Doctors from across the region have come together to denounce what they consider poor management at the Montérégie-West Integrated Health and Social Services Centre (CISSSMO). A damning statement sent to elected officials in early February warned that the pandemic had exposed “untenable and dangerous circumstances” caused by a chronic shortage of personnel and exacerbated by a lack of governance and accountability by senior management. The letter was signed by six area doctors, including Dr. Catherine Bélanger and Dr. Félix Le-Phat-Ho, the COVID-19 coordinators for, respectively, the Haut-Saint-Laurent and the Jardins-Roussillon local health networks.
“According to the Act respecting health services and social services, it is the responsibility of the institution to ensure the safe delivery of health and social services to users,” the doctors stated in their letter. “We believe that the establishment has failed in its duty.”
For Dr. Bélanger, COVID-19 has shone a spotlight on longstanding problems with the management at CISSSMO: “There is a culture of management that is encouraged by high level managers – it is coercive, it is inhumane, and it is impersonal.” She describes how overtime is routinely demanded of nurses and orderlies and says that this dubious strategy used to compensate for gaps in personnel “is just the way things were run.”
With the pandemic, staff shortages worsened. Family physicians mobilized quickly to prioritize the needs of hospitals and long-term care residences (CHSLDs). Overcrowding in hospitals was avoided by the creation of community care centres in hotels and CHSLDs; these were able to accommodate COVID-19 patients who did not need hospitalization. The provincial government also introduced emergency measures that reduced certain hospital activities and reallocated health care personnel; this was to allow the new priority-care activities to be staffed. Family doctors such as those at the Ormstown Medical Clinic (OMC) approved the reallocation of 100 per cent of their nursing staff – nurses who would normally be working in family medicine.
“Any professional that could be taken was taken,” says Bélanger. “We approved this, but when the (COVID) numbers went down, our people were not returned to us.” She says the CISSSMO is now “filling gaps in personnel with the people who normally serve our community.”
At the same time, Bélanger reports that there have been serious inefficiencies and difficulties with all this movement of staff. She notes that at one point, an OMC nurse had been left waiting at home, as she had not been told where to report to work.
In their letter, the doctors allege that the service breakdowns tied to staff shortages – and the questionable human resource management – have had dire consequences, including “avoidable deaths and suffering that will leave an indelible mark on our communities.”
In a press release issued to commemorate one year of the pandemic, the CISSSMO president and CEO, Yves Masse, acknowledged the alarm sounded by the doctors. “The pandemic situation has accentuated our workforce issues, and I assure you that the CISSSMO team is working tirelessly to find solutions,” he says. “We are reaching out to physicians and unions to continue the collaborative work already underway.”
“We all have the same objective of offering quality health care and social services, and it is by working together, with one voice, that we will be able to improve the situation,” Masse concluded.