Read Ariane Lacoursière’s report
This country has long had a community culture focused on the services offered to the population. They are at the service of the person. Here we have a culture of bureaucracy, job silos, work organization, centralization and collective agreements. People are at the service of the public service. It is an impossible mission to believe that we will come close to what is happening in Denmark and elsewhere in Europe.
A great social project
Home care is taken out of the CISSS and CIUSSS. We can clearly see with these state monsters that the formula does not work. Let’s bring home care to a more human scale, with separate funding. Through the band, we could decompartmentalize tasks with distinct working conditions. No offense to the unions. The municipalities could manage this in partnership with a local community organization, but the funding has to follow, otherwise we get stuck at the starting point. Funding must be consistent with regional realities as well. Treating 10 people in a neighborhood like Hochelaga-Maisonneuve does not cost the same price and does not require the same logistics as 10 people in a rural area, in Abitibi or elsewhere. A great social project that could make Quebec a leader in this area in Canada.
A standard that must change
The quality of home care necessarily implies the stability of home caregivers. Everyone wins. Unfortunately, at the CLSC in our town (Drummondville), this aspect is not considered: seven different health and social service assistants in seven days, this is the norm (despite customer complaints).
A good idea … which is expensive
It is obviously a good idea to take inspiration from Denmark. However, withholding taxes, according to my quick research, are 52% on income in Denmark (similar to the combined rate here) and consumption taxes are 25%. All have to pay 8% of their salary or pension income as a contribution which resembles unemployment and the pension scheme. Do not forget that the duplication of the state (federal and provincial) is expensive! Are Quebecers ready to pay more?
Michèle Jenneau, Montreal
A lot to learn
What inspires me the most about this report is that home caregivers in Denmark are multitasking while Quebec caregivers are very specialized. In Denmark, beneficiaries can more easily identify with the person helping them, while Quebec beneficiaries must necessarily tame a greater number of stakeholders. Danish workers see fewer beneficiaries each day and thus spend less time walking from house to house during the day. We have a lot to learn from Denmark.
“I would like to live in Denmark”
I would like to live in Denmark. I will soon be 79 years old and I live alone in my house. It’s not just health care. If I need to change a bulb on the ceiling, maintain the exterior of the house, a battery to be changed in the smoke detector, etc. Our elected officials, these utopian people in their projects, should think about training and finding retired people who could help the elderly at home to accomplish these tasks too difficult for the little old lady alone.
The wrong turn
I’m moving to Denmark because here in Quebec, we don’t listen to seniors, we continue to think for them. A home for the elderly, however luxurious it may be, favors only a few seniors. How much more, at home, could benefit from it with these sums? We take the wrong turn because a senior living at home leads a more normal and bright life.
Quebec Wayne Gretzky on the bench
Quebec has the notorious clumsiness of keeping Wayne Gretzkys on the bench like the Dr Réjean Hébert (what about the Dre Joanne Liu, pandemic expert) who nevertheless enjoys notoriety, even abroad, and who offers similar solutions. Since Minister Rochon, governments have advocated home care: words, but no concrete actions … at most, timid. I was head of the geriatric service for more than 10 years in Granby and responsible for the medical services of CHSLDs for 25 years; I have made, on average, more than 300 home visits per year for 42 years with these vulnerable people: the bureaucrats far from the field are encrusted in their immobility for fear of making waves… and for lack of imagination. As for the politicians: lots of mousse, little chocolate!
Richard Gosselin, doctor since 1971
Impressive stability … and necessary
What impresses me is the stability of the staff with the patients. My mother ended her days in a residence for dependent people. She spent more than 15 years there. She had very good care, but often with changing staff, especially in recent years. The most traumatic moments for her were during the baths, once a week. It was often a different person: a young man, a new attendant, a replacement… Human dignity, respect for this aging body, we forget that. We found her extraordinary, my mother, she never complained or raised an objection. What woman !
A common sense system
I have worked for a long time in the CHSLD network, and it is not new that Quebec is inspired by Denmark in terms of the services offered to people with loss of autonomy. Denmark has always been a model. I find their system based on common sense. What would be difficult to apply here is the multiplicity of tasks, given the importance and influence of unions in the community. On the other hand, I do not agree when we say that a nurse who gives basic care or who picks up a little in the house on the way wastes time to go and give care to another patient. If we calculate the time that all stakeholders waste on the road to distribute specialized care from one patient to another, in addition to transportation costs, it would be much more profitable. But would unions and orders accept these changes? That remains to be seen…
A desirable approach
I agree with these initiatives: the decompartmentalization of tasks is the top priority. Without these changes, we will be stuck with a ceiling on the tasks to be integrated. Past experiences have demonstrated pitched union battles in certain regions of Quebec. However, I wish Quebecers this approach. Like any change, we will adapt.