In a November media tour, Geneviève Biron, head of Santé Québec—the new agency in charge of the province’s health care system—repeatedly stated that health care users will be her top priority. Many commentators pointed out that government after government has been saying the same thing for decades. What makes this system overhaul any different from the many others before it? And what does “centring users in every decision” actually mean?
Time goes by fast from one election to the next. And unfortunately, long-term objectives tend to fall by the wayside when a government is seeking re-election. This may be an argument in favour of the new agency: Santé Québec could be less shaken up by a change in government than the Ministère de la Santé et des Services sociaux. Or so goes the thinking.
Of course, we are still at the speculation stage at this point. Santé Québec is a brand-new agency and the challenges are already numerous. Only time will tell if it’s the right solution. One thing is for sure: our current situation is not sustainable.
Primary care and surgery wait list still the main issues
I think we can all agree that Quebec offers truly world-class medical care—if you can access it. I’ve lost count of how many times, in my more than thirty years as a doctor, I’ve heard people say that once you are in the system, it does work well.
Our primary care services are no longer able to meet the demand. Pressures such as a predictably aging population have only widened the gap between supply and demand. Our doctors are aging too (25% of them are 60 or older), and work values have changed: much like everyone else, our doctors are also seeking a healthier work-life balance. Not only that, but the heavy burden of family medicine means fewer medical students are choosing it as a specialty.
Yet Quebec governments have deliberately dangled the possibility of a family physician for every Quebecer. We now know that the math there is unrealistic, and that we need to work with other points of access to care.
The way I see it, the best and most realistic solution is to leverage multidisciplinary teams to make primary care more efficient. The leadership at Santé Québec should be focusing on access to the right professional at the right time. And you can’t make that vision a reality without investing in primary care.
Imagine the anxiety of endlessly waiting for surgery that never comes. Right now, 160,000 people are on the surgery wait list, and 10,500 of them have been waiting for over a year. We urgently need to reduce the surgery backlog and increase access to operating rooms, to get specialist physicians performing more surgeries and give people the medical care they so desperately need.
We need a more modern structure
In her interviews, Geneviève Biron has said that Santé Québec is in fact making the system leaner and eliminating 21 other, smaller structures by merging CIUSSSs and CISSSs and becoming the province’s sole health care employer. That may be true, but becoming Canada’s single largest employer surely comes with its own share of red tape.
Now, from a medical standpoint, I can only hope—beg, even—that Santé Québec will lighten our administrative burden and improve interoperability. I sincerely hope that as the new, sole employer, Santé Québec will opt for a modern computer network that makes it easier for information to be shared between institutions so we can take better care of our patients, regardless of where they typically go for treatment. As 2024 winds down, let us keep our fingers crossed for a new digital system that is strong and efficient and keeps data secure.
Geneviève Biron and her team have a lot on their plate. Let’s give them the benefit of the doubt and see what the future brings.
Dr. Jean-Joseph Condé
French spokesperson and CMA Board member for Quebec
This commentary was initially published in Le Soleil