Access to health care | The urgency to act in the Laurentians

Behind the bucolic image of the Laurentians, the fourth region of Quebec suffers from one of the worst access to health care in Quebec. For many treatments (physical, geriatric, psychiatric, neotalalogy, etc.), it ranks last or penultimate.

Faced with this permanent state of crisis, the Coalition Santé des Laurentides (CSL) was created in the fall of 2020. It brings together the 76 municipalities, 8 MRCs, associations of doctors, community movements, chambers of commerce, institutions of higher education, citizens and others.

Urgent basic needs

On May 6, 2021, following the work of the CSL, the National Assembly adopted a resolution that recognizes the significant financial catch-up and the acceleration of its hospital infrastructures to be done in the Laurentians. Another motion on the application of the Urgent Health Plan for the region was adopted on May 11, again unanimously. This last motion was co-presented by MP Guy Ouellet, with the opposition parties, but also with the Minister of Health. The government is therefore fully aware of the situation.

Despite the recognition of needs, the government’s real commitments remain extremely insufficient. Except for minor improvements, the Saint-Jérôme Regional Hospital (HRSJ) has not been renovated for more than 30 years while the population has doubled.

The sums planned by the previous government are still not in the works, and represent only a third of what is urgently needed as an investment: ie 1.2 billion dollars for the updating of the HRSJ. The same reality affects other hospitals, such as Saint-Eustache and Mont-Laurier (located more than 250 km from Montreal). These require investments three times higher than what is currently in the plans. All this without mentioning the three other hospitals in the region still without a project and struggling to provide basic care.

The dilapidation of these six hospitals is unequivocal. They were never designed to handle the current number of residents of the Laurentians, as well as the ever-increasing affluence of vacationers.

Systematic underfunding

Today, the region is the fourth in demographic terms. These 650,000 citizens of Quebec (7.5%) only receive between 4.3% and 5% of the health budget. The situation is more dramatic when vacationers are taken into account, which then places the Laurentians in third place among the most populated regions of Quebec.

Budgeting being historically negative, the glaring shortages of space and equipment make the recruitment of health professionals, particularly doctors, extremely difficult. Added to this situation is the allocation by the government of a very small number of positions open to physicians interested in settling in the region. The region has the worst ratio of doctors per 100,000 inhabitants, at 147 instead of the national average of 248. More than 91,000 citizens are waiting for a family doctor.

Dramatic effects

Worse still, nearly a third of patients in the Laurentians have to seek treatment outside the region, well below the targets set by the Department of Health and Social Services. This is extremely problematic, especially since transport is long, difficult and expensive. Waiting lists are getting longer, load shedding is getting longer, waits for diagnostic tests are creating a lot of anxiety. In addition, these delays often cause a deterioration in the state of health of patients.

Hope for a forgotten region

The Government Health Plan can offer hope. It aims for reinvestments in medical infrastructure, better home care and decentralization. However, this Plan lists priority regions in Quebec, but completely omits the Laurentians.

On May 11, during a meeting with the Minister of Health, Christian Dubé, the latter said he was concerned about the situation and undertook to work actively on it. We can only ardently wish it. Already in 2018, the Auditor General of Quebec identified three hospitals in a pitiful state: Chicoutimi, Maisonneuve-Rosemont and Saint-Jérôme. The other two got concrete commitments, and that’s perfect. But we are still waiting for Saint-Jérôme and for our region. We will persist.

* Co-signatories, members of the Coalition Santé Laurentides steering committee: DD Lyne Couture, president of the Association of General Practitioners Laurentides-Lanaudière (AMOLL) and family physician; Dr Daniel Picard, President of the Association of Physicians for the Advancement and Progress of the Saint-Jérôme Regional Hospital (AMPAHRSJ) and specialist in nuclear medicine; Dr Simon-Pierre Landry, family physician in Mont-Tremblant and emergency physician at the Laurentian Hospital in Sainte-Agathe-des-Monts; Dr Paul-André Hudon, President of the Council of Physicians, Dentists and Pharmacists (CMDP) of the CISSS des Laurentides; Marc Bourcier, mayor of the city of Saint-Jérôme; Michael Leduc, General Manager of FADOQ Laurentides; Annie Bélanger, General Manager, Moisson Laurentides; Pierre Charron, mayor of the city of Saint-Eustache and prefect of the MRC of Deux-Montagnes; Daniel Bourdon, mayor of the city of Mont-Laurier and prefect of the MRC d’Antoine-Labelle; Nadine Le Gal, director general of Cégep de Saint-Jérôme; Muriel Laberge, Rector of the University of Quebec in Outaouais

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