OUTAOUAIS – After touring the region to spread their theory about drastic under-funding in the Outaouais’ healthcare and related education systems, Équite Outaouais’ (EO) message was recently confirmed in a study published by Bertrand Schepper from the Institut de recherche et d’informations socioeconomiques (IRIS). While the Outaouais represents 4.7% of Québec’s population, it only receives 3.5% of the provincial healthcare budget, which amounts to a shortage of about $250 million per year.
EO, an organization that mobilizes Outaouais residents concerned about inequities in health, education and social justice services, approached IRIS to conduct the study in January 2018. The study combined the Outaouais’ five MRCs and compared them with similar regions; Bas Saint-Laurent, Saguenay
Lac-Saint-Jean, and Mauricie et Centre-du-Québec.
“Funding shortages are something a lot of people already knew about, but the study was done to get official numbers and confirm what was often only an impression,” said Christian Bernier, EO representative. The study validated every speculation they had. “The only surprises were bad ones. Funding was worse than we thought in a couple of areas, like the number of classes offered, and economic impact on the region,” he added.
“The lack of funding for the Outaouais’ health system creates pressure on the entire system and translates into reduced accessibility and lower quality services
compared to similar regions and the Québec average,” says the study.
The most affected areas were “building management” and “administrative expenses” which only represented 68.7% and 69.1% of the provincial average respectively. Staff shortages (doctors, nurses, specialists, support staff) are a major result of the funding deficiencies, which in the last ten years has led to more than 1.4 million Outaouais residents seeking services in Ontario where they are more accessible. This amounts to 139,283 residents per year, costing RAMQ more than $100 million annually in reimbursements. “If [this money] was instead spent in the Outaouais for treating patients, it would generate an additional 1,650 jobs,” claims the study.
The number of beds for short term stays for every 1,000 inhabitants in the Outaouais is only 75% of the provincial average; 185 extra beds, the equivalent of a small hospital, would need to be added to reach the average. This shortage, partly due to space restrictions, makes hiring new doctors and specialists difficult, which further contributes to the lack of staff.
The Centre intégré de santé et de services sociaux de l’Outaouais (CISSSO) declined to comment on the study.
Vocational education lags too
The study found that funding for vocational education isn’t helping the problem. The number of programs offered are significantly lower than other comparable regions, which has resulted in a large number of students attending schools elsewhere; 25% do not return to Québec to work. Schepper claims that in order to reach provincial averages, Québec needs to invest an additional $141 million annually in vocational programs to welcome 12,000 more students which would promote the creation of 2,153 jobs.
What’s being done?
According to Pontiac MNA André Fortin, in the last budget the Minister of Finance recognized that some regions have traditionally received more financing than others. “As such, the budget announced an increase of $300 million to ensure all regions receive the same funding, based on population and needs. The long-term answer is to compensate regional health authorities based on medical acts, which will be put in place over the coming years,” he said.
Noemie Vanheuverzwijn, Ministère de la Santé et des Services sociaux media spokesperson, explained the budget increase further: “In 2017-2018, the funding gap for all service programs was close to $300 million after population revision (for all regions). For the Outaouais, it amounted to $15.9 million. [The $300 million] will [compensate regions lacking resources].”
However, Vanheuverzwijn warned people to be cautious when interpreting the study’s results (comparing between regions) because “each has their own context”. “The use of a simple ratio of beds or expenses related to population doesn’t take into consideration things like mobility, additional costs related to university mandates or
related to fixed costs of small institutions. For example, it’s normal that Montréal has higher per capita expenditures because they provide services to [non-residents].” Vanheuverzwijn said socio-demographic factors also need to be considered because populations with below-average incomes use more health and social services, and population density impacts nfrastructure costs.
The most pressing issue, said Fortin, is the workforce deficiency; measures have to be put in place to attract and retain professionals to the hundreds of open positions across the Outaouais. “Among other things, we’re proposing to reduce training time for ward aids by introducing on-the-job training for part of their schooling, which will ensure they can provide care more quickly,” he explained. His party is also considering expanding the services pharmacists can offer to reduce hospital and clinic workloads.
The entire study is available in French at https://cdn.iris-recherche.qc.ca/uploads/