Health cuts

Job losses ‘unavoidable’ in round two of health cuts

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By Trevor Greenway

After slashing 800 health positions across the Outaouais, the head of CISSSO says that he still needs to cut an additional $30 million from its budget, money that will “certainly” result in more job losses. 

The CISSSO was mandated by the province’s new health department, Santé Québec, to slash $90 million from its budget in an overall effort to cut $1.5 billion from the province’s health sector by April 1. Last week, CISSSO announced it was cutting 800 health jobs as part of the cuts. However, CISSSO CEO Marc Bilodeau told the Low Down on March 20 that those cuts only represented two-thirds – $60 million of budget cuts – with an additional $30 million coming down the pike. 

“I think it’s unavoidable,” said Bilodeau when asked if the next round of cuts will result in job losses.  “Because 70 per cent of my expenditures are related to human resources, so expecting to cut without impacting positions is almost impossible.”  

While many of the 800 positions cut last week were vacant, with 104 personnel losing their jobs, Bilodeau says the next round of budget cuts will be especially difficult. He said the first round of cuts was focused on the “easy stuff,” like abolishing vacant positions. He admitted that there would be an impact on residents. He added that not all of the impacts of the cuts would be bad. 

“There would be some impact, but impact doesn’t mean, necessarily, negative impact,” said Bilodeau. “So it could have an impact on how the care is delivered but not necessarily on the amount of care being delivered.”

Dr. Bilodeau used the example of adapting patients with “very common mental health problems” into group therapy settings rather than one-on-one sessions: “I can have 10 patients in the same room with one healthcare provider, and I can do, basically, 10 times more than what I would do with a one-on-one intervention.” He added that managing hours, morale and work-life balance for front-line staffers will be key to moving forward successfully. 

Bilodeau said about two-thirds of the 104 health jobs cut in the region are front-line staff positions, but he added that many have been offered other positions “in more critical areas of our healthcare system.” 

SOS Outaouais president Jean Pigeon told the Low Down that, while the 800 job losses aren’t as dire as recent headlines suggest, the fact that over 600 vacant positions won’t be renewed kills any chance of recruiting more doctors, nurses or medical technicians to an already underfunded health region. According to the Observatoire de développement de l’Outaouais, it has estimated that the Outaouais region faces a funding shortfall of $180 million when compared to other regions in Quebec. 

“We need to point our fingers at the government here,” said Pigeon. “They are the ones who are making these decisions. And clearly this is not Mr. Bilodeau’s fault. It’s just going to create an overwhelming burden again in the workplace environment. Can we really let go of people that we need in a network that is underfunded and understaffed? No, it’s just chaotic.”

Three full-time positions abolished in Des Collines

According to health watchdog group Vigi Santé, the cuts will be felt locally, as three full-time positions in the Des Collines are being abolished: one at the CHSLD in Masham and two admin positions related to proximity services. 

“Two of them are actual job losses; the third one is a reassignment,” said Vigi Santé spokesperson Marcel Chartrand. 

Chartrand also noted that a 0.5 nursing position is being moved from the Masham CLSC to Cantley. Chartrand added that the cuts are also suspending key projects in the region, including a new seniors’ home in Masham and a multi-purpose, permanent vaccination centre in the Des Collines region.  “We are told time and again that services are not and will not be affected,” said Chartrand. “Hard to believe, as with fewer resources, there will be delays in providing services, and waiting times will be extended.”

No decision on CLSC in Low, yet

Dr. Bilodeau told the Low Down that, while there isn’t yet an official decision to cut services at the CLSC in Low to one day a week, he did say that “measures are on the table.”

“Obviously, some of those places like Low could be affected,” said Bilodeau. “I’m not saying they will be because it’s still being analyzed now, and we haven’t made a decision as to where it’s going to be with the last $30 million that we need to cut.” Gatineau MNA Robert Bussière did not return the Low Down’s calls for comments.

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Low seniors worried about health cuts

Local Journalism Initiative / / / , , , ,

By Trevor Greenway
Local Journalism Initiative

Kent Canavan’s mouth was filling with blood and he needed emergency help. 

He had just had his wisdom teeth out and was bleeding profusely at his home in Low. 

He rushed over to the CLSC to get some more bandages and have his wound looked at, but when he arrived, the doors were locked. It was lunchtime, and nobody came to help him, so he rushed back home to try to stop the bleeding.

“The door [to the CLSC] was locked, and I ended up going back to my apartment, and I ended up on the floor – I passed out,” said Canavan to the mayor, councillors and those gathered on March 14 during an emergency CLSC meeting in Low. 

