When the sole radiologist practising in the Gaspé town of Amqui retired a couple of years ago, residents in need of medical-imaging scans had no choice but to travel more than 110 kilometres west to Rimouski.
Since then, the Hôpital d’Amqui has closed almost 10 per cent of its short-term care beds and abolished the positions of 10 nurses — cuts which the town’s mayor blames on Health Minister Gaétan Barrette’s administrative streamlining reforms.
And residents are bracing for the impact of more cuts as the regional health authority continues with a two-year plan to chop $20 million from its budget. Already underway is a plan to transport blood samples collected at Hôpital d’Amqui for analysis in Rimouski, adding a delay of two to three days in getting back test results.
“The minister’s reforms have done nothing to improve health care in our region,” Mayor Gaëtan Ruest told the Montreal Gazette. “Instead, they have weakened us.”
Since Barrette’s reforms took effect on April 1, 2015, critics have focused their attention mostly on the Montreal area. But the reforms have also produced repercussions in the far-flung regions of Quebec, in places like Amqui (population: 6,200) that garner much less media scrutiny.
On Saturday, Ruest will discuss his town’s experience at a day-long conference to be held at the Université du Québec à Montréal. The conference — featuring as speakers patient-rights advocates, former health-care managers, academics, doctors and social workers — marks the first attempt, in the absence of any government studies, to evaluate Barrette’s restructuring of the health system.
Under Barrette’s reforms, the government eliminated more than 1,300 managerial positions across the province and got rid of regional health agencies to save more than $130 million a year in administrative expenses. In lieu of the health agencies, the government created umbrella organizations — known by their French acronyms, CIUSSS and CISSS.
The Hôpital d’Amqui, like every hospital in Quebec, lost its chief executive and board of directors, and would now be overseen by a CISSS. For Ruest, the loss of local governance has been a disaster. The hospital is now being managed by administrators in Rimouski at the CISSS du Bas-Saint-Laurent.
Ruest said he’s worried that the combination of cuts and a lack of local governance could mean that a developer who is considering building a long-term care centre in Amqui might choose another city instead.
“The minister never had a mandate from the population to restructure health care the way he has,” Ruest added. “He never talked about these things during the last election campaign. And then after the election, no one was ever consulted about his reforms.”
Alain Paquet, the former executive director of the CSSS de la Matapédia (which oversaw the Hôpital d’Amqui), said that health services in Amqui are already in a “fragile” state, and he can’t see how the hospital can absorb any more cuts.
“What’s worrisome is that all the cuts are being made in the context of centralized governance,” Paquet said. “Yes, the citizens are extremely concerned about the future of their health care.”
Isabelle Malo, the head of the CISSS du-Bas-Saint-Laurent, has pledged to maintain Hôpital d’Amqui’s emergency department and operating-room hours after Ruest raised concerns last summer. But in a letter to the mayor, dated Aug. 26, she wrote that the CISSS would still be “reorganizing certain services” without specifying what those services might be.
