New call for tenders | Quebec still as dependent on private health agencies

Dependence on private agencies in the health network is not about to be reduced.


On Monday, the Government of Quebec launched a call for tenders which provides for the granting to private agencies of more than eight million hours of work per year for nursing care and assistance employees, i.e. nurses, nurse clinicians , nursing assistants, orderlies and auxiliaries, these famous employees who have to lighten the administrative tasks of nurses.

Québec thus aims to fill working hours in all regions of Québec with tens, sometimes hundreds of thousands of hours per year depending on the region.

The contracts that will be awarded to the agencies are for six months, but the tender includes three renewal options of the same duration, so it will in fact cover two years. A rough calculation on the basis of 35 hours per week over 52 weeks indicates that this represents the equivalent of just over 4,600 full-time jobs.

Another contract already awarded

In addition, similar contracts have already been awarded this fall for nearly one million hours per year to agencies for occupational therapists, physiotherapists, social workers, respiratory therapists and other jobs related to these professions. In the latter case, we are talking about a total of nearly 855,000 hours per year, distributed among all the regions, again for a potential duration of two years.

Since, in the latter case, the contracts have already been awarded, we know their value and it amounts to 60 million per six months, for a total of 240 million for the full duration of 24 months. On the same summary calculation basis as above, we are talking here about the equivalent of 470 full-time jobs. On the nursing side, as the contracts have not yet been awarded, we do not know their value, but since the needs as quantified are similar to last year, we can expect more than 750 million, last year’s total, all items combined, having reached 875 million.

Dubé: a law after the fact?

These contracts come as the Minister of Health, Christian Dubé, has been repeating in all tones for months that he is trying to free himself from the agencies. Tuesday, in an interview with the Journal de Montreal, he even said that he was considering a bill to regulate the use of agencies, a bill which could be tabled as soon as the next parliamentary session in January.

The idea of ​​a bill to regulate a practice that is already governed by contractual obligations leaves the Fédération interprofessionnelle de la santé du Québec (FIQ) perplexed. In an interview with The Canadian Press, its vice-president, Françoise Ramel, struggles to follow the minister’s speech: “Of course we are surprised because he speaks out of both sides of his mouth. On the one hand he talks about making a bill against independent labor, then on the other hand he makes a call for tenders with so many hours. »

The crisis in all of Quebec’s health establishments, which are all short of staff, leaves her little choice, she admits without difficulty: “We are also aware that we cannot eradicate the call for help -freelance work overnight like that. It has to be progressive. »

TSO for agencies too

“Of course it’s a network dependency which is huge. We really need these people right now, but where are they going to find them? asks Françoise Ramel. However, she is delighted with the terms of the call for tenders, which obliges agency employees to work compulsory overtime when the establishments ask them to.

Also, the agencies are prohibited from hiring an employee who has left the network less than a year ago: “What is also good about this call for tenders is that it better fits mandatory overtime for agencies and better framed time before rehiring a person leaving for the network. It could help stem the bleeding of personnel. Except that we will not bring staff back like that if there are not better working conditions, attraction and retention of staff that are put in place. »

It is obvious that these hirings of personnel from private agencies, which are far from decreasing, risk being at the heart of a negotiation that promises to be difficult, the positions of Quebec and the unions being very far from each other.

Data by region

Non-nursing staff: Montérégie in the lead

Last fall’s awarding of contracts for non-nursing staff (occupational therapists, physiotherapists, social workers) demonstrates where staffing shortages are most severe and thus contains some surprises. It is not Montreal, which ranks second with more than 178,000 hours of work from agencies (over one year, like all the figures that follow), which wins the prize, but rather the Montérégie with more of 280,600 hours.

In the regions: Abitibi and Mauricie in short supply

In the regions, the breakdown of these contracts shows that Abitibi-Témiscamingue presents the most pressing needs by far, ranking third behind Montreal with a grant of 92,000 hours, despite a limited population. Next comes Mauricie–Centre-du-Québec, where private agencies obtain nearly 72,000 hours of work, and Lanaudière, with more than 67,000 hours.

Outaouais and Estrie in good shape

Conversely, the contracts indicate that the needs seem minimal in the Outaouais (680 hours granted over one year) and in Estrie (879 hours) and all the same very modest in the regions of Laval (8308 hours), Laurentides (8523 hours) and Gaspésie–Îles-de-la-Madeleine (9500).

It should be noted that the shortage seems extremely severe on the side of social workers and social work technicians who, in several regions, monopolize nearly half and sometimes more than half of the hours granted to private agencies.

Medical care

In the case of the call for tenders for nursing care and assistance, which is still in the process of being tendered and for which, therefore, fewer details are known, The Canadian Press has identified the most glaring needs, namely over 100,000 hours per year.

Montreal: major needs

Thus, unsurprisingly, we find that in Montreal, the CIUSSSs of the Centre-Sud and the North of the island between them need 405,000 hours for nurses, 480,000 hours for attendants. When we add the CIUSSS de l’Ouest-de-l’Île, we see the need for more than 780,000 hours of auxiliaries, these famous aids to lighten the administrative burden of nurses.

Montérégie, Laurentides and Côte-Nord in difficulty

Montérégie remains the champion in terms of beneficiary attendants with a need of 738,800 hours in the CISSS de la Montérégie-Ouest alone. The CISSS de la Montérégie-Centre needs nurses for 120,000 hours. The CISSS des Laurentides, for its part, wants to fill nearly 560,000 hours of attendants and more than 236,000 hours of nurses, and the North Shore offers 322,000 hours of attendants.

Significant needs in Quebec, Bas-Saint-Laurent and Laval

The Capitale-Nationale, for its part, offers 200,000 hours for attendants and 100,000 hours for auxiliaries. The Bas-Saint-Laurent needs 190,000 hours of nurses and 175,000 hours of orderlies. Finally, Laval offers just over 125,000 hours to nurses.

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New call for tenders | Quebec still as dependent on private health agencies


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