GASPÉ – Ambulance service gaps have become a rare commodity at the Gaspé Peninsula Integrated Health and Social Services Centre (CISSS).
From a rate of up to 3.5% in the last quarter of 2022, this rate has dropped to 1.56% in 2022-2023 and further to just 0.24% in 2023-2024.
Companies have made significant efforts to hire paramedics or have relied on independent labour to fill positions. “It’s difficult to reach 0% because there are situations where there are last-minute illnesses or difficulties replacing someone who was already on the schedule. When we’re talking about 0.24%, the efforts have been remarkable, and people have found solutions,” says Jean-François Sénéchal, Deputy Director of Medical and Professional Services at the Gaspé Peninsula CISSS. When a shortage occurs, staff are strategically redeployed across the territory.
Since 2018, several shift schedules have been converted to hourly schedules. “The argument has always been that it would be easier to recruit and retain staff when we have hourly schedules because, in terms of personal and social life, it’s easier to plan activities. This confirms that the arguments for the conversion were well-founded,” says Mr. Sénéchal.
The advantages of hourly schedules facilitate redeployment and allow for faster response times because people are already in the ambulance—a response time of less than a minute—while the on-call schedule requires the paramedic to first go to the paramedics station to take charge of the vehicle and then respond to the call, resulting in a response time of approximately eight minutes.
There are still a few on-call shifts available in the Gaspé, however, the goal is to one day see the region covered 100% with hourly schedules.
“For example, if we’re talking about Mont-Louis or Murdochville, it’s clear that what we have left as on-call teams doesn’t have much travel time during the week. If we put these teams on the hour, it would be, in quote, a waste of resources,” explains Mr. Sénéchal.
In Gaspé, an on-call team was converted to a 10-hour shift, a change that initially sparked controversy, but has since produced promising results.
Currently, there’s a 24-hour team in Gaspé and in Rivière-au-Renard, in addition to the 10-hour shift in Gaspé.
“Based on the volume of activity and our redeployment capacity, we think we made the right decision,” concludes Mr. Sénéchal.
GASPÉ – Women’s groups are once again denouncing the situation of understaffed obstetrics departments at hospitals in the Gaspé Peninsula, particularly the one in Sainte-Anne-des-Monts.
The Haute-Gaspésie hospital has experienced a staff shortage and service disruptions nearly every month for the past two years due to a lack of trained nursing resources available to work in obstetrics.
Committees have been formed in each of the local networks to find solutions, including training more nurses to work in the obstetrics department.
“But one of the fundamental issues is retention because the working conditions are demanding. We are calling on the Legault government, Health Minister Christian Dubé, and Gaspé MNA (Member of the National Assembly) Stéphane Sainte-Croix because we believe there is undoubtedly a deeper issue, which is to strengthen local services. The citizens of the Gaspésie and the workers are not second-class citizens because we live in the Gaspésie and we have the right to have local services that operate year-round,” says Nastassia Williams, coordinator of the Table de concertation féministe de la Gaspésie-Îles-de-la-Madeleine, who also speaks on behalf of the Maison des familles Haute-Gaspésie and the Syndicat des infirmières, infirmiers auxiliaires et inhalothérapeutes de l’Est-du-Québec.
The organizations say these service interruptions generate considerable stress for families expecting a child and pose real risks to the health and safety of the mother and baby. In addition to increasing anxiety, these discoveries can lead to unwanted or unnecessary medical interventions, disrupting the safe progress of deliveries.
The Gaspé Peninsula Integrated Health and Social Services Centre (CISSS) formed committees last December to find solutions after a series of department closures and service disruptions in Haute-Gaspésie.
Discussions on the issue are ongoing, “We have nurses working in other departments who have agreed to work in obstetrics, sending them to Quebec City for training at the CHU. We’re in the process of organizing this schedule,” says CISSS President and CEO Martin Pelletier.
He predicts it will take until the fall for the obstetrics department to stabilize. “The medical staff is also stretched thin. We don’t want to lose a doctor in the meantime, because otherwise, it would be a different story,” says the director.
