MUHC issues show Barrette in denial
They came in wheelchairs and motorized scooters. They are transplant recipients and cancer survivors. They suffer from degenerative diseases and cope with chronic illness.
Overcoming obstacles to accessibility and setting aside the challenges of being in frail health, several dozen patients turned out to put a human face on $120 million in cuts that have taken place over the last few years at the McGill University Health Centre.
It took Quebec Health Minister Gaétan Barrette mere hours Thursday to rebuff the concerns the MUHC Patients’ Committee brought to light, insisting once again that any problems at the hospital network are due to a lack of leadership rather than underfunding. At least he offered them a response, this time, which is more than he did when they wrote him a letter.
Barrette seems determined to discredit the MUHC and cast it as the author of its own misfortune. But one has to wonder to what extent this is a defensive strategy to mask the failings of his own reforms.
Bill 10, which Barrette pitched as both a cost-saving initiative and an exercise in improving efficiency, has failed to deliver on its promise to usher in an new era of patient-focused health care. Instead, the radical restructuring of the health system has sowed much chaos and confusion.
The MUHC was (initially, at least) spared the disbanding of its board and being merged into an unwieldy umbrella organization, known as a CIUSSS, its French abbreviation. But it has nevertheless been touched.
As a highly specialized care centre, the MUHC has had to pick up the slack for procedures and services that other hospitals abandoned, such as vascular surgery. Yet Barrette continues to hold the MUHC to a 10-year-old clinical plan that never foresaw the reorganization of the health sector and the redistribution of responsibilities to justify current funding levels. So his adherence to this outdated script defies reason. The fallout from Bill 10 may also be having an indirect impact on patient volumes from the MUHC, which continue to rise for cardiac and cancer care, among other specialties.
When Montreal filmmaker Mark Blandford went to the
St. Mary’s ER with a ruptured abdominal aneurysm in November 2015, the experienced surgeon there who might have saved his life was barred from operating. Unbeknownst to many, even in the emergency room, the procedure had been discontinued as a cost-cutting measure by the hospital’s new management, the West Island CIUSSS. So Blandford was transferred to the MUHC, where he died.
Publicity surrounding the Blandford case might help explain the endless overcrowding in the ER at the new Glen site.
Some patients may legitimately fear the services they need are no longer available elsewhere, so they take no chances and come to the MUHC first.
The MUHC is a convenient foil for Barrette. The more it pushes back against the financial straitjacket it is being forced to wear, the more he portrays it as a victim of its own ineptitude. The more he shrugs at the complaints of doctors and patients as whining, the more his harsh treatment creates a climate of fear in the health sector that speaking out will result in being singled out for harsh treatment.
The MUHC is the canary in the mine shaft of the health system, so to speak, chirping about deteriorating conditions while putting itself on the line.
What’s less clear is how badly other hospitals are being harmed by the dismantling of programs and structures because the law of omertà prevails.
None of this means there is no room for improvement at the MUHC. But it exposes Barrette’s blaming and shaming as selfserving. And the cure for what ails it is most certainly not more upheaval and restructuring.
Barrette has said the MUHC needs to be stabilized. But that will not happen by merging it with one or both of the CIUSSSes in the western part of Montreal, an idea he says is only hypothetical and did not come from him, but that he is nonetheless considering.
Stabilizing the MUHC should start with being honest about what its needs are and being clear about its mission. And it must include funding that takes into account the realities of the care it is providing.
Barrette should not so quickly dismiss the veterans of the health system as mere proxies in his protracted political stalemate with the institution.
The users of the MUHC are not only patients, they are citizens and voters who have tremendous insight on the state of the health care in Quebec — and they are greatly alarmed.
They are not only anglophones, who have a historic attachment to the MUHC, but francophones and Montrealers of diverse backgrounds who gravitate to the excellent — bilingual — care it still provides against all odds.
Standing up for the MUHC is not about dredging up the divisions of the past, or vilifying the health minister (although his antics would certainly make that easy were it the goal). The battle to save the MUHC is about defending something that is dear to all Quebecers, regardless of language, origin or ethnicity: our public health system.