Analysis: Quebec’s health-care system now worse than ever


No new health agency can magically solve the huge shortage of staff that’s behind this crisis, and that might take years to resolve.

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By every major indicator — from emergency-room overcrowding to record-high surgical wait times and the lack of available spaces in nursing homes — Quebec’s health-care system is now arguably the worst it’s ever been.

Although Quebec has made it a priority to tackle wait lists for cancer surgery, more than 4,400 oncology patients are still waiting for their operations, according to the Health Ministry’s own statistics. Of that number, more than 600 are waiting longer than the medically acceptable delay of 57 days, potentially putting their health at risk.

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“There are probably a lot of people dying on these wait lists,” patient-rights advocate Paul Brunet, executive director of the Conseil pour la protection des malades, told the Montreal Gazette on Friday.

“These are record highs.”

Source: Quebec Health Ministry
Source: Quebec Health Ministry

Even the wait list for so-called non-urgent surgery has now swelled to nearly 164,000 people. Almost 14,000 Quebecers today have been languishing more than a year for their surgery. At a year’s wait, a non-urgent surgery starts to become urgent.

Two weeks ago, the Montreal Gazette reported an unprecedented five Montreal emergency rooms were filled to more than 200 per cent capacity. This, despite the fact there have been fewer ER visits by patients. The reason? Hospitals have fewer staff than before the pandemic.

This shortage of medical personnel — from nurses and anesthesiologists to respiratory therapists and family doctors — is placing the system under enormous pressure. Many burned-out nurses have quit the profession. Quebec’s health network now needs more workers than ever — at least 12,425, to be exact — in order to resume functioning properly.

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As numerous studies have amply demonstrated, the key to managing health care well is to focus on prevention. But the wait list for home care had ballooned to a record high of 21,009 as of September, up by a staggering 119 per cent since 2019.

In yet another crucial indicator, Quebec’s health-care system appears to be failing our elders. More than 4,500 Quebecers are waiting sometimes years for a bed in a public long-term care centre, known in French as a CHSLD. That’s up by nearly 84 per cent since 2019.

If some of these Quebec elders received home care, they might not have deteriorated to the point where they needed to go into long-term care. But for some, long-term care is not available. As an indirect consequence, some elders at home may take a tumble and fracture their leg or hip. They’re then rushed to a hospital. And what happens to them then when they get to a congested ER?

It’s not unusual for some elders to spend days lying on stretchers in Quebec ERs. An abundance of research has underscored the higher medical risks associated with languishing in an ER hallway, bereft of dignity and privacy.

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For much of this year — as Quebec’s health system has gone from bad to worse — Health Minister Christian Dubé has focused on a structural reform of the system, known as Bill 15. Now, ER doctors are accusing him of ignoring their pleas.

“While all ministerial attention was focused on Bill 15 and the reorganization of the health-care system, the network has come to a complete standstill,” Dr. Marie-Maud Couture wrote in a letter to Dubé, as reported by La Presse.

For much of the pandemic, Quebecers were willing to give Premier François Legault what amounted to a pass, despite the fact Quebec declared the highest COVID-19 death toll of any province in the country. But now they seem to be less forgiving, as Legault has plummeted in the polls.

Legault and Dubé’s bet is that Bill 15 — and with it, the creation of a new Crown corporation, Santé Québec — will go a long way to fixing the beleaguered health network. But no new agency can magically solve the huge shortage of staff that’s behind this crisis, and that might take years to resolve.

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