Two CSBE reports expected in December

This text is part of the special booklet Aging well, staying young

After revealing the weaknesses in the governance of the health system in a preliminary report, the Commissioner for Health and Welfare (CSBE) will publish not one, but two final reports next December.

The first will deal with the issue of public health, and the other will focus on that of the elderly. “We thought that public health was not an area that had received enough attention. We have so many expectations about what we will say about the elderly that no one will hear what we say about public health, ”explains Health and Welfare Commissioner Joanne Castonguay.

To this will also be added several studies carried out by university researchers. Thus, results will be published on the subject of human resources management, mortality, and also the comparative costs of caring for the elderly in private and public establishments.

Different decisions

the first preliminary report released earlier this month underlined the absence of a comprehensive strategy and the lack of information regarding the care and services given to the elderly. “Without information, you can’t make good decisions. And the decisions would have been different ”if such data had been available, summarizes the Commissioner.

Could access to this kind of data have saved lives during the first wave? Without wanting to comment, Mme Castonguay nevertheless believes that the situation in Quebec “would probably have had less consequences, but it is very difficult to say, after the fact,” she supposes.

The CSBE’s final report on eldercare will also contain more information on mortality in CHSLDs and its causes. “In general, what we observed was in the most populous areas that there was the most transmission”, describes Mr.me Castonguay. “But if we had better data, we probably would have taken more of that information into account, but that’s only a question that can be raised,” she says.

Without information, you cannot make good decisions. And the decisions [quant aux soins et services donnés aux aînés] would have been different [si de telles données avaient été disponibles]

Even though the granularity of the data was already present before the health crisis, it was exacerbated by the health reform piloted by the former liberal minister, Gaétan Barrette, according to the commissioner. “All the data is accumulated in a single region, and we have no more information [pour un] hospital or [une] installation. It made the problem worse, ”she explains.

And it is this lack of data that would have complicated decision-making. “This one is very difficult, since it is not based on solid information. “

The Commissioner also cites the absence of an integrated quality control process. “There is no one who has an overview of the quality of the entire network. The final report will also come back in detail to the flaws in the control mechanisms, in particular the heterogeneity of the attention paid to quality among the senior managers of the establishments.

For example, if a health center has set up a hand washing policy, we do not necessarily ensure that it is followed, notes the Commissioner. “It is as if we were saying that Quebec students are strong in mathematics because they have all followed their course”, without checking whether they have succeeded, she illustrates. “So, by not asking for accountability at the governance level, we don’t know. “

Focus on the flaws in the health system

By deliberately releasing the preliminary report in September rather than June, when it was ready, the Commissioner wanted to put it in the spotlight. “We thought we were going to be blamed for trying to sneak it out. So we decided to wait until the start of the school year so that it receives the attention it deserves ”, notes Mme Castonguay.

The latter also underlines that solutions have already been proposed several times by experts and that better care does not simply mean better financing. “It is a question of giving the necessary attention and reorganizing according to the needs”, she specifies.

Due to the heavy task of the CSBE, Mr.me Castonguay believes that it “practically went around the entire system”. “The stakes have been around for so long that, in order to fully explore each of the questions, it requires serious analysis,” observes the Commissioner. “We are trying to meet the mandate in December, but we will not stop there. ”

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