But for women, the stakes are higher. Traditionally female professions are more affected, they say. “This is an issue we see in the healthcare and education sectors, which are traditionally female professions, where adequate working conditions have not been provided. It’s a sector that has been neglected for years. We have people who are burning out, people who aren’t being replaced. The day the government considers issues affecting women, whether in terms of services or jobs, as a priority, the issue will decrease and we will have fewer workforce issues,” analyzes Ms. Williams, who points out that public services have been neglected for years.
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.
The town of Huntingdon is at risk of losing its first-responder service.
The municipality issued an urgent plea for new volunteers on January 30, referring to the need as immediate and great.
The town reports that at least 13 individuals have completed the required 60 hours of training in just under twenty years since the service was launched in May 2005. The number of first responders has now dwindled to a total of four volunteers.
Volunteer first responders are trained according to medical protocols to assess and stabilize patients in a variety of situations before an ambulance and emergency medical technicians arrive at the scene. Emergency interventions are often more efficient thanks to this collaboration of first responders.
In Huntingdon, first responders handle about 100 calls annually.
“We want to keep the service,” says Huntingdon’s mayor, André Brunette, though he admits recruitment has become more difficult. “Not everyone is suited to do this kind of work,” he acknowledges, while suggesting that the town is encouraging those with an interest in this type of community service to come forward.
Huntingdon director general Johanne Hébert points out that four people is simply not enough. “They are exhausted. They are on call 24 hours a day. We put certain measures in place, but it comes down to the fact these people are firefighters, they are first responders, but they also have jobs and families.”
As a result, Hébert says first responders presently only respond to calls where there is a high potential of cardiorespiratory arrest. There are four levels of first-responder services in Quebec, and this is the highest priority, but it means there is a greater reliance on emergency medical technicians to respond quickly to severe allergic reactions, severe trauma, and urgent medical calls.
“The population does not have to worry that there will be fewer services if the program were to close,” Hébert says, pointing out that Paraxion paramedics serve the town, and the fire department is part of the regional mutual aid network. “But it is always a plus. We have saved lives,” she says.
Huntingdon assistant director general Caroline Hébert-McKenzie confirms the town is doing everything it can to maintain the service. She says that since going public with their tenuous situation, at least three individuals including one new resident have come forward to volunteer. Several members of the Huntingdon fire department have also voiced an interest. “Things are moving in the right direction,” she affirms, noting the town is already in a better position to keep the service.
Last month, the Protecteur du citoyen, Marc-André Dowd, released his highly anticipated 2023-2024 Annual Report, shedding light on widespread challenges in Quebec’s public services. The report emphasizes systemic failures in various sectors, ranging from public health and social services to corrections and public integrity, calling on government bodies to prioritize citizen needs and restore accountability.
Long Waits and Service Disruptions Plague Government Agencies
The report reveals that government departments and agencies often fail to prioritize citizens, leading to delayed services and long wait times. Problems with reaching the Tribunal administratif du logement (TAL), and delays in issuing crucial civil documents, such as birth and death certificates, have been flagged. The Protecteur also raised concerns about the Société de l’assurance automobile du Québec (SAAQ), where the transition to a new platform led to issues like wrongful license suspensions. While labor shortages were acknowledged, Dowd stressed that they should not serve as an excuse for consistent service disruptions. The Ombudsperson called for an urgent reevaluation of how public services manage their responsibilities, putting citizens’ needs at the forefront.
Indigenous Communities Still Waiting for Action on Viens Commission Recommendations
The report also included the first progress update on the Viens Commission, which investigates the treatment of Indigenous peoples by public services. While some improvements were noted, such as safety initiatives for Indigenous women, the Ombudsperson criticized the pace of reform, including the failure to integrate the United Nations Declaration on the Rights of Indigenous Peoples into Quebec’s legal framework.
