Quebec nurses unions criticize health-care reform

A federation of health-care unions says the Quebec health minister’s reform presents an “undeniable risk” for the continuity of patient care and for care in remote areas, because of the increased mobility it will require of staff.

The Fédération interprofessionnelle de la santé (FIQ), which represents 80,000 nurses, nursing assistants and other care professionals, delivered the clear-cut verdict in the brief it sent to the Health and Social Services Commission, which is studying Bill 15 tabled by minister Christian Dube.

Moreover, the FIQ and the FIQP (private) believe that, under the guise of laudable objectives, the bill “jeopardizes universality, accessibility, equity and quality of care as well as union democracy,” it reads.

The FIQ agrees with the Minister that the status quo is no longer acceptable and that a change of culture, local management and greater efficiency of the structures are needed.


Since there will be a single employer — Santé Québec — and since Québec wants there to be a single seniority per professional for all of Québec, and not per institution, the FIQ says that nurses will have to demonstrate “increased and unlimited mobility” to meet the agency’s needs.

“Is it reasonable to believe that a school health nurse can work with seniors or in intensive care overnight?” the FIQ asks.

“It is also possible that mobility within the network will have negative impacts on access to care in certain regions far from major centers or in certain care sectors, such as CHSLDs or hospitals, for example,” the FIQ continues. “Care environments known for their problematic work organization could be abandoned in favor of more attractive environments.”

As for the risks affecting the continuity of care, the FIQ explains its fears again by the expected increased mobility of personnel.

“Not only is nothing in the project put in place to ensure the stability and adequate staffing of care teams, but if it were adopted as is, it would destabilize and weaken the care teams even more by allowing excessive mobility,” the FIQ writes.

The federation gives the example of CHSLDs, which experienced enormous difficulties at the height of the COVID-19 pandemic.

“Staff mobility has a negative impact on the quality of care offered in addition to contributing to the spread of infections and viruses,” he said.


The reform also creates too much room for the private sector, particularly the specialized medical centres, “the big winners of this reform,” the FIQ believes.

The bill “must not become a Trojan horse that will signal the end of the public network that emerged from the Quiet Revolution, by allowing the private for-profit or non-profit sector to replace the State in some of its fundamental missions for the most vulnerable people, particularly in home care and mental health.”


The FIQ fears that the Dubé reform will also create a network that is too centralized, that loses its capacity to adapt to local realities, and whose local managers will, in reality, have little room for maneuver, the FIQ fears.

“Bill 15 will only accentuate this loss of contact with the field, particularly in terms of management,” the union organization said.

This report by The Canadian Press was first published in French on May 9, 2023.

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