The meeting was called after residents were told that the town’s only medical clinic – the CLSC – would be reducing its hours to just one day a week, by appointment only. Close to a dozen seniors were present at the meeting, telling their personal stories and the fears they have about the potential cuts. 

“The blood was coming out so bad at the time that, when I did come to, I grabbed a facecloth and rammed it into the crevices to slow down the bleeding,” added Canavan about his incident last year, before the impending reduction to one day a week. Now, he is worried that things will get even worse for patients in Low. 

Fellow Low resident Debbie Cameron was in tears as she spoke about the constant support she needs from a home care nurse to look after her severely disabled son, who is a quadriplegic and suffers from dysphagia, spina bifida, diabetes and hydrocephalus. She said with the looming health cuts, in which $1.5 billion is being cut from healthcare in Quebec and $90 million in the Outaouais – home care services could be cut by 50 per cent, and she doesn’t know what she will do. 

“He can’t even scratch his own nose, he can’t feed himself, he has difficulty speaking,” she said through sobs, as she described her son’s daily struggles. “I need support badly.” 

Cameron said that her son’s home care nurse is “wonderful,” but she knows just how overworked she is. When Cameron’s 42-year-old son had an operation in Montreal last year, his home care nurse had to come every single day to drain the wound, and she said she worries how the cuts will affect her son’s quality of life.  “They bend over backwards, but the time constraints – they are given too many people to look after, so they can’t do their jobs properly,” said Cameron.

Low Coun. Lee Angus was present at the meeting and said that councillors feel helpless in the fight for healthcare up the line, as residents have been faced with diminishing services for close to a decade. He said cutting services to just one day a week at the CLSC will have a detrimental effect on the region’s aging population.

“And you have to make an appointment when you want to go?” asked Angus. “So, you gotta plan when you’re going to be sick. It’s pretty pathetic to have a building there and nobody to man it and no services. I have been sick before and had to drive to Gracefield to get service, and that’s fine for me – I have a vehicle, I can do that – but there are lots of people who live around the village who don’t have vehicles and can’t get there.”

Low Mayor Carol Robert echoed some of Angus’ statements at the meeting, saying that her council feels a bit powerless in the fight for healthcare. She said that her council can put forth resolutions to try to pressure the province to make certain decisions, but ultimately Low doesn’t “have the power to change the health system.”

“The only thing we can do is put forth a really strong resolution, pinpointing all the points that were made here today and not only send it to all the other levels of the ministry but also the MRC, so that all the mayors support our resolution,” she said. “We’re not the only ones that are being hit – up north it’s the same thing, so they will support our resolution.”

Resident Colette Canavan, who has been an advocate for healthcare up the line, said at the meeting that the CLSC in Low will officially be reduced to one day a week, by appointment only, as of April 1. This has not been confirmed by CISSSO. 

The cuts are part of the province’s austerity measures that will see $1.5 billion cut from the health sector by March 1. 

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CISSSMO works to maintain services in face of budget cuts

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Sarah Rennie – LJI reporter

As part of the $1.5 billion in budget cuts announced by Santé Québec, the Centre Intégré de Santé et des Services Sociaux de la Montérégie-Ouest (CISSSMO) is looking to reduce spending within the regional healthcare system by $140 million.

In a recent report by La Presse, the integrated health and social service centres were asked to submit plans for cutting costs; and for the first time, these plans could include measures that would more directly affect user services. The report identified programs such as local service points, and the network of Aire Ouverte locations was among those being targeted by budget compressions.

The CISSSMO does not offer a local service point in the Haut-Saint-Laurent region; however, locals make use of the services being offered at the Centre Valleyfield shopping centre location, which opened in 2021. Available services include vaccinations, blood work, and screening for colorectal cancer, pertussis, and streptococcus A.

Other nearby points of service operated by the CISSSMO are in Vaudreuil-Soulanges, Chateauguay, and Mercier. While there is no direct service point, a mobile team provides certain of these services in the Haut-Saint-Laurent.

A representative for the CISSSMO’s communications and public affairs department would not confirm whether these local points of service in operation would be affected by budget cuts.

“With regard to local points of service, our management committee is still analyzing this service in order to limit the impact on users,” they said. “With the need to return to a balanced budget, all services are being reviewed with a view to offering and quality services, at the lowest possible cost.”

Last year at least 24,568 vaccine doses were administered at the Valleyfield service point, while 741 individuals were screened for COVID-19 or influenza. A total of 474 screenings for colorectal cancer took place, as well as 642 tests for streptococcus A, and 196 tests for pertussis. The staff at the service point filled 15,376 appointments for blood work in the last year as well.

