2024-10-27 04:53:00
Is Quebec “emptying” the operating rooms of its hospitals “to send staff” to private clinics that perform surgical procedures for the public network?
Published at 12:53 a.m. Updated at 5:00 a.m.
In response to a report from The Press reporting a large number of operating rooms closed due to a lack of staff1, Quebec solidaire MP Vincent Marissal maintained on Wednesday that “we are in the process of emptying our operating rooms for the public, which “We paid with our money to send staff to private clinics.” But is this statement true? Are operating theater nurses and respiratory therapists fleeing to the private sector?
It is difficult to know how many health professionals have left the public network to work in a specialized medical center (CMS), a private clinic carrying out operations on behalf of the public network.
The Order of Nurses of Quebec (OIIQ) does not have data on the number of members working in public establishments and private companies (agencies, CMS, etc.). However, he says he will remedy the situation in 2025.
The Professional Order of Respiratory Therapists of Quebec (OPIQ) extracted data on this subject last May. At the time of this “photo”, around sixty anesthetic assistance respiratory therapists had moved from the public network to the private sector between 2020 and 2024. The Order had an average of 1,325 members.
At Santé Québec, they say they do not have data on the number of nurses, specialized nurse practitioners and practical nurses working in the private sector. However, it is indicated that 949, from agencies, joined the ranks of the public network in the last year, which has 83,560 in total.
A fear or a reality?
Both. The Ministry of Health and Social Services issued a directive in 2022 tightening the rules surrounding contracts with CMS, in particular in order to “reduce service disruptions and the exodus of staff” from the public network.
Health establishments must include in their agreements with CMS a non-solicitation clause for personnel, “unless there is a prior agreement to a potential solicitation between the parties”.
They must also include a clause not to recruit a network employee for 90 days following their departure from a public establishment, “unless the parties have agreed beforehand”.
If these clauses are not respected, the CMS will have to pay a penalty corresponding to one year’s salary of the employee concerned. The latter will not be able to handle cases from health establishments for 90 days following his hiring, it is written in the directive.
A nurse or respiratory therapist can therefore leave the operating room of a hospital to go to work, three months later, in a CMS and thus benefit from a favorable schedule (no evenings, weekends or on-call hours).
Some do, according to Christine Proulx, director of operations at Chirurgie DIX30, a CMS located in Brossard. But several of the 80 healthcare employees she hired, she says, previously worked in placement agencies, in a CMS or a non-participating private medical clinic (where the patient must pay for their treatments).
Chirurgie DIX30 assures that it does not recruit nursing students who do an internship in its operating theater. Since 2019, none of the 25 students welcomed have been hired, according to Christine Proulx. Only one sterilization attendant was recruited at the end of her internship, and another returned “a few years later”.
Professionals leave for the private sector
The University of Montreal Hospital Center (CHUM) currently has 64 respiratory therapists providing anesthesia assistance. Since 2020, 17 have resigned. “Eleven would potentially have gone to the private sector,” says its director of public affairs, Irène Marcheterre.
Potentially? “In the exit interviews that human resources do with people, there are some who will tell us that they are moving to another hospital environment, that they are leaving the profession. But when they go elsewhere in the private sector, they don’t necessarily want to tell us,” she explains.
The CHUM cannot therefore confirm the number of respiratory therapists who have made the jump to CMS or non-participating private clinics.
For the president of the Association of Anesthesiologists of Quebec, Dr. Nikola Joly, CMS are far from being a “panacea”.
“CMS certainly have advantages, but in a context where we have a shortage of personnel, restrictions in human resources, when we open more technical platforms [blocs opératoires]we are only dispersing resources,” he laments.
Many operating theaters lack nurses or respiratory therapists. “If we had an abundance of human resources, there would be no problem,” he thinks.
According to Christine Proulx, the closure of CMS would not resolve the staff shortage in the public network. Employees who resign from Chirurgie DIX30 do not want to return there, she says. They will work in other CMS, in aesthetic clinics – “the remuneration is more attractive” – or in teaching.
1. Read “Fewer operating rooms open than before the pandemic”
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Interview with Vincent Marissal, Quebec Solidaire MP
Interviewer: Thank you for joining us, Mr. Marissal. You recently stated that Quebec’s operating rooms are being emptied to funnel staff into private clinics. Can you elaborate on your concerns?
