Michel Martin is a freelance writer living in Hull, Que.
Canadian Medical Association Journal 1995; 153: 1001-1002
[résumé]
During Quebec's provincial election campaign last fall, health care issues played a predominant role. Among the concerns successfully highlighted by the Parti Québécois were the bottlenecks and waiting periods for surgery.
This spring, Dr. Jean Rochon, the minister of health and social services, made good on his party's campaign rhetoric by releasing an action plan that promised to reduce waiting periods for surgery by 50%.
Rochon, a public-health specialist and former dean of medicine at Laval University, also laid out some specific goals describing how the overall objective is to be attained:
Among other things, Girard's committee will develop methods for measuring, evaluating and reporting about the functioning of operating rooms. One question that Girard and his team will investigate is why presurgery and postsurgery stays in hospital are much longer in Quebec than elsewhere in North America.
Girard, who also hopes to develop interprovincial comparisons, thinks the development of methods of measurement will prove useful to colleagues outside Quebec.
Nine types of operations are considered a priority for transfer to day surgery; among them are operations to repair hernias and varicose veins and remove cataracts. The nine operations cited represent 80% of the procedures that will be transferred to day surgery. The province estimates that savings from these transfers will amount to $19 million annually, and that a further $16 million will be saved by moving certain minor operations from day surgery to doctors' offices. Improvements in the management of operating rooms are expected to yield productivity increases of 10%.
To date, Rochon has obtained the support of the representatives of medical organizations directly affected by his action plan. Dr. Michel Talbot, president of the general surgeons' organization, Dr. O'Donnell Bédard, president of the anesthetists' association, and Dr. Henri-Louis Bouchard, president of the orthopedists' organization, participated in the working group that developed the management guide for operating rooms. Girard expects this support will continue.
As well, Dr. Renaud St-Laurent, president of the Association des conseils des médecins, dentistes et pharmaciens du Québec, has indicated his support for Rochon's action plan. Each Quebec hospital has a body that groups members of the three professions who work in hospitals.
However, Dr. Paul Landry, director of public affairs for the Quebec Hospital Association, sounded a dissonant note. "We agree with Dr. Rochon's overall objective," he said. "In 1992, we published an information kit about increasing the use of day surgery, which has had a positive impact in Quebec's hospitals.
"Nevertheless, we doubt that the objectives for increasing operating room productivity and reducing waiting times for surgery can be achieved in an environment of further budget cutbacks, cutbacks that will result in the closing of operating facilities in Quebec hospitals."
Landry also wonders whether Quebec's community-health clinics will be able to handle the workload resulting from follow-up required because of the increased use of day surgery. For instance, how will the centres be able to provide additional care and nursing services in the home in the face of budget cutbacks?