Aire Ouverte to remain

While the CISSSMO representative was less direct about the future of local service centres, they confirmed the regional health authority would be maintaining its Aire Ouverte activities “throughout the Suroît, Haut-Saint-Laurent, and Jardins Roussillon territories.” They noted, however, that in order to continue to ensure coverage of the entire region, service hours would be adjusted.

There is currently a permanent Aire Ouverte location in Salaberry-de-Valleyfield, as well as satellite offices in partnership with the Carrefour Jeunesse Emploi locations in Huntingdon, Chateauguay, and Roussillon. Another satellite office is open in Beauharnois in partnership with the self-help centre Le Dahlia.

Each of these locations provide health services for 12- to 25-year-olds, including mental and sexual health, free of charge and without an appointment.

The CISSSMO notes that Aire Ouverte staff in Valleyfield will continue to welcome clients from across the CISSSMO territory. Teleconsultations are also available when required to ensure services are accessible for all those who need them.

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Three positions axed at Barrie Memorial amidst CISSSMO spending reductions

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Sarah Rennie – LJI reporter

The Centre Intégré de Santé et des Services Sociaux de la Montérégie Ouest (CISSSMO) is facing a delicate financial situation. Santé Québec has imposed a return to a balanced budget, forcing the regional health institution to cut over $140 million in spending.

According to the CISSSMO, a reduction in the use of agency staff, greater control over spending, the abolition of vacant positions, and the reorganization of certain departments allowed for a reduction in the anticipated budget deficit to $83 million. Still, reports have emerged that up to 160 jobs, including practical nurses, orderlies, and clinical nurses may be lost.

The CISSSMO has been working over the past several weeks to implement a plan that will minimize the impacts of budget cuts on public care and services while ensuring these remain accessible. The organization is also highlighting the significance of treating staff with kindness. As a result and to be more efficient, the CISSSMO is prioritizing the reduction of administrative functions and the reorganization of care.

A representative for the CISSSMO’s communications and public affairs department says that of the positions to be abolished, almost two-thirds are vacant positions that had not been filled. They explain that certain departments were created during the pandemic, and surplus team positions were filled to support the organization during the health crisis.

The CISSSMO representative confirms that a certain number of current positions will be eliminated but adds that this number is subject to change. At least one administrative position and two orderlies at the Barrie Memorial Hospital have been affected by these measures; however, the representative maintains these changes do not impact the emergency or professional sectors.

Most of the affected employees will be reassigned to clinical sectors such as the Maisons des Ainés et Alternatives, the Hôpital Anna-Laberge, and the Hôpital du Suroît. This will allow the CISSSMO to open additional beds, to better meet patient needs, and to further reduce its use of agency staff.

“Some units were overstaffed by up to 250 per cent on day shifts, whereas evening and night shifts were required,” The representative adds, noting that shifts have now returned to a pre-pandemic structure. “We are making sure we respect the nurse-patient ratios recommended by our CISSS nursing directorate, so there will be no impact on patient care.”

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Gaspé Peninsula CISSS needs to reduce 160,000 working hours

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Nelson Sergerie, LJI Journalist

GASPÉ – The Gaspé Peninsula Integrated Health and Social Services Centre (CISSS) is considering how to respond to the request to reduce hours worked by 3% in order to make up for part of Santé Québec’s shortfall. 

The organization calculates that this request represents 160,000 working hours, equivalent to 100 full-time positions. 

However, for the current year, the use of independent labour to maintain services alone represents 400,000 working hours and costs between $25 million and $30 million. 

In an email, the CISSS indicated that it is continuing its review of how to reorganize services to reduce hours worked, with the intention to prioritize a reduction in independent labour. 

This could ultimately result in a reduction in hours worked, without reducing the number of positions as is happening in other regions of Quebec. 

The review also involves maintaining a sufficient number of employees to provide services. 

Among other measures, a moratorium is underway on the posting of administrative positions which will lead to a reduction in hours worked. 

In addition, discussions are held every week with Santé Québec on the evolution of the financial situation and on the directions to take. 

The Gaspé Peninsula CISSS must recover $40 million by March 31 to meet the budgetary restraints requested by Quebec, which is the equivalent of a month and a half of activities. 

The President and CEO of the Gaspé Peninsula CISSS, Martin Pelletier, has already indicated that it was impossible to achieve this objective in the short time frame set out by the Quebec government. 

“I’ll tell you right away. It won’t be $40 million. It will be what we are able to do. Forty million dollars in five months would take drastic measures. We will not do that,” the leader said at the organization’s last board meeting at the end of November. 