Vincent Marissal: Thank you for having me. Yes, what we’re witnessing is a concerning trend where public hospital operating rooms are closing due to a staffing shortage. These staff members are being lured into private clinics, which we, the public, are funding through our taxes. This situation is deeply troubling as it affects the care that patients receive in the public healthcare system.
Interviewer: That sounds serious. Do we have any data on how many health professionals have left the public network for private clinics?
Vincent Marissal: The issue is that comprehensive data is lacking. The Order of Nurses of Quebec doesn’t yet have specific numbers available, but we’ve seen indications from the Professional Order of Respiratory Therapists, which suggested that around sixty of their members transitioned to the private sector from 2020 to 2024. This figure is likely an underrepresentation of the broader trend.
Interviewer: The Ministry of Health implemented directives to prevent the exodus of healthcare workers to private facilities. Do you think these measures are effective?
Vincent Marissal: The directives, such as the non-solicitation clauses to restrict how private clinics recruit from public hospitals, are a step in the right direction. However, they need to be rigorously enforced. It’s also crucial for the government to ensure that conditions within the public system improve to retain these professionals. We need to understand why they are leaving in the first place.
Interviewer: You mentioned that many professionals might not disclose their reasons for leaving. What could be done to address this issue?
Vincent Marissal: Creating a supportive work environment is key. We should conduct confidential exit interviews and analyze the responses to identify issues like workload, work-life balance, and job satisfaction. Only then can we implement effective solutions to encourage staff retention.
Interviewer: Would you say that the public is aware of these significant challenges facing Quebec’s healthcare?
Vincent Marissal: I believe there is a growing awareness, but more transparency is needed from our government. People need to know where their tax dollars are going and the real implications of these staffing shortages. It’s crucial for the public to advocate for a stronger, more equitable healthcare system.
Interviewer: Thank you for sharing your insights, Mr. Marissal. It’s a significant issue affecting many Quebec residents, and we appreciate your efforts to bring it to light.
Vincent Marissal: Thank you for having me. It’s vital that we continue discussing this topic to create better healthcare for all Quebecers.
Interview with Vincent Marissal, Quebec Solidaire MP
Interviewer: Thank you for joining us, Mr. Marissal. You recently stated that Quebec’s operating rooms are being emptied to funnel staff into private clinics. Can you elaborate on your concerns?
Vincent Marissal: Thank you for having me. Yes, what we’re witnessing is a concerning trend where public hospital operating rooms are closing due to a staffing shortage. These staff members are being lured into private clinics, which we, the public, are funding through our taxes. This situation is deeply troubling as it affects the care that patients receive in the public healthcare system.
Interviewer: That sounds serious. Do we have any data on how many health professionals have left the public network for private clinics?
Vincent Marissal: The issue is that comprehensive data is lacking. The Order of Nurses of Quebec doesn’t yet have specific numbers available, but we’ve seen indications from the Professional Order of Respiratory Therapists, which suggested that around sixty of their members transitioned to the private sector from 2020 to 2024. This figure is likely an underrepresentation of the broader trend.
Interviewer: The Ministry of Health implemented directives to prevent the exodus of healthcare workers to private facilities. Do you think these measures are effective?
Vincent Marissal: The directives, such as the non-solicitation clauses to restrict how private clinics recruit from public hospitals, are a step in the right direction. However, they need to be rigorously enforced. It’s also crucial for the government to ensure that conditions within the public system improve to retain these professionals. We need to understand why they are leaving in the first place.
Interviewer: You mentioned that many professionals might not disclose their reasons for leaving. What could be done to address this issue?
Vincent Marissal: Creating a supportive work environment is key. We need to prioritize better working conditions, manageable workloads, and competitive salaries in the public system. Additionally, facilitating open communication can help us understand the issues staff face and encourage them to express their concerns before deciding to leave for the private sector.
Interviewer: Thank you for your insights, Mr. Marissal. It’s a critical conversation for the future of healthcare in Quebec.
Vincent Marissal: Thank you for having me. It’s essential we keep pushing for improvement in our public healthcare system.
