TABLING OF THE QUEBEC OMBUDSMAN'S 2008-2009 ANNUAL REPORT - A number of deficiencies for which urgent action is required



    QUEBEC CITY, May 26 /CNW Telbec/ - The Québec Ombudsperson, Raymonde
Saint-Germain, is critical of many instances in which the public service has
failed to uphold citizens' rights. In tabling her 2008-2009 Annual Report, she
noted a number of worrying situations and unsatisfactory follow-up to the
recommendations made in last year's report. She also emphasized problems
affecting the general public as a whole, particularly in the health and social
services sector, and paid particular attention to the situation of vulnerable
people, including seniors and the mentally ill.

    
    Residential care for seniors: The Québec Ombudsman notes many
    unacceptable situations
    

    The grounds for complaints received by the Québec Ombudsman in 2008-2009
include user transfer conditions, the capacity of certain private residences
to care for their users, poor care quality and mixed client groups.
Accordingly, the Québec Ombudsman has recommended that the MSSS should
intensify its quality assessment visits and take steps to ensure that
certified private residential facilities are included. In addition, it has
recommended that quality indicators be included in management agreements
between agencies and institutions, and suggests that contracts with private
resources should indicate expected quality levels and quality control methods.
It also recommended that resources should have the capacity to meet the
special needs of their residents. In response to these recommendations, the
MSSS confirmed that it has set a target of visiting 12% of all facilities by
June 2009, and has undertaken to draw up a separate profile for each region,
showing the current state of residential resources that have purchase
agreements for places or services. It will also analyze the conditions of
agreements between health and social services agencies, health and social
services centres and private promoters. (Page 64)

    
    Certification of private seniors' residences: the MSSS must speeds up the
    rate of inspection visits

    Roughly 99.7% of all private seniors' residence owners applied for
certification within the time allowed. However, as of April 7, 2009, only 686
out of a total of 2,199 residences had actually obtained certification. (Page
68)

    Unreasonable delays before seeing a physician in some hospital emergency
    rooms
    

    Many of the complaints received by the Québec Ombudsman concerned the
long wait before seeing an emergency room physician. This situation is a
reflection of the problems many citizens experience when they need primary
medical services. The Ministère de la Santé et des Services sociaux (MSSS)
must find alternative solutions to ensure that users whose condition is
assessed as being level 4 (less urgent) or level 5 (not urgent) have access to
primary care services outside hospital emergency rooms. The MSSS has already
acknowledged that the solution to emergency room wait times lies in providing
access to primary care services. In the meantime, however, it has proposed
four steps that it hopes will improve the situation, at least in part. They
are: agreements between emergency rooms and the existing primary care network
to redirect less urgent cases during triage, support for innovative work
organization projects, application of collective prescriptions during triage,
and development of mechanisms that will allow family physicians to direct
their patients to the right place (page 75).

    Even more complaints about access to home support services

    The Québec Ombudsman continued to receive complaints about wait times and
failure to provide the required number of hours of care and services. The gap
between needs and supply continues to grow, and the Québec Ombudsman has
therefore recommended that the MSSS should specify the prioritization criteria
for access to services, and instruct institutions to apply these criteria with
timelines and specific accountability. (Page 78)

    
    Launching of protective supervision programs for incapacitated
    individuals: Average time of 111 days for processing by the Curateur
    public
    

    Despite the Curateur public's efforts over the last year, the Québec
Ombudsman has once again observed significant delays in the opening of
protective supervision programs. The average time required to obtain the
necessary court ruling is estimated at 154 days, plus an average period of 111
days for processing of the file by the Curateur public. The Québec Ombudsman
has therefore recommended that the Curateur public should report to it on the
outcome of the steps taken to reduce processing times. The Curateur public has
undertaken to do this by the end of 2009. (Page 94)