Gaspé Peninsula CISSS needs to reduce 160,000 working hours Read More »

Stéphane Sainte-Croix attentive to the $40 million in cuts requested by the CISSS

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Nelson Sergerie, LJI Journalist

GASPÉ – The Gaspé Member of the National Assembly (MNA) will work to ensure that Santé Québec and the Quebec government take into account the specificities of the Gaspé in the context of the $40 million budget cuts requested from the Gaspé Peninsula Integrated Health and Social Services Centre. 

Stéphane Sainte-Croix reacts this way to the reflection launched by the CISSS on ways to maintain the emergency services at Grande-Vallée, Murdochville and Paspébiac CLSCs 24/7. 

The CISSS is analyzing the idea of replacing nurses with auxiliary nurses who would be linked to remote nurses to maintain the care offered at these establishments. Grande-Vallée Mayor Noël Richard indicated that when a nurse is mobilized in a facility transfer, this would be equivalent to a service interruption in his facility, which he describes as unthinkable in his community. 

He points out that the closest hospitals are more than 100 kilometres from Grande-Vallée. 

The Québec government has assured the public that the financial cuts would not result in a reduction in patient services. “The minister was clear on this. We are sensitive to the issue. Once the recommendations are known, we will take note of them and do our work to ensure that the service offer is maintained,” says Mr. Sainte-Croix. 

The MNA indicated that he wanted to give the CISSS time to carry out its exercise to recover the requested amounts. 

“We will work to maintain the service offer. If it requires us to review the effort in terms of rigour, we will be happy to support our CISSS, but let’s give management time to do its exercise and, from there, we can establish our scenario and the work that will come to maintain our service offering,” he says. 

Mr. Sainte-Croix understands the particularities of the region, especially the distance to travel to have access to care and the fact that there is no major service hub. 

“There is a question of cost behind the territory and the service offering. We dare to hope that the particularities will be recognized for the future,” mentions the MNA. 

As for the specific CLSC file, Mr. Sainte-Croix is concerned. “We will remember that this is not the first time that we have had a reflection at this level. We will let the CISSS do its exercise. For the moment, we are listening. We are aware of the issues and we are very sensitive to the issue.” 

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CISSS Cutbacks: CLSC emergency rooms in the territory will remain open

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Nelson Sergerie, LJI Journalist

GASPÉ – The Gaspé Peninsula Integrated Health and Social Services Centre (CISSS) assures that it will not close the 24/7 emergency rooms at the Grande-Vallée, Murdochville and Paspebiac CLSCs, despite their low attendance at night. 

Martin Pelletier, President and Chief Executive Officer (CEO) of the Gaspé Peninsula CISSS, emphasized that no such closures are being considered as the network scrambles to find $40.7 million in savings to meet a $535 million budget. “We are not there. We are really not there,” says Mr. Pelletier. 

This CLSC emergency room question regularly comes up in the news. In 2013, before the creation of the Gaspé Peninsula CISSS, the former regional health and social services agency of the Gaspésie conducted a review that included the issue. It was mentioned in 2017 following the Barrette reform, which had once again caused discontent among the population. 

“Can we review the use of resources from these less busy emergency rooms to help other busier emergency rooms at the same time?” wonders Mr. Pelletier, considering that a doctor and a nurse are on site while the volume of activity is lower. 

“Another thing we can look at is: do we always need a nurse or could we use a nursing assistant in a network where there is not a lot of night volume? But (the nursing assistant) would be affiliated with a nurse who is already working (at another location) and able to be in contact if a case requires the judgment of a nurse. This is another example of transformation work,” he says. The union will have to be involved. 

The overall labour shortage situation is forcing the region’s health network to explore this avenue. “We’re going to have to look. It’s not just a question of budget, it’s a question of survival and maintaining services and the ability to find resources to offer these services. Even if I had the budget, the problem is finding the resources. Changing our ways of doing things is essential to the survival and sustainability of services,” says Mr. Pelletier. 

This hypothesis, raised following the Gaspé Peninsula CISSS board of directors meeting on November 28, is not being well-received by the Eastern Quebec Nurses, Auxiliary Nurses and Respiratory Therapists Union. 

“It’s a complete rejection,” says union president Pier-Luc Bujold. “The population has the right to quality service, professional service and we cannot, to a certain extent, replace a nurse with a nursing assistant,” he adds. 

He provides examples of administering medication in an emergency or managing triage, which could not be done by a nursing assistant. 

“In terms of collective agreements, it doesn’t hold water and, logically, it doesn’t hold water to send a nurse from Grande-Vallée to work in Gaspé,” says the president. 

