Quebec Healthcare October 2022-

Written by  //  January 20, 2023  //  Health & Health care, Québec  //  No comments

Dr. Mark Roper (posted on Facebook)
The RLS sub-region of Faubourgs – Plateau-Mont-Royal – St-Louis-du-Parc (632) is a unique medical region in Quebec. The worst rate of registration with a family doctor in the province is 60%. This is far from the Quebecois average of 79% and the best sub-region, Charlevoix has 92%. With a total population of 166,866 inhabitants, 67,012 citizens are orphans. Despite this serious situation, the MSSS calculates that there is a surplus of front-line family doctors in the territory of 21 full-time doctors.
Their calculations are simplistic. One family doctor on the front line for every 1,500 inhabitants translates needs 111 doctors, with is 132 is in place. But absent from the calculation is the effect of portability. Doctors in the territory have registered 67,004 Quebecers who do not live in the territory
It is surprising that businessmen like Mr. Legault and Mr. Dubé chose to follow the simplistic calculations of his MSSS. Mr. Legault considers that the doctors of the region do not work hard. His minister Mr Dubé follow the same logic and transfer the doctors to the 450 regions. For us, portability is a measure of water quality.
Speaking of the large regions, the population of Montreal has the worst registration rate with a family doctor in Quebec at 68%, far from the best region, Lac St Jean at 92%. There are more than 600,000 orphan Montrealers. Despite this situation, 382,954 patients from other regions are registered with family doctors in Montreal. If Montreal’s family doctors only saw its own residents, there would be an 86% enrolment rate.
At present the percentage of orphans in Montreal and several sub-regions is increasing. Montrealers without a family doctor (and doctors about to retire) are stuck with three options:
• Do without a family doctor and see an occasional walk-in clinic,
o It does little to address the complex needs of primary care and has poorer outcomes
• Go into the rapidly growing private sector
o The current rate is $3,000-5,000 per year for three visits and a blood test.
o It’s hard to swallow when your tax dollars are spent to provide health care to your fellow citizens in the 22 regions where enrollment rates are over 90%.
• Stop healthcare portability.
o It won’t be long before people in the regions insist that doctors in their area prioritize locals and send other patients back to their local areas where there is less shortage.
o This is a challenge because it is a core tenet of our health care system that encroaches on the doctor-patient relationship.
o There is no effort made by the government or surrounding areas to repatriate these patients despite the allocation of doctors for them in their areas.
To find the situation in your territory go to Where are the Family Doctors? (where-is-my-doctor.com)

20 January
Quebec health minister apologizes for end-of-life care for Robert Bourassa’s widow at St. Mary’s Hospital
Regional health board vows to investigate Andrée Simard’s treatment after family goes public with complaint
The family’s description of Andrée Simard’s treatment prompted Quebec Health Minister Christian Dubé to offer them his apologies “in my name and that of the network,” while the minister responsible for end-of-life care, Sonia Bélanger, said the responsible health board must “review practices at St. Mary’s Hospital so that a situation like this one never happens again.”
Simard, the widow of former premier Robert Bourassa, died last November, several days after being admitted to the hospital in Montreal’s west end.
Soon after Simard was admitted, it became clear she was going to die, Bourassa said in a lengthy letter to the hospital administration which she shared with the French newspaper, La Presse.
Denied a transfer to the palliative care unit, every request by the family to get appropriate care for Simard in her final hours turned into a pitched battle, Bourassa said.

2022

29 December
With viruses overwhelming Montreal ERs, ‘we’ve had to virtually create space’
The associate chief of the emergency departments at the Royal Victoria and Montreal General hospitals said he thinks it’s the worst December he has seen.
A combination of three viruses and a shortage of staff have conspired to make this one of the most difficult Decembers in memory at hospital emergency rooms across Quebec.

5 December
What’s gone wrong: More than 800,000 Quebecers wait for family doctor
Four years ago, the CAQ promised a family doctor for every Quebecer, but in the last election campaign, it had to admit that wouldn’t be possible, which has left many people feeling lost in the system.
The head of the Primary Care Division at the MUHC, Dr. Mark Roper, says a full-time family doctor will make more than 2,000 diagnoses per year, everything from high cholesterol, to hypertension, to diabetes. By catching conditions and illnesses early, family doctors can prevent life-threatening complications such as stroke and heart attack, he said.
“For every 100,000 people who do not have a family doctor, we observe an increased mortality of 60 per year,” he said, adding that would mean 360 Montrealers die each year because of lack of access to a family physician.