    The Curateur public must visit more of its wards

    For the last ten years, the Québec Ombudsman has reminded the Curateur
public of the importance of understanding its client base. However, the
Curateur public is finding it difficult to meet its targets as the number of
wards continues to grow steadily and the workload of its personnel continues
to increase. The Québec Ombudsman has recommended that the Curateur public
should submit a review of the steps taken to understand its clientele, no
later than January 2010. (Page 97)

    
    Still no optimization of the Curateur public's reassessment processes for
    protective supervision programs
    

    The Curateur public failed to meet its own deadline of December 31, 2008,
for completion of its reassessment of protective supervision programs. It has,
however, undertaken to report to the Québec Ombudsman on the results of its
actions in May 2010. (Page 98)

    Curateur public: Documentation that is difficult to understand

    Following a number of complaints during the year, the Québec Ombudsman
has recommended that the Curateur public should use the principles set out in
the Act respecting administrative justice as a basis for producing explanatory
documents with a generalized version of its final report and accounts that
will be more easily understood. (Page 100)

    SAAQ: Unacceptable delays for obtaining medical opinions

    For the fourth consecutive year, the Québec Ombudsman has criticized the
time taken by the SAAQ to obtain medical opinions. This situation causes
significant prejudice to road accident victims, who must wait several months
before receiving the money they are owed. The SAAQ believes the delays will be
shortened when its action plan is implemented in 2009. However, the Québec
Ombudsman has recommended that it should set improvement targets so that it is
able to assess the impacts of its restructuring on the time taken to obtain
medical opinions. The SAAQ followed up on this recommendation on May 14, 2009,
and has presented its improvement targets, to be implemented by January 1,
2011. The Ombudsman will be vigilant in monitoring the achievement of these
targets. (Page 37)

    SAAQ: A much-needed overhaul of the computer system

    Every year, citizens are adversely affected by the limitations of the
SAAQ's computer system. The Québec Ombudsman has therefore recommended that
the SAAQ should treat the system overhaul as a priority. (Page 41)

    
    Unacceptably long telephone wait times at the Crime Victims Compensation
    Directorate (CSST)
    

    The Québec Ombudsman noted an average wait of seven minutes from pick-up
by the automatic answering machine to transfer of the call to an agent. This
long wait can have serious consequences for a particularly vulnerable client
group. The Québec Ombudsman has therefore recommended that the Crime Victims
Compensation Directorate should submit a plan of action by June 30, 2009,
aimed at bringing the average wait time as close as possible to the standard
of 20 seconds for 80% of calls received, as recommended by the Centre
d'expertise des grands organismes. (Page 47)

    CARRA: Inadequate information given to participants and beneficiaries

    The information provided by the CARRA, which citizens use as a basis for
important decisions, can be inaccurate, incomplete and difficult to
understand. Following a number of complaints about this issue, the Québec
Ombudsman has recommended that the CARRA should inform it of the results of
steps taken to improve information quality when it implements its 2009-2010
action plan. (Page 48)

    RRQ: Unfair impacts of combined benefits

    After receiving a complaint, the Québec Ombudsman noted that situations
involving a combination of benefits from the RRQ and the SAAQ can produce
unfair outcomes. In practice, citizens who find themselves in these
circumstances have no recourse since the authorities are simply applying the
law as it currently stands. The Québec Ombudsman has therefore recommended
that, as part of the pension plan review due to take place in the fall of
2009, steps should be taken to ensure that the rules applicable to benefit
combinations do not have the effect of reducing the recipient's income from
its original level. (Page 50)

    Child and youth protection centres

    An investigation by the Québec Ombudsman revealed that people adopting
children from abroad do not have access to the same services as those adopting
children from Québec. Some regional disparities were also observed. The Québec
Ombudsman has therefore recommended that the Ministère de la Santé et des
Services sociaux (MSSS) should harmonize these services and report to it on
the progress made in January 2010. (Page 56)

    
    Some major deficiencies in complaints handling systems of detention
    facilities

