Phasing out private intermediaries | “Turning us off is not the solution”

At a time when Quebec is grappling with a major staff shortage in its health network, some job centers are questioning the government’s desire to stop using their services within three years and say they want to be part of the solution.

Posted at 06:00

Ariane Lacoursiere

Ariane Lacoursiere
The press

“Turning us off is not the solution. There are not enough nurses in the network,” says Léonie Côté-Martin, president of the mediation agency Groupe Serenis.

“We understand that the government wants to strengthen the network. But we want to be a partner in this. We believe in finding the best balance to provide the best service possible […]† We have a role to play in meeting emergency needs. Especially in certain regions”, adds Richard Mercier, president of the Regroupement des agencies de placement de personnel de la santé.

Earlier this week, the Minister of Health and Social Services, Christian Dubé, said he gave himself three years to free himself from private bodies.

According to Patrice Lapointe, board member of the Association of Private Companies of Caregivers of Quebec, weaning agencies is “neither desirable nor feasible.” “My agency has been around since 1974. We are in network support mode. It’s not realistic to manage 100% of needs without us,” he says.

When she says she supports the government in its desire to regulate the agencies, Ms.me Côté-Martin wants to “be part of the solution”. According to her, the agencies make it possible to reintegrate staff into the health network who would otherwise leave the profession. “If you only knew how many people I’ve recruited to work in restaurants and shops…” she says.

Other places in the world have shown that healthy coexistence between public and private leads to better results, says Ms.me Cote Martin. She adds that the government is doing business with private surgery clinics to reduce waiting lists. “Why do we go through the private sector in these areas, but not with nurses? she asks.

“Mammoth” Tender

The government will have to do a lot to get rid of the agencies, as evidenced by a first group tender launched in January to hire agency workers in the health network under new, stricter terms. About a hundred agencies responded to this tender.

In total, the need for independent labor is estimated at 3.5 million hours per year in the sites covered by the tender, excluding the regions of Montreal and Laval, among others.

At the CISSS de la Montérégie-Ouest, it is estimated that 541,000 hours of temporary staff are needed each year, just for the beneficiary escorts. The CISSS states that “the number of hours was estimated from the hours” […] used in the past year. The establishment says it significantly increased the offer of home care last year, when the number of hours increased by 23.7%. “Due to the lack of staff, it has been decided to use an independent workforce for this service,” explains the CISSS by email.

At the CISSS du Bas-Saint-Laurent, the annual need for self-employment for nurses is estimated at 142,000 hours. Spokesperson Gilles Turmel explains that the agency’s nurses mainly work “in our 24/7 units,” namely hospitals and CHSLDs. “Even if we ask for a certain number of hours, we are not obligated to use them,” he adds.

The CIUSSS de la Capitale-Nationale estimates that the need for independent labor for patient carers is 185,000 hours per year. Spokesperson Annie Ouellet explains that the greatest needs “are mainly to be found in our 30 CHSLDs, in mental health care and in the hospitals of Portneuf and Charlevoix”.

The needs on the North Shore are also important, as explained The press last Saturday.

The Ministry of Health and Social Services (MSSS) assures that, despite this impressive tender, the intention is to “reduce the use of self-employment”. “However, in the current situation, it is not possible to prohibit the use of agencies without risk, especially for institutions in remote regions, the care and services offered to the population,” the MSSS notes.

New guidelines are included in Quebec City’s tender to “prevent temporary workers from offering better working conditions (rosters, etc.) [réseau] “, notes the MSSS. In particular, the rates that agencies can charge are capped.

The President of the Federation of Health and Social Services (FSSS-CSN), Réjean Leclerc, welcomes the measures taken by the government to reduce the use of private entities. But according to him, the grouped tender shows exactly how great the network’s dependence is on the authorities and how great the shortage of healthcare personnel is. During the pandemic, the government accelerated the training of nearly 10,000 beneficiary carers to work in CHSLDs. “Despite this, many people are still missing,” notes Mr. Leclerc op. According to him, there is an urgent need to improve working conditions in the public sector to stop the exodus to the private sector.

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