For the Fédération interprofessionnelle de la santé du Québec–FIQ and Fédération interprofessionnelle de la santé du Québec | Secteur privé–FIQP, a single observation can be made after reading the 2022-2023 budget presented today: the public health network will remain very vulnerable in the face of unforeseen events, due to a lack of strong measures to attract and retain healthcare professionals. The budget choices show that the government has failed to learn the lessons of the pandemic: without improving the capacity to provide care in the public health network, both the population and the Québec economy will be exposed once again.
Signals ignored once again
The Federations are dismayed that the government has failed to build on the consensus of many observers in the field and the reports on the management of the pandemic. Working with less has been the norm for a long time and it is high time to change the tide and tackle the crisis in working conditions. The Federations have many times asked the government to plan provincial labour needs over the long term, using a provincial workforce planning exercise, and to invest in stable work teams dedicated to implementing safe ratios.
This crisis will not be resolved in the short term, as unfortunately there are no new measures to deal with it in the budget. Of course, the collective agreements will have to be implemented, but this does not represent new money to turn things around and put in place attractive measures other than the temporary and unilaterally decreed premiums. This will mean that the tap of dependency on private and independent labour can continue to run, squandering the resources of the government that promised to tackle it. It is worth noting, however, the effort to encourage greater use of other health professionals on the front line and in prevention and health promotion.
Rebuilding trust with the network
The healthcare professionals’ trust has been shaken more than once by broken promises. Healthcare professionals also hear speeches on reforming the health network and remain skeptical. The Federations deplore the fact that a billion dollars is being earmarked over five years to “restore the health network” without giving details of the measures the government plans to put in place. This approach has gone on long enough.
Stalled choices for the care of the elderly
The growing needs for health care for the elderly and access to front line require a long-term vision. With a much lower deficit than expected, the Minister of Finance could very well have given that much-needed boost to the shift towards home care and services. The amounts invested are clearly insufficient to meet the estimated needs at four billion dollars over five years. He is investing twice as much new money in homes for seniors as in home support; the government has not understood the population’s wishes. He finally provides a budget of three billion over five years for the residential housing action plan, but again this will be presented later. If we add the private CHSLDs, of which about twenty could be private subsidized, we don’t know when or how. That’s a lot of murky issues in this budget.
“The government’s resistance to considering investments in health as an urgent economic measure is inexplicable, any more than it makes sense in light of the collective trauma we suffered during the pandemic. The social and economic costs are such that major investments are needed now. Our members are demanding immediate and coordinated measures that consider their needs. However, it remains uncertain whether the network will be able to recover from the pandemic without risking further staff distress. A lot of money is earmarked for measures that have yet to be announced. The healthcare professionals would have hoped for some hope, but unfortunately they were not heard.”
Julie Bouchard, President, Fédération interprofessionnelle de la santé du Québec–FIQ
“Whether we like it or not, the government’s budgetary choices affect the most vulnerable in our society and women, who make up most of the workforce in the health network. The working conditions and quality of the care provided are of major importance for the healthcare professionals and the two are closely connected. A lack of new measures for stabilizing the work teams, like the gradual implementation of safe ratios, will not stop the exodus for private agencies, the use of MOT, the substitution of job titles, offloading, work overload and absenteeism.”
Sonia Mancier, President, Fédération interprofessionnelle de la santé du Québec | Secteur privé–FIQP