On many occasions since the start of the pandemic, while trying to come to the aid of the citizens of Marie-Victorin, the deputy Catherine Fournier and her team have come up against what they call the “administrative labyrinth” of the system. of health in Montérégie. Referral from one instance to another, lack of communication between establishments, lengthening delays; there are many problems, argues the MP.
The constituency office has received many requests for help from citizens since the start of the pandemic, mostly related to the health system.
“This relationship with the citizen is the main and essential role of a deputy,” says Catherine Fournier, in an interview with Southern Mail. But to help these citizens, we need to be able to get quick answers. ”
“Our greatest difficulties experienced on a daily basis since the start of the pandemic are due to the lack of communication with the CISSSs and between the CISSSs,” she continues. It’s a bit like the 12 labors of Asterix… Sometimes it went well, but often there are things that catch on. ”
Montérégie is one of the rare regions in Quebec to be served by more than one integrated health and social services center (CISSS).
“In Montreal and Montérégie, this is where it is most administratively complicated,” says Catherine Fournier. My constituency is among others covered by two CISSS. And what complicates matters even more is that the Public Health Department (DSP) is independent and covers the entire territory but reports to the CISSS Montérégie-Center… ”
“When we have questions, we call the DSP most of the time. Often, we are told that it is rather the CISSS that we should ask our question … where we are told that it is the DSP that we should ask our question …, she says, exasperated. And it takes three or four days before getting the response from the DSP, and three or four days before getting that from the CISSS… ”
“The citizen must be at the heart of our actions. We cannot ask each person to know the administrative maze of the health system inside and out. ”
– Catherine Fournier
The member gives as an example the case of parents of a child with autism spectrum disorder (ASD), who wondered about the cuts in services during confinement. After contacting the CISSS Montérégie-Est, which covers the territory where the family lives, the team had to relaunch it several times to finally be told, two weeks later, that it should instead contact the CISSS Montérégie-Ouest. .
“How could no one tell us before that that we had to go through Montérégie-Ouest?” asks the member.
Catherine Fournier recalls that the objective of the Barette reform was to lighten the structures. But according to her, the important thing is rather that there is good communication between the authorities and the population, and between the authorities themselves.
“Structures have been removed and have become silos, vaults that do not speak to each other,” she laments. It is better to have more structures if we have better communication. We need to focus our actions on results. ”
The member therefore hopes that the communication channels will be improved but also that eventually the entire health system be reviewed.
“The crisis has shown the limits of the Barette reform,” she adds. It made it possible to see with a magnifying glass what is wrong. “
Savoie report: recommendations to be applied in Montérégie
In an effort to improve the health care system in preparation for a second wave of coronavirus, the government has ordered a Diagnosis of the coordination of public health and infection prevention and control activities during the first wave of the COVID-19 pandemic in Montreal. Produced by Deputy Minister of Health Dominique Savoie, the Savoie report tabled on July 23 makes several recommendations.
Although it concerns the Montreal region, the report “reflects the situation experienced in Montérégie”, according to Catherine Fournier. This is why during the study of the budgetary appropriations of the Ministry of Health, on August 20, she asked Minister Christian Dubé if he intended to apply the recommendations of the report in Montérégie.
The Minister’s response could not be clearer. “The answer is yes, we will make sure of that”, indicated the one who was until very recently Minister responsible for Montérégie. “I understand very well the problems experienced in Montérégie,” he added.
Some recommendations of the Savoie report
- That closer links between the General Directorate of Public Health (national section) and the Regional Directorate of Public Health (regional section) be established by holding regular exchanges and specific consultations.
- That for regional tactical / operational linkage, exchanges be concentrated in a committee of deputy CEOs, with the regional director of public health or his representative.
- That when more than one CISSS covers the same district or the same city, the CEOs concerned identify one of their own to act as a single point of contact with the elected representatives of the territory covered.
- That in times of crisis, CEOs plan regular or even daily exchanges with elected officials in their territory to communicate essential information. (Editor’s note: Catherine Fournier’s office specifies that the CEOs of the CISSSs did not take part in the weekly meetings that were held last spring with the provincial and federal elected officials of the Montérégie, the prefects of the MRCs, the mayor of Longueuil and the representatives. of the Regional Directorate of the Ministry of Health.)
The CISSS Montérégie-Est, which did not wish to grant an interview to the Southern Mail on the subject, nevertheless affirmed that he was in constant communication and that he maintained excellent relations with the deputies of his territory as well as with the two other health establishments of the Montérégie.
“As the requests from citizens which reach us via the offices of deputy always relate to specific files, we must often take the time to make detailed checks with the persons concerned, we are told by email. Finally, considering the regional responsibilities of the various CISSS de la Montérégie (particularly public health), it may happen that a request addressed to an establishment is ultimately transferred to another establishment, resulting in additional delay. ”
For its part, the CISSS Montérégie-Center told the newspaper that it would not comment on the Savoie report, as it does not address its territory. The CISSS adds that it has not received any question or communication of dissatisfaction from the deputy’s office.
The CISSS Montérégie-Ouest did not respond to our requests for interviews.