“It’s too big, it is not manageable,”

«C’est trop gros, c’est pas gérable»

The management of the health network has become so cumbersome and complex that it’s hard to respond to the emergency in the NURSING homes, where dying dozens of people per day.

The crisis of the COVID-19 in the accommodation centres in recent weeks has highlighted the deficiencies in the management of superstructures, the CISSS and the CIUSSS, put in place in 2015.

“It is too big, this is not manageable. It should be much closer to the patient, ” says Anne-Marie Chiquette of the REA, an association of executives from the health network.

The biggest CIUSSS, one of the eastern Townships, having not less than 19, 000 employees and manages 34 CHSLD public and private.

The structure is so imposing that Quebec just to know what exactly is going on in NURSING homes.

The CHSLD Grace Dart (photo) is a good example of the jumble of administrative. It is the CIUSSS of the West-Island of Montreal, even if it is located near the Maisonneuve-Rosemont Hospital, which is part of the CIUSSS of the East-of-the-Island-of-Montreal.

“It is monstrous. It makes things extremely slow, ” says Marie-Sophie L’heureux, a former nurse and editor-in-chief of Health inc.

The one who has decided to lend a hand in the fight to the COVID-19 considers that the health-care system has been too centralised with the successive reforms carried out by the ex-liberal ministers Philippe Couillard and Gaetan Barrette.

Not easy to explain…

Yesterday, in press conference, François Legault has illustrated the complexity of the network which is struggling to send workers into NURSING homes.

François Legault

“What we must understand is that our network is divided into six CIUSSS, here, in Quebec, there are CISSS then CIUSSS, O. K. ? So, it depends on the regions. It is more complicated to Montreal because there are several of them, there are CHU, in addition to […]. The end more difficult is when we take, say, the CHU Sainte-Justine […], that has doctors available, they are sent in what CISSS, in what CHSLD? This is where it becomes complex, ” he said.

It was later taken up by cushioning the impact of the structure. “Me, I don’t think the important issue here, it is the heaviness of the machine “, he said.

The Journal has documented, in recent weeks, a number of cases where communication was difficult between the government and stakeholders in the health network.

In 2016, when he was in opposition, François Legault was even attached to the ex-mayor of Drummondville and current leadership candidate, liberal, Alexandre Cusson, to denounce the size of the CIUSSS of the Mauricie and Centre-du-Québec.

However, he did not split the property in two since his arrival to power, but made some refurbishments.

“I have thrown in the towel,” says Dr. Patrick Chagnon, a former internist at the Hospital in Victoriaville, which is part of this CIUSSS. “There is only one guideline, that of the ministry, nothing else,” he says, referring to local initiatives.

System disorganized

For the former minister of Health, Rémy Trudel, the system is disorganized to respond to the war in coronavirus.

“When we go to war, we do not send everyone in a patchwork manner, as we see currently,” he said. It takes a unified structure, not an organizational chart to no end. ”

The three acronyms used yesterday by François Legault

CISSS : Center of integrated health and social services

CIUSSS : integrated Center for academic health and social services

CHU : Centre hospitalier universitaire

What they said

“The current crisis highlights the aberrations of our public network. What are the impacts of many reforms and many cuts. “–Andrée Poirier, Alliance of professional and technical staff of the health and social services

“When there is a DG nearest, well it is our box, it is our house, this is our establishment. When one is inside a machine office-democratic, the attachment is less. “–David Levine, former director of the Hôpital Notre-Dame

“It’s like a big Titanic that struck the iceberg centres for the elderly. “Marie-Sophie L’heureux, a former nurse and editor-in-chief of Health inc.

– With the collaboration of Elizabeth Laplante and Marie-Christine Trottier

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