1 December
Quebec health minister asks nurses to come back to help struggling health-care system
He is calling on nurses to come and help out at busy Info-Santé 811 phone line, which received around 10,000 calls on Wednesday.
Quebec needs more nurses to help answer 811 calls, health minister says
As pediatric emergency rooms continue to deal with unprecedented levels of sick children, family doctors and clinics are also overcrowded and overwhelmed. Many parents are exhausted just looking for someone to call and a place to bring their sick child.
During question period, Liberal health critic André Fortin criticized Dubé for his poor results and said emergency rooms are overflowing.
“In Repentigny this morning, Madame Speaker, it’s 181-per cent occupancy in the emergency room,” he said. “In Sorel, 194 per cent. In Buckingham, 208 per cent and in Mont-Laurier, 300-per cent occupancy in the emergency room.”
Fortin said that every day, up to 1,500 Quebecers leave a hospital emergency room without seeing a doctor.

23 November
Quebecers say it’s time for a mixed health care system. They’re right!
Beryl Wajsman
We’ll give the Premier this. During the campaign he made statements that the health care system would start looking at private sector assets to help the public sector. It’s now time to put the words into reality.
M. Legault, on almost any issue, makes clear that his decisions will be based on “social acceptability.” Well now he’s got it. And he needs it.
An Ipsos/MEI poll last week demonstrated that 73% of Quebecers support the adoption of a mixed health care system as exists in France and Sweden. Throughout Canada, 64% have come to that acceptance.
“If Canadians still worry about the excesses of the American system, they are ready to experiment with mixed models like those of France and Sweden,” says Emmanuelle B. Faubert, economist at the MEI. “In the Quebec context, this shows that there is a clear mandate for the CAQ’s independent mini-hospitals project.”
Events since the election have proven why. With the government still not being able to deliver on its goal of more health care at home, even paediatric emergency rooms have exceeded capacity. And this is not because of Covid. But a respiratory virus that happens often this time of year. It’s gotten so bad through the system generally that just this week Federal Health Minister Duclos announced the release of an emergency $270 million worth of health care transfers to Quebec.

20 November
Quebec parents struggle to get children’s antibiotics amid nationwide shortage
Respiratory illnesses in children are lasting longer than usual, says infectious disease specialist
Canada is seeing a nationwide shortage of antibiotics and children’s pain and fever medication as respiratory illnesses among young patients surge.
Amoxicillin — a first-line antibiotic used to treat bacterial infections in children — is on back-order in Quebec. It’s also used in Clavulin, which is in short supply.
Shortage of ‘first-line’ antibiotic hits as surge in children’s respiratory illnesses strains supply (7 Nov.)

14 November
Quebec’s college of physicians is urging people to wear masks in public as hospitals are battling a trio of respiratory viruses that are filling up emergency rooms.
The order is recommending masks be worn on a “voluntary and preventive basis” in public places, crowded private spaces and on public transit.
It says hospitals are facing a “triple threat” of viruses – COVID-19, influenza and respiratory syncytial virus, or RSV.
A report by the Canadian government for the week ending Nov. 5 found that levels of influenza and RSV across the country are higher than expected for this time of year.
Health Minister Christian Dube has formed a crisis group to try and reduce overcrowding at hospital emergency rooms across Quebec.

13 October
Allison Hanes: Montreal’s ER crisis is being made worse by new policy, doctor says
It’s intended to lessen pressure on ERs, but may be having the opposite effect in some cases, prolonging the stay of elderly patients in hospital wards.
A dearth of family doctors, a shortage of medical staff in hospitals, too few beds, an aging population with increasingly complex problems, a resurgence in contagious viruses besides COVID-19, and pent-up need from patients who were unable or unwilling to seek care for minor ailments due to the risks of the pandemic are all taking a serious toll on the fragile health-care system.
Noémie Vanheuverzwijn, a spokesperson for the Health Ministry, confirmed a new protocol was put in place last month aimed at freeing up hospital beds and helping clear emergency rooms, where patients line the corridors waiting to be admitted.
“Considering the progression of short-term bed occupancy by a clientele requiring an alternative level of care in the Montreal region, a specific accompaniment by a ministerial team has been in place since September to co-ordinate all the best practices required on the island of Montreal,” she said.
The change is part of a greater push to send patients home with support while they await openings in long-term care facilities or other transitional care.

Immigration regularization needed for the sake of public health
Status for all is an effective solution to the failures of immigration policy and the negative health impacts it has had on my neighbours.
(Montreal Gazette Opinion) As a public health nurse, I see every day how important access to health care is in stopping contagion and improving health equity. But as a resident of Parc-Extension, I see that many of my neighbours cannot access vital health care, simply because of their immigration status. That is why I am adding my voice to those of almost 1,000 health-care workers and health organizations from across Canada who have signed an open letter calling on Prime Minister Justin Trudeau to develop a comprehensive and inclusive immigration regularization program granting status to all migrants currently living in Canada. We are also calling on provinces to ensure universal access to health care for uninsured patients.
Sasha Dyck, RN, serves on the board of the local tenant advocacy group and is a cofounder of Park Extension Mutual Aid and a member of the Healthcare for All Network.

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