Our health system in the Outaouais is mapped into two very different realities: rural hospitals and CLSCs plus the urban, Gatineau, infrastructure. The entire zone has one top-heavy management, CISSSO, contained entirely within Gatineau. The ministry’s performance reviews, year after year, rank CISSSO among the worst-
managed health and social services agency in all of Quebec. Some years ours ranks the absolute worst. A more detailed analysis would show Outaouais’ rural services now even worst managed, all at-a-distance.
This is management, not the front-line professionals who make our health services work as well as they do. Outaouais’ big problem — the Ministry admits — is management, our region’s closed-door management.
Despite these annual reports, Gatineau’s management failures keep repeating. At their most outrageous, CISSSO’s bureaucrats insist “all goes well!” CISSSO refuses to discuss these problems in detail, certainly with media, and merely issues communiques on each occasion of closed services, missing surgeons, nursing shortages, beds lining the halls, mechanical breakdowns. Week after week we learn that the Pontiac Community Hospital, serving an area about the size of the Republic of Ireland, cannot provide obstetric care due to another “shortage” of surgeons or nurses. Administrators blame staff, blame nurses, blame specialists, blame politicians and budgets — yet they are in charge. When do we hear promises of better management?
We don’t. And, therefore, if Quebec, with its surplus, does not have the resources nor the will to intervene, perhaps a look at best practises for management elsewhere is needed, those used in the private sector.
In business, management showing such consistent poor outcomes would have been sacked – procedures streamlined, personnel changed at the top, and penalties imposed on salaries and bonuses. Why does the Ministry not impose salary penalties on consistent management failures?
Is the Ministry of Health afraid it’s own role in short-changing the Outaouais’ budget will be exposed? Or perhaps the Ministry’s inability to increase the number of front-line doctors accredited each year?
When CISSSO announced the suspension of obstetric services in Pontiac, why aren’t management penalties also announced? If a Quyon family was to sue CISSSO for the hypothetical injury, say, attempting childbirth in a car on the side of the road, will the managers be told to defend themselves in court?
Since when are managers not responsible for their decisions? Each manager accepted the well-paying position, knowing the position’s history and problems. Part of every manager’s job description – by definition – is to solve problems, not blame someone else.
The Outaouais’ situation is serious. Unless strong measures are adopted, our problems will continue. To obtain managerial accountability — and better, faster
decision-making—we need management made local again. That’s the carrot, and financial penalties are the stick; take your pick, because the current management just means continued failure.
(Agree? Send your comments or this editorial to: CISSSO, Comite admin, 104 rue Lois, Gatineau, J8y3R7.)