system are deep-rooted, deep-seated and cannot be sorted out through a piece of legislation from the Minister of Health. Obviously, the government has not spoken to us about the bill, let alone consulted with us. It seems that this is going to be yet another law drafted in an office by a handful of people.
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So
if I am a mother waiting to give birth and I have to be transferred
because there are no obstetrical personnel left in Sept-Îles, I
consider this a
breakdown in services in my region, which is the North Shore. It is
certainly a breakdown in services when the emergency room in Les
Escoumins is closed and the person has to travel three hours back and
forth to be treated in Baie-Comeau. 