Nelson Sergerie, LJI Journalist
Integrated Health and Social Services Centres (CISSS) must find a way to recover a $40.7 million cost overrun in a budgetary effort requested by the Quebec government on a budget of $535 million.
This represents 8% of its $535 million budget and must be achieved by March 31 which will be a major challenge, a goal that the Union of Nurses, Auxiliary Nurses and Respiratory Therapists of Eastern Quebec calls unrealistic.
“That’s the target. As a manager and government employee, that’s the target. I have to implement the mechanisms to achieve it. Afterwards, I will be judged on the achievement of results. This is a big chunk to take on for the few months I’m given. The message is very clear: the budget must stop swelling. The idea is to respect the budgets we’re going to be given,” explains President and Chief Executive Officer (CEO) Martin Pelletier.
The requested amount represents approximately 1.5 months of CISSS’ operating costs.
In a situation where the costs of supplies, medications and the application of the latest collective agreements have a direct impact on the budget, the order looks set to be even more difficult for the future.
“These are elements that add pressure to the system. Normally, these costs related to inflation are subsidized. This year, as such, it’s not. Not up to the cost increases. From there, it’s a pressure that follows us,” mentions Mr. Pelletier.
Four main areas have been identified to achieve the objective: rigour and management rights over staff in order to recover everything that could be done and over supplies; a freeze to increase or develop services; optimizing operations and reviewing the service offering to see if it is adapted to needs.
Considering the Gaspé Peninsula has one of the oldest populations in Quebec and given the distances to travel to receive care, the CISSS plans to highlight these unique challenges to the Quebec government.
“Certainly, this must be taken into account. We have small teams in large territories that we must keep in place to ensure continuity of services. These are assets that we want to keep. On this, there are no major compromises. This is well understood by Santé-Québec. We will see if there are adjustments that will be granted,” hopes the President and CEO.
Despite this budgetary reshuffle, Mr. Pelletier affirms that care for the population will not be affected.
“There will be things that will be transformed. We look first at where we have room in the activities we do that do not affect services. When we get there, it will be a review that will take into account the needs of the population. A review that is necessary given the province’s ability to pay,” says Mr. Pelletier.
The use of independent labour accounts for $25 to $30 million of the $40.7 million to be recovered. “This must be taken into account. It is not a simple formula to say that we stop using independent labour. The consequences are harmful. We use it because we have needs to fill teams, to maintain services. The withdrawal of independent labour would mean that we would have to close services,” he says. The CISSS must free itself from independent labour on October 18, 2026.
“Our budget balance plan was initially over three years because it gave us time to recruit and transform things to be able to eliminate it as much as possible,” says Mr. Pelletier.
In terms of infrastructure, projects to modernize care units are suspended for the moment.
“We see ourselves having to endure obsolescence for longer in certain sectors. I’m thinking of the Youth Centre in Gaspé that was in the pipeline. It’s unfortunate to see that it will be on hold longer than expected. For the next year and a half, there will be a slowdown in this area,” he says.
The union believes that it is unrealistic to compress the budget so quickly, citing as an example what will happen during the holiday season.
“We are on the eve of a difficult period. The holiday season creates a lot of difficulties with replacements, a colossal force to keep services open 24/7. There is a lot of overtime and mandatory overtime. It is a period that costs a lot of money to provide service to the population. It is completely disconnected that Santé-Québec gives the CISSS and CIUSSS a goal of recovering significant amounts in three and a half months,” notes the union president, Pier-Luc Bujold.
Senior management met with the union to inform it that no compensation reduction will affect staff directly, However, the union fears that management will apply new provisions of the new collective agreement to achieve financial goals.
The coming years will not be rosy as Quebec must review its expenses following an $11 billion deficit.
“The Santé-Québec megastructure will not be a measure to really save costs,” says Mr. Bujold, who invites the CISSS to review the use of independent labour.
“There is still unjustified use (of independent labour) on our territory. For several months, we have been asking the CISSS de la Gaspésie to save money without affecting the members we represent,” says the union representative.