The deployment of home support services in Quebec has been “slowed” for 20 years by the lack of a clear plan, a new report says, at a time when the Legault government is promising major change in the area.
This is the conclusion of the third volume of the study on home support policies carried out by the Commissioner for Health and Wellbeing, Johanne Castonguay At home: the first choice.
After carefully examining the entire system and then measuring its effectiveness, this third report looks back at the genesis of this policy, adopted in 2003, and its implementation over the last two decades.
However, if it had an “ambitious vision”, the results 20 years later would be “mixed”, concludes Johanne Castonguay.
In fact, in the absence of a “real implementation plan” and in the context of “gradual structural reforms” in the health system, the goal of making home the first choice of treatment for Quebecers has “not emerged as a real priority,” she writes.
“It was very avant-garde at the time, but unfortunately we didn’t implement it,” explained Johanne Castonguay in an interview on Thursday. “The result is that it was not implemented as we would have liked. »
A maladaptive system
Consequently, the current home support system, resulting from policy adopted in 2003, is “complex”, “poorly integrated” and “challenging” for users and carers to navigate.
Some quick observations:
- With the same health needs, not everyone has access to the same services.
- Pathways to home support are not easy to read
- User evaluation practices are heterogeneous
- There is no uniform quality standard
- The distribution of roles is problematic
For example, different community organizations that provide home support services have different criteria for assessing who can access them. These criteria also partially differ from those of the CHSLDs.
In addition, a current government update presented this year, which was intended to dust off the policy, “does not contain any new measures that are capable of bringing about the necessary improvements,” judges the Commissioner.
Worse, this new update “is even more centralized,” estimates Johanne Castonguay, which “restricts the scope for action even further.” [des établissements] to improve what is available locally.
At the start of his second term, François Legault promised to bring about “a real revolution” in home care. In its first term, the Legault government invested another 2 billion in the transition to home care. The latest Girard budget calls for new sums of 103 million this year for 963.5 million in new money within five years.
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