Health: the social contract is broken

During a discussion, former Prime Minister Jacques Parizeau told me this that I have never forgotten. “Between citizens and any government there is a sacred contract. That of delivering the best possible public services. »

“Especially, he said, in education and health. The important thing is to ensure that everyone has the greatest possible equality of opportunity. On all levels, it is an elementary question of justice. »

This contract, I added, is therefore not only political, it is also social, fiscal, and even moral. “You understood everything Legault”, he replied with a smile.

The problem is that since the first zero deficit hunt in the 90s, there has been a major breach of contract. Over the years, our education system has once again become the most unequal in the country.

The health network has again become incapable of taking good care of all Quebecers who need it, including the most vulnerable. The umpteenth crisis that is undermining the emergency room to the point of endangering patient safety is just one symptom among many others.

In a rich and advanced society, however, there is nothing normal in trembling with fear at the idea of ​​setting foot in an emergency because you know you will spend long hours or days there.

nothing normal

There is nothing normal in having to fear ending your life in a CHSLD, having to beg for non-existent home care, waiting until exhaustion for a family doctor or surgery.

There is nothing normal about having to pay for private care while others are waiting on public waiting lists.

In short, take it from the angle you want, the breach of contract is obvious. And it’s not from yesterday.

To justify it, the pandemic has its back too broad. Our health and social services system was seriously dysfunctional long before COVID.

Bureaucratized and centralized to the point of absurdity, crisis or not, he has all the agility of a pachyderm trapped in quicksand.

After the emergency physicians sounded the alarm in the media, the Minister of Health, Christian Dubé – the most popular incumbent for ages – set up a crisis unit limited to the Montreal region.


The hour is serious, indeed. Well elsewhere in Quebec as well. In this cell will be the CEOs of the same mega CIUSSS who, because they are terribly far from the field, rarely know what is going on there. Hopefully the experts who are supposed to add to it will know better.

At the same time, COVID has not said its last word. By lifting the mask requirement in enclosed public places – a very bad idea that all Western governments have had – other nasty respiratory viruses are also making a comeback.

Those they contaminate end up in already crowded emergency rooms. It was written in the sky. And we are only at the end of October…

In an interview with Le Devoir, the Dr Donald Vinh, immunologist at the MUHC, says he fears that “the winter wave, combined with other respiratory viruses, could create a hurricane. It will always be the same people who will suffer: the young and the old. Without forgetting people with disabilities.

Basically, we can’t get out of it. As long as the “sacred contract” of which Mr. Parizeau spoke to me is not restored for the public health network, we are condemned to sail from crisis to crisis.


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