November 1, 2012

Annual Report 2011-2012

Corps

The report tabled this morning is based on the action we took during the fiscal year ending on March 31, 2012. We intervened regarding 58 out of 80 government departments and public agencies and 190 out of 299 health and social services network institutions.

I would be remiss if I didn’t applaud how open these instances were to correcting their lapses and mistakes once the Québec Ombudsman pointed them out.

In Québec, most of the time citizens are provided with quality public services if and when they actually gain access to them. However, I see and ever-widening gap between the services on paper and what is really available for citizens. This disconnect creates great dissatisfaction in citizens, and they have every reason to feel this way.

At a time of shrinking public funds, difficult choices have to be made. Given a lack of sufficient resources to meet all public needs, too often the resulting gap between what is intended and what is offered ? and the vagueness that surrounds it? causes inequalities, especially from one institution to another and from region to region. For exemple, we witnessed these kinds of disparities for people with disabilities and seniors who need long-term home support services. We also saw that the amounts earmarked for this purpose had, in fact, not been set aside, despite a demonstrated need to do so.

Sometimes this gap between what there is in theory and what there is in the real world means a lack of services or continuity in service delivery. This is what people with a physical disability, an intellectual disability, or a pervasive developmental disorder experience. Even though the access plan provides for dovetailing and coordination of action among rehabilitation centres for physical disabilities and rehabilitation centres for intellectual disabilities and pervasive developmental disorders, the Québec Ombudsman knows for a fact that what really occurs is altogether different… to say nothing of what happens when a child starts school.

We have also noted unreasonable wait times, the consequences of which are especially worrisome when vulnerable people are affected. I’m particularly disturbed by the fact that crime victims still have to wait several months before finding out whether they qualify for the plan that enables them to obtain the compensation, care and services provided by law. Not bad enough that these people have to deal with the trauma of being a crime victim they also have to cope with the stress of waiting for compensation, which, in addition to the toll this takes in human terms and in terms of their health, also puts some of them on shaky financial ground.

We have also seen the appearance of unplanned accessory costs foisted without notice on some citizens while other citizens receive the same services free of charge. This difference in how they are treated is unacceptable, as is the laxness that surrounds charging of these costs, cases in point being the lucentis or avastin administered in private clinics.

Similarly, the wait times for certain services such physiotherapy, audiology and speech therapy, or for certain tests, such as colonoscopies, within the public system are so long that in reality accessibility to them is reduced. I wonder about how equitable access to them truly is when people with private insurance or sufficient financial means can get these services more quickly at private clinics because they can afford them.

Alongside this, the amount that last-resort financial assistance recipients are reimbursed for medically required items does not reflect current prices. The result is that some of them deprive themselves of the items even though they really need them.

Access to certain administrative tribunals is a striking example of the gap between what is and what should be.

Despite the principles of accessibility and promptness enshrined in the act respecting administrative justice, the wait times for a hearing with the Tribunal administratif du Québec is more than 23 months. At the Régie du logement, for general civil law cases, tenants and landlords alike have to wait more than two years for a first Régie du logement hearing and even longer for a decision. Access to justice must be more than hypothetical; to be real, it must include the right to a decision within a reasonable timeframe.

At a time of tighter public finances, I’m calling of public managers to make preserving services a priority and seeing to service availability in due time. I also urge them to exercise greater transparency so that citizens are better informed as to the services they can realistically expect to get, the conditions for accessing them, and the wait time involved. And because the lack of transparency in itself can create inequality, I am also calling for greater fairness for all.