    Many detention facilities do not make full use of the register of inmate
complaints, and there is therefore insufficient information available to
improve practices and manage risks. The Ministère de la Sécurité publique has
undertaken to make quarterly reports on this subject to the Québec Ombudsman,
beginning in August 2009. (Page 24)

    Medical escorts to hospital appointments: Reconciling security
    requirements and rights

      - The Québec Ombudsman has recommended that the Ministère de la
        Sécurité publique (MSP) should review the internal directives of
        detention facilities so that the use of physical restraints in
        hospitals is based on the level of risk and on the security context.
        (Page 25)
      - The Québec Ombudsman received a number of complaints, from physicians
        among others, concerning the lack of confidentiality in discussions
        between health professionals and inmates, due to the presence of
        correctional officers during consultations. (Page 26)
    

    The MSP has undertaken to review both these practices as part of its
review of the provincial instruction on custodial methods in hospitals. It
will inform the Québec Ombudsman of developments by December 31, 2009. (Page
26)

    Release on parole: Chronic postponement of hearings

    The percentage of postponements for hearings by the Commission québécoise
des libérations conditionnelles (CQLC) has increased steadily over the years.
At the same time, the percentage of eligible inmates who gave up on parole
increased from 13.8% in 2000-2001 to 35.6% in 2007-2008. Given that the parole
program is a fundamental element of the social reintegration process and a
trial run for unconditional release, the Québec Ombudsman has recommended that
the Ministère de la Justice, the Ministère de la Sécurité publique, the
Director of Criminal and Penal Prosecutions and the Commission québécoise des
libérations conditionnelles should work together to analyze bottlenecks in the
current parole release system, in order to improve existing practices and
simplify their operation. The leaders of the four authorities have undertaken
to report to the Québec Ombudsman on the changes made by January 31, 2010.
(Page 27)

    
    Unsatisfactory follow-up to the Québec Ombudsman's previous
    ------------------------------------------------------------
    recommendations
    ---------------
    

    The follow-up to certain recommendations made in the Québec Ombudsman's
2007-2008 Annual Report has been unsatisfactory, as shown by the following
examples: (follow-up to all the recommendations on page 125 of the Annual
Report)

    Certification of private residences that house vulnerable people

    The Québec Ombudsman reiterates the urgent need for mandatory
certification of private residences for people with addictions, mental health
disorders or intellectual deficiencies. Without certification, there is no
guarantee that residents will receive proper care and treatment in a safe and
clean environment. (Pages 70 and 128)

    Consent for care dispensed to incapacitated individuals

    The Curateur public has not yet reviewed the steps taken to ensure that
health and social services institutions request consent for care dispensed to
incapacitated individuals. The Curateur public has assured the Québec
Ombudsman that it has completed its analysis and will report on its
conclusions by June 2009. (Pages 96 and 127)

    
    Assessment of care quality and quality of life (Mental Health Action
    Plan, 2005-2010)

    The Québec Ombudsman believes the effort made by the Ministère de la Santé
et des Services sociaux to assess the quality of life of users with mental
health disorders is insufficient. (Pages 86 and 131)

    Social Reintegration Plan and contracts with local social reintegration
    support funds
    

    The Québec Ombudsman is worried about the negative impacts of the delays
accumulated by the Ministère de la Sécurité publique (MSP), and notes a
significant disparity between the MSP's words and actions. It recommends that
the MSP should treat this work as a priority, and that it should table the
government's Social Reintegration Plan by June 30, 2009. (Pages 18 and 126)

    Mandatory register for isolation and seclusion cells

    The Québec Ombudsman is dissatisfied with the delay in following up on
its recommendation to introduce a mandatory register for the use of isolation
and seclusion cells in detention facilities. (Page 128)
    -%SU: CPN,SOC
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For further information:

For further information: Joanne Trudel, Communications Department, (418)
644-0510, joanne.trudel@protecteurducitoyen.qc.ca,
www.protecteurducitoyen.qc.ca; Source: The Québec Ombudsman


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