Depersonalization in Healthcare: A Call for Humanized Services
Health and social services are struggling with a lack of resources, leading to what Dowd describes as “depersonalization.” Staff shortages and high turnover have forced many care providers to focus solely on essential services, often reducing patients to their clinical profiles rather than treating them as individuals. The Protecteur du citoyen’s investigations revealed inadequately trained staff in care facilities, leading to improper use of control measures and insufficient care for vulnerable populations, including the elderly and those in youth protection. As Quebec introduces new health reforms, the Ombudsperson warned that real progress would only be made if these initiatives ensure more personalized and accessible care. Concerns remain, particularly regarding the treatment of those in long-term care during the COVID-19 pandemic.
Serious Failures in Correctional Facilities
Dowd’s report uncovered alarming issues within Quebec’s detention centers, where chronic staff shortages have compromised basic human rights. Incarcerated individuals have faced extended periods of confinement, lacked access to clean clothing, and been subjected to restrictive measures, such as the unnecessary use of handcuffs, due to infrastructure inadequacies. Despite a new training center for correctional officers, 20.5% of regular positions remain vacant. The report also highlighted procedural failures during disciplinary hearings, which risked denying prisoners a fair process, and flagged ongoing problems with the transition of healthcare management from public security to health authorities.
Public Integrity: Ending Corruption and Irregularities
Investigations into public integrity revealed numerous cases of favoritism, cost overruns, and misuse of public funds. Examples include a school director bypassing hiring protocols to appoint an ex-colleague, and private expenses being wrongly charged to public funds in CHSLDs (long-term care homes). Dowd noted that while exposing misconduct is crucial, the priority is to end these practices and prevent recurrence. With new legislative changes set to expand the Protecteur du citoyen’s role in managing ethics within government bodies, Dowd expressed his commitment to promoting transparency and ethical governance.
Record Number of Complaints Filed
The Protecteur du citoyen processed a record 24,867 requests this year, an increase from 2022-2023. The agency found nearly 45% of complaints about health and social services to be justified, with the rate rising to 61% for long-term care facilities and 50.3% for hospitals. Complaints also surged in correctional services and public integrity, reflecting growing public dissatisfaction with government oversight.
A Call for Change
Despite the significant challenges, Dowd concluded that public services are generally cooperative in addressing their shortcomings. However, he emphasized the need for sustained efforts to ensure that citizens, particularly the most vulnerable, are not left behind. The full 2023-2024 report is available on the Protecteur du citoyen’s website.
NEW CARLISLE: September 23 marks the International Day of Sign Languages, a global initiative established by the United Nations General Assembly to raise awareness about the importance of sign language for the deaf community.
The day was established with a resolution in 2017 following a proposal by the World Federation of the Deaf (WFD). The United Nations resolution acknowledges that “Early access to sign language and services in sign language, including quality education available in sign language, is vital to the growth and development of the deaf individual and critical to the achievement of the internationally agreed development goals.”
That WFD is made up of 135 national associations of deaf people, representing approximately 70 million deaf people’s human rights worldwide. The proposed date of September 23 was in recognition of the WFD’s founding on that date in 1951. It also coincides with the International Week of Deaf People which takes place September 23 to 29.
This year’s observance emphasizes the unity of sign languages worldwide, urging communities and governments to support and recognize these vital linguistic tools.
Shining a blue light on Sign Languages
To promote and recognize sign languages, communities and governments around the world are encouraged to display blue lights.
Sign language around the world
There are over 70 million deaf individuals globally, with more than 80% residing in developing countries. These individuals use over 300 different sign languages, each with its own unique grammar and syntax. In Canada, American Sign Language (ASL) and Quebec Sign Language (Langue des signes québécoise, LSQ) are most common, with additional Indigenous and Maritime Sign Languages also used.
Statistics Canada reported that in 2021, 8,415 people identified ASL as their mother tongue, while 1,860 reported LSQ.
Furthermore, 37,620 Canadians could converse in ASL, and 6,193 in LSQ. Though estimates vary, the Canadian Association of the Deaf suggests there are approximately 357,000 deaf Canadians and 3.21 million hard of hearing individuals.
