Lysiane Gagnon

By LYSIANE GAGNON
From Monday's Globe and Mail

Hubert Dupont is a severely handicapped man bound for life to Saint-Charles-Borromée, a chronic-care institution in Montreal. The medication he's been prescribed dries out his mouth. He asks for water. "Drink your saliva," replies the orderly.

Another day, another floor, same hospital. Marie (not her real name), paralyzed and confused, is terrorized by the two orderlies who are putting her to bed. They pretend that a man, watching her through the window, is masturbating. She cries and begs the orderlies to stop; they go on.

Mr. Dupont told his own story to reporters. As for Marie, we know what happened in the privacy of her room because her siblings, worried by her declining health, hid a recording machine in the room. The 30-hour tape, depending on who was on duty, revealed moments of tender care, but also a great deal of revolting behaviour from some of the staff.

Marie's relatives followed due process. They alerted the hospital's director and the house commissioner, whose duty is to act on the complaints of the residents. Nothing was done, or next to nothing: The two guilty orderlies received a two-day suspension. After Marie's siblings moved their sister to another institution, they decided to go public so that others would be spared the same fate.

Radio-Canada and La Presse ran the story on Nov. 24, igniting a torrent of public indignation. The affair took an even more dramatic turn on Nov. 27, when Saint-Charles-Borromée's director, Léon Lafleur, who had been reported missing for two days, was found dead. He had hanged himself in a motel room halfway between Montreal and Quebec City.

Mr. Lafleur had been sharply criticized by Health Minister Philippe Couillard and the public for his reaction to Marie's treatment. Not only did he say that a two-day suspension was penalty enough for the orderlies, but he minimized their deeds as mere "black humour."

Mr. Lafleur, who had a personal history of depression, was unable to cope with the storm — as he had been unable to cope with the powerful union that was the real boss at Saint-Charles-Borromée.

Thirty years ago, La Presse ran a series of articles on the same hospital, which revealed that the union systematically stood up for the workers who were abusing patients. Orderlies and nurses who respected their patients — doubtless a majority of the staff — were silenced by the intimidating tactics of the union. Years passed, staff and management changed, but the same culture of violence remained.

The task force sent by Mr. Couillard published its report last week. It is damning: The stories of Mr. Dupont and Marie were just the tip of the iceberg. Saint-Charles-Borromée is now under trusteeship. The government-appointed envoy has four months to solve the crisis.

Unfortunately, Saint-Charles-Borromée, despite its particularly troubled history, is not an isolated case. The scandal shed light on the hidden misery of chronic-care patients who are reduced to silence because they are so dependent on their care-givers. It also highlighted the relative impotence of the managers of the health-care institutions. They are bound by rigid rules — all spelled out in great detail — that are negotiated between government officials and the top brass of the labour movement, far distant from the real problems and needs of local institutions. This is a perverse effect of Quebec's overly centralized system of negotiation for the public sector.

This system has to change before the Huberts and the Maries see their quality of life improve.