Quebec budget 2022: $8.9 billion to ‘restore’ health system

Human resources and digitization will get most of the focus when it comes to the additional spending announced Tuesday.

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QUEBEC — The COVID-19 pandemic was devastating for Quebec, leading to the deaths of more than 14,000 people to date. But it also brought a form of silver lining, the Coalition Avenir Québec argues in its budget plan presented Tuesday: it highlighted the many fragilities of the health-care system that must be prioritized, with management of staffing key among them. And it showed that the aging health system is capable of rapid, massive change when necessary, bringing hope that it can be reformed.

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Recent headlines indicate the government has a long hill to climb. The number of Quebecers waiting for a family doctor, which was at 400,000 when the CAQ took power in 2018, has at least doubled to 800,000. Health Minister Christian Dubé recently conceded the true number may be as high as 1.5 million. The health-care system is lacking more than 4,300 nurses, lists are long to enter seniors’ residences, and the number of patients waiting more than 48 hours on a stretcher in the ER before getting a room has tripled in the last four years, the Journal de Montréal reported this week. More than 58,000 patients spent more than two days lingering on stretchers in the last year alone.

The government is pledging to invest $8.9 billion over the next five years to restore the province’s health system, primarily through putting more money into human resources, improving the province’s archaic medical data processing system that still uses fax machines, creating better information technology, and through improvements to hospital infrastructure.

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In its budget, the government is promising “a cultural change in the organization of work conditions” that will address long-standing complaints about enforced overtime and a lack of stable work schedules, spending $400 million in the first year to increase staff, decentralize scheduling and end the “abusive imposition of overtime.” Another $150 million is going toward increasing the number of administrative agents to lessen the workload on nurses forced to do extensive paperwork.

The health crisis also highlighted the system’s inability to provide real-time information. In one example, administrators could not decide on where to transfer patients during the pandemic because they didn’t know the COVID-19 outbreak situation in the province’s numerous long-term care centres. To modernize the information system, the government is promising to accelerate the shift to cloud computing to protect patients’ data, and to maintain telemedicine practices that proliferated during the pandemic. Also promised is the improved transfer of data from hand-written folders to computerized systems, so that all patient medical information could be available on a patient’s smartphone.

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To provide more spaces for the province’s aging population, Quebec’s 10-year Infrastructure Plan has earmarked nearly $23 billion in investments in the health and social services sector, with roughly half allotted to maintain existing infrastructure and the other portion going toward building new structures.

Acknowledging that the pandemic is not over, the government is setting aside $1.7 billion to “prepare for the risk of potential future waves” in 2022-2023. The money would go toward an annual campaign to administer one dose to the entire eligible population ($375 million), the purchase and distribution of nearly 60 million rapid screening tests, primarily in pharmacies ($350 million), COVID-19 screening for two months at the rate of 30,000 tests per day ($300 million), and expenditures for additional beds, equipment and staffing at health-care centres, for a period of 20 weeks ($275 million). With 9,000 patients suffering from lingering long-COVID symptoms that include breathing and memory problems, the government announced it will open 15 clinics to provide specialized care.

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In total, Quebec has estimated it will have spent $16 billion in health-care services related to the pandemic by 2026. It spent $9 billion in the first year of the outbreak.

With the number of people ages 70 and over forecast to double in the next 20 years, representing nearly two million Quebecers, or 20 per cent of the population, the government said it is increasing funding to allow people to age in their homes for as long as possible. (In 2020-2021, just under 400,000 Quebecers received home-care services). For this year, $100 million is earmarked for home services, and another $38 million to improve aid for informal and family caregivers. Another $75 million is set aside for opening new seniors’ homes.

Asked what in the budget would address the lack of access to family doctors, Finance Minister Eric Girard said that would be up to the health minister to announce.

Liberal finance critic Carlos Leitão said the lack of details in the health plan was telling.

“What is missing is a roadmap on how we are going to spend that money that addresses everyone. Access to a doctor, wait times for surgeries, long wait times in ERs — there’s no detailed plan on how to do any of that,” Leitão said.

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