Sophie Kuijper Dickson, LJI Journalist
Outaouais’ healthcare authority announced Thursday it would be cutting 727 permanent positions across the region in response to the province’s demand it balance its budget by the end of the end of this month.
Dr. Marc Bilodeau, president and CEO of the Centre intégré de santé et de services sociaux de l’Outaouais (CISSSO), said in a press conference this would include the elimination of 127 currently staffed positions, 25 of which are management positions, as well as 600 vacant positions.
The majority of the cuts are to administrative positions, but also affect around 30 clinical positions, including nurses, psychologists and social workers.
Alain Smolynecky, president of STTSSSO-CSN, the union representing 77 of the 127 employees who will be losing their jobs, confirmed four of these jobs are in the Pontiac region – a nurse and three administrative assistants. He also said of the 600 vacant positions being cut across the region, two are at the Pontiac Hospital, both nurse’s aide positions.
These cuts are the latest in CISSSO’s efforts to reduce its planned spending by an amount of $90 million, its share of the cuts Santé Québec mandated last fall for all healthcare networks across the province in an attempt to tackle its $1.5 billion deficit.
Dr. Bilodeau previously assured spending cuts would not affect jobs, but on Thursday, which he admitted was his hardest day in the position since he stepped into it last March, he said job cuts were unavoidable, as salaries represent 70 per cent of the network’s expenses.
“While this decision is difficult, it is necessary to assure the sustainability of our services, and optimize the use of public funds,” Bilodeau said, assuring cuts would not affect healthcare services as all clinical employees would be offered another job elsewhere in the network as part of a restructuring of the workforce Bilodeau says will save money.
“The intent is to be able to offer them other roles in more critical positions where we have vacancies,” he later told THE EQUITY.
“The current posture costs me a lot, because if I don’t have enough people working evening and weekend shifts, I need to pay people overtime to fill those vacancies, which costs me way more than if I have regular personnel throughout the 24/7 cycle.”
Other cost-saving measures have included the elimination of 231 temporary assignment positions and the reassigning of many of the people in those positions to more critical roles, as well as a reduction in hours dedicated to providing home care.
“It’s clear that about 50 per cent of our surplus over our allocated [spending] amount was going towards home care,” Bilodeau said Thursday, noting the high demand for in-home care is a direct consequence of the fact that the region is lacking long-term care beds.
He said CISSSO has evaluated homecare being provided across the network and “assured the amount of help being given was corresponding to the need.”
“There’s a difference between the need and the demand [ . . . ] Finding these gaps is what enabled us to reduce some of the services being given.”
Admin positions take biggest hit
As for the administrative roles being cut, Bilodeau said he is confident they were surplus.
“What we know is our administrative ratio, which can be compared with other organizations in the province, was a bit higher than the average,” he said. “So this shows that we had some room to maneuver, and we were able to reduce our administrative ratio without impacting care negatively.”
But Smolynecky said it is not possible these cuts will not touch frontline care.
“It’s false because most of the people in administrative positions are in support of nurses. So by cutting those people, nurses will have to go back to doing more paperwork and will have less time to take care of people,” he said.
“In health systems, everybody is a piece in the chain. Everybody needs the other one. If we cut in cleaning, we’ll have more viruses, more bacteria, more sick people. The nurse needs people to fix the equipment. We all have to work together.”
Smolynecky doesn’t buy Bilodeau’s argument that CISSSO’s higher ratio of administrative workers to nurses justifies cutting back on the network’s administrative jobs.
“That’s the point-form given to him by Santé Québec. In fact, we have less nurses in the Outaouais per thousand habitants than all other regions of Quebec,” he said.
“Because we have less nurses and still have the same amount of cases and paperwork to do, they had less time to provide health care. So that’s the reason why we had more administrative people, to reduce the paperwork to the nurses and doctors, to help them have more time to take care of people.”
Smolynecky highlighted the fact that CISSSO is underfunded by about $200 million annually, as found by a study produced by the University of Quebec in the Outaouais.
“It doesn’t make sense that we have to cut $90 million from the $200 million we don’t receive.”
Jean Pigeon, spokesperson for the healthcare advocacy group SOS Outaouais, echoed this point, one he has been making since the founding of the group last year.
“This announcement, presented as an optimization measure, is in reality a symptom of chronic underfunding that is dangerously undermining our healthcare network,” Pigeon wrote in a statement following Thursday’s news.
Bilodeau said he agrees the Outaouais has been historically underfunded, and said the network is working on “having a bigger piece of the pie in order to avoid having inequitable distribution of healthcare in the province.”
Despite this long-term ambition, he said Thursday’s cuts only get CISSSO two-thirds of the way to the $90 million it needs to save before Quebec tables its new budget at the end of this month, and so further cuts and restructuring will be needed to recuperate the remaining $30 million.