Over 800,000 Quebecers are currently looking for a new primary care physician in their area. Wait times to find one can extend to more than two years in Montreal, where the population faces one of the worst health-care accessibility crises in the country. This issue directly results from Quebec’s poor commitment to creating a safe, inclusive, and anti-oppressive workplace in the health sector. The province needs to address the institutional racism plaguing its healthcare sector and foster a space where health professionals can focus on their work without being exploited or oppressed.
Instead of dedicating themselves to mitigating high patient demand, doctors in Quebec are required to spend around 40 per cent of their time working shifts in short-staffed hospitals and nursing homes. The requirement was introduced in 1990 amid considerable nursing staff shortages in the public sector. Over the past 30 years, this staffing crisis has only worsened and hit a fever pitch during the COVID-19 pandemic, when the public sector saw roughly 4,000 nurses step away due to burnout and inadequate pay.
Beyond this, physicians spend between 15 and 20 per cent of their time on unnecessary paperwork to reconfirm the statuses of already injured or disabled patients. Cutting this number by any margin would dramatically increase the time doctors have to see patients.
The government must support nurses with better compensation and management. Without this essential step, dissatisfied physicians in the public sector will keep quitting and moving to private practices, a shift that the provincial and federal governments have implicitly and explicitly encouraged.
Past policy decisions in Quebec also played a part in fostering the current health-care crisis. Caps on medical school enrollment in the 1990s due to low population growth and cost-cutting efforts by former Premier Lucien Bouchard resulted in upwards of 500 doctors taking buyouts or retiring, many of whom would still be in practice today.
The false austerity outlined above is only compounded by the institutional racism within the health-care sector. In 2022, a McGill University Health Centre study on racism found that both employees and patients of colour have been subject to shared experiences such as racist verbal harassment and microaggressions. The first of its kind in Canada, the report also offered an empirical argument against Premier Legault’s false assertions that there is no systemic racism in Quebec.
Health care is not a safe space, especially for Black and Indigenous health-care workers and women of colour in particular. Black nurses in Quebec are regularly turned away by patients while also experiencing considerable difficulties finding employment in the first place. Racist and sexist discrimination is explicitly manifested, as evidenced by a 2021 job posting from the Saint-Eustache Hospital requesting that only white women apply.
The treatment of Indigenous patients also fosters a dangerous and oppressive environment, turning away any possible Indigenous nurses, especially those trained in traditional wellness and healing that the province does not consider scientifically sound. The story of Joyce Echaquan, an Atikamekw woman who livestreamed her nurses insulting and degrading her as she died, reflects how hateful cultures of exclusion in the health-care system determine who deserves to be “saved.” In response, the province announced in 2021 a $15 million plan to implement diversity training for employees. But the National Assembly has failed to advance motions toward equitable access to health care such as Joyce’s Principle, a document demanding that Indigenous people gain access to all health-care and social services free of discrimination.
By listening to nurses on the ground such as Yvonne Sam, the province must sanction the racist barriers of access to health care and invest in anti-oppressive medical school education. In order to address the systemic racism that pervades Quebec’s health-care system, the government must first recognize it. If the government cannot offer solutions to a health-care system as racist, overworked, and fundamentally flawed as Quebec’s, the road to care and recovery for workers and patients alike will be paved with peril.
