The Corporation of Ambulance Services of Quebec (CSAQ) and the Federation of Paramedic Cooperatives of Quebec (FCPQ) reject the proposal to “nationalize” prehospital services put forward by the CEO of Urgences-santé. They believe that the public company, which covers the territories of Montreal and Laval, is far from being an “exemplary model” and that it must improve its performance in the provision of its services.
The CEO’s comments reported Tuesday in The duty provoked strong reactions. François Charpentier proposes to “nationalize” the prehospital system by setting up a pan-Quebec operational center which would coordinate the 10 health communication centers (CCS) in the province, which are responsible for handling emergency calls requiring the intervention of ambulances. .
According to him, the prehospital sector could be “much more efficient”, given the billion dollars invested there annually by the Quebec government. He points out that the Urgences-santé budget amounts to approximately $200 million for 38% of calls in Quebec. According to the Ministry of Health, 53 ambulance companies are present in the province.
The aftershocks did not take long. “It is more in the court of Urgences-santé that there are duties to be done at the operational level than in the court of the rest of Quebec”, judges the president of the CSAQ, the Dr Sébastien Toussaint, who represents 28 ambulance companies and six CCS. “When he talks about nationalizing, it is to compensate for the lack of labor, the poor management or use of resources that exist in the territory of Montreal and Laval. »
The FCPQ, for its part, is surprised and worried about “the effects of the solutions proposed” by the CEO of Urgences-santé. The public company “does not represent an exemplary model,” she wrote in a press release. “Cooperatives are regularly called upon to provide reinforcement in the network to resolve impasses in terms of availability of personnel and resources,” we add.
The general director of the Cooperative of Ambulance Technicians of Montérégie (CETAM), Martin Benoit, affirms that private companies are more “innovative” and “agile” than the public company. “We demonstrated to the ministry this summer [lors des négociations des contrats] that, if Urgences-santé were managed like a private company, we [ferait économiser] to the State 21 million dollars by being more efficient”, he asserts, based on a report by an independent firm commissioned in 2023 by associations of private ambulance companies (and of which The duty was able to become aware).
CETAM redistributes its profits to its members in the form of discounts. “But in the best year, we made 10%, which is a minimal profit margin. We did a bunch of projects using these public funds,” maintains Martin Benoit.
He cites as an example the development, three and a half years ago, of community paramedicine, which consists of sending a paramedic alone in his vehicle to an elderly patient so that he can determine, with a home care nurse, the type of support required. CETAM also invested more than $100,000 to develop an “improved mechanized chair stretcher”, in partnership with the École de Technologie Supérieure, he adds. The prototype will be available in summer 2024.
Martin Benoit recognizes that improvements are possible in the pre-hospital sector, but “finds it easy to say that nationalizing the model would solve everything”. ” It’s not that. This is really thumbing your nose at all of Quebec’s ambulance services. »
“Rather than investing in structure” by creating a national operational management center, Sébastien Toussaint believes that we must focus on a provincial computer-assisted dispatch system, which François Charpentier also proposes.
Québec solidaire is for nationalization
Solidarity MP Vincent Marissal, for his part, says he is in favor of a nationalization of pre-hospital services, in order to “better channel” the public funds granted to this sector. “We are sending a lot of money there, and the accountability is really not there with the [entreprises] private,” says the health spokesperson for the second opposition group.
Quebec indicates that the new contract concluded with ambulance companies imposes “transparency conditions” and includes “financial penalties for those who do not deliver services”. “But it’s not a law. These are contracts,” retorts Vincent Marissal. He wants hospital companies to reveal their profit. “Because at the moment, it’s the data that’s missing and it’s quite important. »