According to him, these measures would not be attractive and could harm staff retention. “We have already expressed our concerns about this and the CEO tells us that nothing will be done in this regard without having discussions with us and that it holds water. For us, it doesn’t hold water,” says the union representative. 

Former Gaspé Member of the National Assembly, Gaétan Lelièvre, who fought for the survival of the services in 2017 believes that the CISSS is not on the right track with the idea of changing the teams to offer these services. 

Mr. Lelièvre notes that this is a security issue. “This is a decrease in the level of security of the population. Political and economic stakeholders must send a very clear message to Quebec: we do not accept these service cuts,” says the former minister responsible for the regions in the Marois government between 2012 and 2014. 

He points out that health is a basic condition for regional development. “We know that the government has an $11 billion deficit to wipe out, but we cannot accept that this is in services as essential as a CLSC that serves communities 100 kilometres from a hospital. This is unacceptable,” continues the man who is now a regional development advisor. 

For his part, Noël Richard, the mayor of Grande-Vallée, fears service disruptions in the emergency room if the CISSS was to go ahead with this idea. He notes that if a nurse has to go with a patient to the Gaspé hospital, the service would be in danger. 

“Because we have a shortage of manpower, we would be in temporary service disruption. This is unacceptable,” thunders Mr. Richard. In his eyes, such a cut is non-negotiable, especially since several concessions have been made in recent years on health issues. 

“The conversion of ambulance drivers from shift schedules to hourly schedules was not included in this program. We also made concessions on community dentistry, but I will not make any concessions on such an essential service,” added the municipal elected official. 

CISSS Cutbacks: CLSC emergency rooms in the territory will remain open Read More »

Quickly cutting $40M from the Gaspé Peninsula CISSS will be difficult

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Nelson Sergerie, LJI Journalist

GASPÉ – The Gaspé Peninsula Integrated Health and Social Services Centre is still facing a $50 million deficit for the fiscal year ending March 31. The organization, however, is focusing on recovering the $40.7 million demanded by the Ministry of Health, mentioned the President and CEO Martin Pelletier following the board of directors meeting on November 28. 

For the moment, there are no plans to cut jobs. “We are not there, and we are not at a  hiring freeze for nurses. We are Some services under development will be reviewed to assess whether they should be maintained. 

Several measures are being analyzed to meet the requirements by March. “I will tell you right away. It will not be $40 million. It will be what we can do. Forty million dollars in five months would take drastic measures. We will not do that,” says the manager. The independent workforce alone represents about $25 million of the projected deficit. 

One example of a measure is to review the housing supply for the independent workforce. Currently, the ratio is one worker per housing unit. “We will implement a measure that will put two or three independent workers in a dwelling, for apartments with several bedrooms, which would eliminate dwellings,” says the president and chief executive officer (CEO). 

This measure could generate savings of hundreds of thousands of dollars. Mr. Pelletier is not concerned that some workers may refuse to come to the region. “Maybe. On the other hand, we are aligning ourselves with other regions. They (health workers from outside) do not come for vacations. Winter is less attractive than summer in the Gaspésie. We have a choice to make and this is an example of a hypothesis that does not affect care,” he says. 

The preliminary studies to launch the engineering work for the emergency and intensive care units at the Maria hospital cannot begin before April 1 due to a lack of funds. 

“We have no guarantee that the project will be included in the PQI (Quebec’s Infrastructure Program) in the next year. The guarantee we have is that we will do the studies next year and if the emergency project is only in a year, it will not prevent us from moving forward. It was an idea to get ahead of things by thinking that the project would be announced next April. We will start in April using independent nursing workers. The idea is to hire nurses to replace them. What we are going to do is not develop new services so we won’t have to create new positions for which we will not be able to respond,” says Martin Pelletier. 

and we will have the year to do the analysis if the emergency project arrives in 2026,” analyzes the President and CEO. 

The MRCs of Bonaventure and Avignon maintain that the project is essential for the Bay of Chaleur area. 

“There were promises made. We have been waiting for more than 15 years. We reiterate that the emergency is in the PQI,” says Bonaventure Prefect Éric Dubé. 

“It is a $100 million project. We estimate that for $250,000, we must find solutions to not delay this project. It’s a relatively small amount on the CISSS and health system budget. We have to find solutions,” mentions his colleague from Avignon, Mathieu Lapointe. 

The elected officials will meet Martin Pelletier on December 11. However, one must not have any illusions. 

“I’m going to tell them the same thing that I just explained. The relevance of the project is recognized. The problem is Quebec’s financial capacity to put this project in the PQI. It’s not at our level. It’s going to happen. When? That’s the question,” says Mr. Pelletier.

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