ÉDITORIAL
Strengthening the System (1)
Quebec’s Covid policies and regulations have focused on personal responsibility and avoiding major surges in the number of people requiring care. Yet we’ve talked comparatively little about the other side of the solution, how to increase capacity in our healthcare system and make it less fragile.
The number of hospital beds in the province has barely increased over the last five years. Yet prior to the pandemic we were already looking at a major demographic challenge - the aging of the baby boomers. The boomers are now entering their 80s, meaning that they’ll be more vulnerable to heart disease, strokes, infections, and falls. Additionally, they’re more likely to need emergency adjustments to pre-existing devices like pacemakers. Add in risks from future pandemics and we clearly need greater hospital capacity.
The main limiting factor in our healthcare system is a shortage of staff, especially nurses. This was the primary reason given over the last few months for reimposing stringent lockdowns.
A significant reason for shortages of nurses is relatively low salaries. Measuring the average salary of a nurse is difficult, as some nurses work part-time while others work substantial amounts of overtime. But their salaries tend to be in line with police officers, firefighters, and bus drivers. All of these jobs are quite crucial to our societies, but to become a nurse requires four years of a demanding university program, making this career choice less appealing. Nurses in Quebec also earn five to ten percent less than in neighbouring provinces, including the maritimes where the cost of living is lower and where further salary increases will soon be implemented.
The Legault government has taken some initial steps to address this problem, primarily by offering nurses bonuses to entice them back to Quebec’s public system. However, these initiatives have had only limited success. This is not surprising, since bonuses help to address salary concerns for a few months or years, but the long-term salary disadvantages of a nurse aren’t addressed. So perhaps it’s time to think of paying nurses in line with engineers, economists and architects, careers that require training of about the same duration. This would mean raises of about 50%. The costs for taxpayers would be high, but costs of lockdowns are far higher.
We also need to increase the capacity of nursing faculties at universities, as well as making it easier for nurses from other countries to immigrate to Quebec and practice their profession. Ontario recently took steps in these directions. Identifying tasks such as administrative work that nurses perform but which could be assigned to employees with less specialization would help free up badly needed resources too. Making it a priority to eliminate mandatory overtime requirements would also make the nursing profession more attractive.
It’s clear that the status quo is not sustainable. We can’t keep locking down society every winter in the name of protecting a fragile health care system. The costs of such an approach far outweigh those of strengthening the system and paying our healthcare workers what their services are worth.
Ian Barrett
