The Minister responsible for Seniors, Sonia Bélanger, contests the methodology used by the Commissioner of Health and Well-being (CSBE) in Quebec’s file on financing home care and claims that the failures in the offer do not result from from a lack of funds anyway.
“It’s not a question of money,” said the minister in an interview with Duty. And at some point, there is a limit with public finances. »
The share of the Health budget devoted to home help was 4.5% in Quebec in 2021-2022, lamented Commissioner Joanne Castonguay in a vast report on the subject made public on Tuesday.
Even if this proportion is slightly increasing, it remains “modest” and makes Quebec one of the places in Canada where this share is the lowest, concluded the CSBE.
However, Sonia Bélanger argues that this share would be twice as high if we applied another “methodology”. “Our home support services currently represent 8% of program expenditure budgets for direct services to the population. So, when I hear Mme Castonguay says that we are the province that invests the least in Canada, well I do not agree at all with his conclusions. It’s a question of methodology. »
According to the minister, the CSBE calculation gives a lower percentage of total expenses than elsewhere because the latter includes drug costs and doctors’ fees, which would not be counted elsewhere in Canada. She also criticizes the commissioner for not having taken into account certain tax credits.
At the CSBE office, we recognize that the ratio can vary depending on what is included in these expenses, but we add that the method chosen had the advantage of making it possible to compare Quebec with other Canadian provinces.
“However, whatever method is used to calculate this ratio, the fact remains that the response rate to long-term home support needs remains low in Quebec. Despite significant spending and increases in recent years, many users of these services receive little or no support. It is this observation that is important and calls for action. »
A priority or not?
The government has injected $2.6 billion more into home support and services for the next five years (in the first CAQ budget, in 2019), she says. “The money is there. The promise is made,” says Sonia Bélanger. “And it’s not just a question of funding. The challenge is really to review the organization of work. »
Mme Bélanger emphasizes that home help is nevertheless “a government priority”.
However, the subject was not among the five priorities presented Wednesday by Prime Minister François Legault at the entrance to his caucus meeting (education, health, economy, environment and protection of Quebec identity). Questioned on this, the minister replied that home support “is part of the health priority”.
How will she then ensure that the subject is not sidelined in favor of other, more pressing health issues, such as the emergency room crisis? “I am the minister responsible for seniors and Christian Dubé asked me to support him. […] I have full responsibility for organizing home support, she answers. In any case, if we do not improve home support, there will be repercussions on hospitals. »
Like the CSBE, it believes that the creation of the Santé Québec agency is a golden “opportunity” to reform the organization of home care. But how ? The agency’s team should be able, she says, to make the home care offer “more efficient”, she believes.
No new regional offices
The minister also does not seem very enthusiastic about the commissioner’s proposal to make users contribute more to the bill for home services.
In a press scrum on Wednesday, she repeated that she wanted to “preserve public services”. Resistant to private agencies, Mme Bélanger believes that care must be based on two pillars: the services offered by CLSCs and those provided by social economy companies providing home help.
She also describes as “very interesting” the request for their grouping so that more of their services are covered by the government, such as personal assistance services and respite for caregivers. “They do extraordinary work and it must be recognized. »
As for the commissioner’s proposal to create regional offices, Mr.me Bélanger agrees with the idea of consolidating services, but is not convinced that this should go through “offices”.
Currently, home support is managed by six different programs (services offered in CLSCs, various tax credits, assistance for caregivers, support for community organizations, etc.)