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Longueuil – As part of its 2026 Agenda campaign A strong public system: What if we dared to do it?, the APTS (Alliance du personnel professionnel et technique de la santé et des services sociaux) has announced its theme for this month: “Listen to people on the ground: what if we dared to do it?”. At a time when decisions that shape the public health and social services system are more and more centralized and disconnected from workplace realities, the APTS argues it’s time to pay more attention to those who are carrying the full weight of the system on their shoulders: health and social service workers.

For decades, governments have been carrying out structural reforms while promising to make the health care system more efficient. From the creation of CSSSs to that of integrated centres (CISSSs and CIUSSSs) and more recently Santé Québec, each transformation has led to greater distance between decision-makers and realities on the ground.

At the same time, successive rounds of deficit reduction have undermined the system’s ability to respond to Quebecers’ needs. Chronic underfunding has fuelled the development of profit-driven, privately owned service providers, while teams working in the public system face crushing workloads that have now become chronic.

The outcome is well known. Our public system is falling apart, Quebecers are finding it more and more difficult to access care and services, and pressure on workers continues to mount – all while expert knowledge from the ground has gradually been removed from decision-making processes.

“Expert knowledge of the health and social services system is not located in health ministry offices,” said APTS president Robert Comeau. “It belongs to professionals who work for the system and provide support for Quebecers on a daily basis. If we really want to make our system stronger, we need to start listening to the people who keep it going.”

September: Put workers’ expertise back at the centre of decision-making

Québec’s provincial elections are only a month away. At this point, the APTS has a message for every party hoping to form a government: whatever changes are required in the health and social services system, they need to be shaped by the expert knowledge of teams on the ground.

This is why the APTS is putting forward three suggestions to bring about a change in culture and put workers’ expertise back at the heart of decision-making.

·       Strengthen mechanisms providing for joint responsibility for unions and employers by ensuring that employees and community organizations are represented on the boards of directors of Santé Québec and health care institutions, and by cancelling the setbacks to joint representation in occupational health and safety introduced by Québec’s labour relations bill (Bill 101).

·       Build on the autonomy and judgement of teams by giving them priority over management demands, and by developing ways of consulting them on decisions that directly affect their practice such as the purchase of equipment.

·       Put an end to the culture of fear that exists in a number of workplaces by providing more protection for whistleblowers and more rigorous follow-up on reports about management directives that put the health of employees or service users at risk.

“We already have solutions for the system’s persistent problems,” said APTS first vice-president Émilie Charbonneau. “People who work in the system every day know what needs to be done. But we have to make sure they can speak out, be heard, and contribute to decisions. If we want to make our system more caring, more accessible, and more effective, we have to dare to listen to people on the ground.”

The APTS

The APTS (Alliance du personnel professionnel et technique de la santé et des services sociaux) represents more than 68,000 members who play a key role in ensuring that health and social services institutions run smoothly. Our members provide a wide range of services for all Quebecers, including diagnostic, rehabilitation, nutrition, psychosocial intervention, clinical support, and prevention services.