Challenges in the Gaspé Peninsula
There are significant gaps in services for the deaf community, particularly in remote regions like the Gaspé Peninsula. Peter Mann, 34, who currently lives in Port Daniel, shared his personal experiences with SPEC as he navigates life with deafness in a region with limited resources.
Diagnosed at birth, Mr. Mann was raised in Port Daniel, first attending Shigawake Port Daniel School, and then New Carlisle High School and Bonaventure Polyvalent before moving to Montreal for work.
Despite returning to the region for a new job in Chandler, he faced considerable challenges due to the lack of sign language services in the area.
“I was diagnosed at birth and have family members who are also deaf,” Mr. Mann told SPEC. “When I started school I learned some ASL. I learned more ASL online because there were no sign language services in the Gaspé Peninsula.
In addition, there have been times in Mr. Mann’s life when he needed an interpreter for lawyers, court appearances and healthcare. “I had to travel to Montreal for an interpreter, which cost a lot,” explains Mr. Mann.
Despite his efforts, finding employment locally was tough. “I looked for ten years for a job, I eventually got a job at RITMRG in May 2023.” However, the language barrier between ASL and LSQ poses additional difficulties. “At work, I use my smartphone to communicate with my boss and coworkers,” adding that he later uses Google Translate to bridge the language gap between English and French.
The lack of local support extends to home adaptations as well. “I have no special adaptations at home, like for smoke detectors or doorbells,” says Mr. Mann. “I have not been able to get those services covered and, if they’re not covered, they are very expensive,” he adds.
His advice to newly diagnosed deaf individuals is to use online tools and resources, as they can be crucial when local services are unavailable “Use online tools to learn ASL. When you can’t get services, you have to do it yourself,” says Mr. Mann. He recommends using internet sites such as lifeprint.com.
Silver Gallan was diagnosed with a hearing impairment in both ears since birth. Now seven years old and in grade two, Silver has undergone numerous tests at several hospitals to determine the extent of her hearing impairment. She has learned that her condition could further decrease over time, with the possibility that she may eventually lose her hearing entirely Tabitha Flowers, Silver’s grandmother, is eager to learn sign language to ensure that Silver is fluent and is able to communicate with her friends and family in sign language. “It is very important for Silver, her family and friends to learn sign language due to the fact that she could be fully hearing impaired one day,” explains Ms. Flowers
“Unfortunately with the lack of resources in our region, it is more difficult to learn sign language considering there are no classes, workshops, etc. that are available. We have reached out to multiple organizations to try and get more resources in our region for the hearing impaired but, unfortunately, in our small communities, there is not enough need for it,” says Ms. Flowers.
Silver would like to learn sign language and become fluent: “I’m discouraged to not know more, but I’m learning online one word at a time,” she says. The family has purchased an online program so that they can learn sign language together.
In addition to the challenges of learning sign language, Silver faces other difficulties in her daily life. “A few of the biggest challenges for Silver is being in a large group of people (due to echoing voices), swimming (being underwater creates pressure in the ears), and riding a bike (since hearing impairments can affect balance),” says Ms. Flowers, noting that Silver is athletic and loves sports.
Silver has also struggled with receiving adequate speech therapy resources, currently, she is receiving the service online rather than in person. Moreover, the family has waited over two years to receive a hearing test at the hospital and, consequently, has resorted to paying out of pocket for an annual test to ensure timely evaluations.
The family does not currently have hearing impairment devices in their home but is prepared to install devices such as special phones, along with alarms and doorbells that trigger lights and vibrations.
Silver says, “It’s important for people to know that hearing aids are not a magic fix and if you talk to a person who is hearing impaired, look at them, speak clearly, and not too fast.” Her grandmother adds, “Silver has experienced some bullying but that doesn’t stop her from enjoying all the things she loves, such as hunting, fishing, karate, dancing and singing. She does all these activities with pride because she knows truly how amazing she is in her own way.”
