2023-05-23 04:59:26
(Quebec) Pursuing a “medical-centrist logic”, Minister Christian Dubé’s vast reform risks “deepening even more” the imbalance between health and social services, deplores the Order of Social Workers and Marriage and Family Therapists.
What there is to know
- Bill 15 aims to make the health and social services network more efficient.
- The Order of Social Workers and Marriage and Family Therapists of Quebec judges that there is “an imbalance between the two pillars of the network, which are health and social services” and fears that the Dubé reform “widens the gap even more “.
- The Order invites the Minister of Health to create “a department specific to social services within Santé Québec” and recommends that the role of the CLSCs be upgraded.
“I think the moment is pivotal to put forward social services”, pleads the president of the professional order, Pierre-Paul Malenfant. The Order of Social Workers and Marriage and Family Therapists of Quebec will testify this Tuesday during the last day of consultations on Bill 15, which aims to make the health and social services network more efficient.
PHOTO EDOUARD PLANTE-FRÉCHETTE, LA PRESSE ARCHIVES
Christian Dubé, Minister of Health, during consultations on Bill 15 last month
According to the Order, the Dubé reform does not go far enough to revalue the mission of social services. “There is a major imbalance between the two pillars of the network, which are health and social services. We see that this imbalance, in the bill, is maintained”, explains Mr. Malenfant, who goes there with a series of recommendations to “avoid widening the gap even more”.
From the outset, the Order regrets that the “social services” component is eclipsed by the name of the new public corporation “Santé Québec”. The Minister’s reform must result in the creation of an agency that will be responsible for all the operational aspects of the Ministry of Health and Social Services, which will focus on the major orientations and planning.
This infers that the network is “healthy”. Where are the social services? It may seem cosmetic, but it’s still something quite revealing.
Pierre-Paul Malenfant, President of the Order of Social Workers and Marriage and Family Therapists of Quebec
While the Order welcomes the establishment of a multidisciplinary council of social services for each establishment in the new structure, it invites the Minister of Health to create “a department specific to social services within Santé Québec” with powers equivalent to those provided for health services.
“CLSC 2.0”
The professional order reminds Minister Dubé that he has before him “a unique opportunity” to restore the imbalance between health and social services through his reform. It recommends that it revalue the role of the CLSCs by giving them the autonomy and leeway necessary to ensure local governance. “You might call it a CLSC 2.0,” underlines Mr. Malenfant.
In other words, the Order recommends the creation of local public establishments and first-line social services, at the level of the MRCs, such as the CLSCs. These establishments should receive an operating budget and be provided with a board of directors giving “a large place to citizens” and to representatives of the municipal and educational milieu, for example, and to social service professionals.
“In the early 1980s, there were around 1,000 establishments in Quebec. In all the communities, there was a board of directors, a management committee, the employees were local employees. There was a whole network that was around, that took care of the community,” says Mr. Malenfant.
We will end up with the present reform with a single institution, Santé Québec, which will have all the powers. […] It is a hypercentralization that goes once morest the good practices that science […] pushes for social services.
Pierre-Paul Malenfant, President of the Order of Social Workers and Marriage and Family Therapists of Quebec
Being the subject of criticism for carrying out an operation of centralization, Christian Dubé has already affirmed that he was thinking of adjusting his reform by creating local monitoring committees composed, among others, of elected municipal officials, in order to “go further in reporting to the public (1).
This is in particular a recommendation from Michel Clair, ex-president of the commission of inquiry which scrutinized the health network in 2000.
For Mr. Malenfant, it should not just be a question of “surveillance”.
“I think that there must also be a question of responsibility, of the responsibility of a body, of a board of directors elected and appointed by local people who will be able to give the guidelines for region-specific services,” he adds.
The Association of Pharmacists of Quebec Health Institutions, the Order of Pharmacists of Quebec and the First Nations of Quebec and Labrador Health and Social Services Commission will be among the last groups heard Tuesday during consultations on the project. 15. The detailed study of the legislative text, that is to say article by article, will then begin.
Bill 15 is a brick of some 300 pages with 1200 articles.
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