The complex public health and social assistance systems provide a range of services. It is critical to integrate the work carried out by sector stakeholders in order to ensure that their approach is coordinated and not in silos.
New reforms are implemented without necessarily considering the outcomes of earlier changes.
This is all the more important when addressing the needs of seniors, which are chiefly met by external resources outside the public system (e.g. family members, associations, social economy groups, private sector, etc.). Stakeholders in the government network must therefore coordinate their actions and integrate their services into those provided by others.
Yves Couturier, researcher at the Research Centre on Aging at Université de Sherbrooke, compared public policies to integrate geriatric services in France and Québec. He observed that the province's system is comparatively simpler than its French counterpart. For example, the Régie de l'assurance maladie and the Ministère de la Santé et des Services sociaux bear the service costs in their entirety, while, in France, several healthcare mutual companies share the expenses. While a single government department oversees health and social services in Québec, they remain separate in France.
Carrying out reforms in Québec is more straightforward than in France, where organizational innovations are often isolated actions. However, the consequence for the province is that new reforms are implemented without necessarily considering the outcomes of earlier changes.
The expertise developed as part of the research project was called upon during a consultation process to establish a new reference framework to guide case managers, who track patients as they navigate the health and social services.