(Quebec) Christian Dubé’s comprehensive reform does not go far enough to improve access to health care, according to the College of Physicians. Draft law 15 focuses too much on what is happening in the hospital and too little on on-site care, the professional code complains.
Posted 5:50pm Updated 5:50pm
“You have to take care of the patient before he has to go to the hospital and after an episode of care, the patient has to leave the hospital in good condition […] I’m talking here about first line and home care,” explains the President of the College, Dr. Mauril Gaudreault, in an interview.
According to the professional code, Bill 15, which aims to make the network of health and social services more efficient, is “oriented exclusively to the organization of care within institutions” and not sufficiently to that outside, such as in family doctor groups (FMGs), health clinics, home care and hospital stays.
“The College believes that it will therefore not be possible to significantly improve access to care across the territory without planning and management focused on local care,” said a brief delivered to parliamentarians on Tuesday The text of the law is presented by Minister Christian Dubé as part of consultations.
“The silence of the bill on this matter causes us to question the government’s ability to address the overcrowding in emergency rooms where patients end up when they are unable to get an appointment at the clinic,” the college writes .
“I think we shouldn’t limit ourselves to what’s happening within institutions, access to care is available across the territory,” stresses Dr. Gaudreault. The college also recently conducted a tour of a dozen health centers in Quebec.
“Everywhere, everywhere I have found problems of access and quality of care, even in certain regions where there were citizens who were deprived of care. It’s not true that we can go on like this, something needs to be done to improve access,” he stresses.
The College of Doctors endorses Christian Dubé’s reform project, which aims to transfer all operational aspects of the Department of Health and Welfare to Santé Québec, a new government entity. The department can concentrate on its planning task.
However, Minister Christian Dubé has to go further if the legal text does not contain enough “concrete measures for better access” alongside some possible solutions, the College notes.
The College recommends that Mr. Dubé amend his bill to add the notion of “nearby care”, which must be provided by integrating all of the network’s resources, including community resources, into the administration of Santé Québec.
The voice of doctors “diminished”
Another source of concern is that the College of Physicians believes Quebec’s reform “appears to seek to diminish the importance of medical leadership” by increasing the authority and responsibilities of the Physicians, Dentists and Pharmacists’ Councils (CPDP) in the organization “watered down”. Care.
In the current form of the bill, the CPDPs will report to the Medical Director and the Interdisciplinary Council of the facility. The college sees this as “a loss of independence of this body”.
“Reducing the level of physician involvement carries a significant risk of demobilizing and disconnecting the medical profession,” the college warns. Doctors are also excluded from the works councils that replace the board members.
In addition, the College believes that the clinical governance statute “concentrates powers in the hands of a limited group of managers, resulting in a real risk of arbitrary decisions” because “the same individuals are responsible for both the ‘granting of privileges and will be responsible for determining penalties'”. for doctors.
The new structure will see the addition of a medical director per facility, replacing the current head of the specialist service, and two other managerial positions, one for general practitioners and one for specialists.
“We agree, but it can’t just be these people. We seem to forget that within institutions there have always been department heads, doctors who take responsibility. […] We have to put that back on the agenda,” says Dr. Gaudreault.
Keeping the CPDPs in their current structure is a solution recommended by the College.
After a two-week break, special consultations on the imposing Bill 15 will resume on Tuesday. In addition to the medical association, the chambers of general practitioners and specialist physicians are also consulted.