Published February 28, 2024

Greg Newing

Local Journalism Initiative

OUTAOUAIS – Outaouais residents discussed the past, present and future of Local Community Service Centres (CLSCs) at a virtual panel discussion hosted by health rights advocacy organization Action-Santé Outaouais (ASO) on February 20.

The event, which attracted over 70 participants, featured speakers Dr. Anne Plourde, researcher at the Institut de recherche et d’informations socioéconomiques (IRIS), Dr. Isabelle Leblanc, assistant professor at McGill’s Department of Family Medicine, and Yves Destroismaisons, a Human Relations Officer with 20 years prior experience as a CLSC social worker in Petite-Nation.

In his introductory comments, ASO Director Mathieu Charbonneau said the idea for the event emerged from discussion workshops about access to healthcare in rural areas held across the Outaouais – including one in Bristol – in November 2023. “One of the main points that came up during these workshops was the role of CLSCs. Participants and representatives from local organizations noted a major decline in the function of rural CLSCs and a net decrease in service accessibility,” said Charbonneau.

The panel focused on the history and origins of CLSCs, the impact of increasing centralization and privatization of healthcare on them and the prospects of the CLSC model for promoting greater access to healthcare in Quebec.

Dr. Plourde spoke about how the model for CLSCs first emerged from grassroots social movements during the 1950s and 60s prior to becoming a government service in the 1970s. She explained that, at the time, health services were private and concentrated in wealthy urban neighbourhoods leaving those living in poor neighbourhoods and rural areas without adequate healthcare.

“In the 60s, local movements decided to take healthcare into their own hands and created community clinics in disadvantaged neighborhoods to respond to needs unmet by the private services,” said Plourde; “The CLSC model was largely based on these grassroots community clinics.”

Panelists noted that, although CLSCs were initially supposed to have a full multidisciplinary health team, offer a wide range of front-line health and social services, and be administered by local democratically elected boards, the vision of province-wide healthcare anchored in local communities was never fully realized.

“One of the big issues is CLSCs never lived up to what they were supposed to be. A great model was created, but it was never given the support it needed. There was chronic underfunding and CLSCs were never given the means to complete their mission,” said Dr. Leblanc.

Leblanc said resistance to the CLSC model over successive governments coupled with a push towards privatization among many doctors in the province eventually led to CLSCs becoming a parallel service to private clinics.

Destroismaisons spoke from his experience working in CLSCs for over 20 years. “Initially, there was a broad range of services offered and they had latitude because they were managed by a local board with a director on site. However, bit by bit, services have been distanced from rural CLSCs. Human contact has gradually been lost over time, and I find that extremely unfortunate,” said Destroismaisons.

“We need to start developing an alternative plan now. I’m not optimistic about the most recent healthcare reforms, but we’re capable of creating innovative models that can respond to the needs of the population in Quebec,” said Dr. Plourde when asked about the future of CLSCs.

“We can still be confident that the majority of actors on the ground in the healthcare system are still motivated by a desire that people get better. I think there’s still a glimmer of hope there. It becomes really difficult for healthcare workers to see how people are being treated and perhaps this is a ­­­­common point to bring people together and make improvements,” added Dr. Leblanc.

For more information and to learn about upcoming events and initiatives organized by ASO visit https://actionsanteoutaouais.org/ or email actionsanteoutaouais@gmail.com.

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