Inspiration for the Social Economy
by Hugh Maynard
The Ici Santé Co-op, with two locations in Montérégie West, aims to provide local health-care services adapted to the reality of the rural municipalities in the region. The co-op has situated itself in a niche between the broad range of mass and specialized health services supplied by the public system and the more costly services offered by private clinics.
Amy Tolhurst, who has worked as the head nurse for the organization since its founding in 2015, noted the co-op model was chosen because it’s well understood in rural communities due to the traditional presence of farmers’ co-ops, and it’s a model that works well because it involves the community.
“The public system does a good job of delivering mass services, but there’s a need to offer more personalized care, to accompany our patients and provide local access to services. The human element in providing health care is important,” she says.
Ici Santé offers a diversified and quality range of health-care services such as blood tests, vaccinations, suture, and preventative care of all kinds. The co-op is trying to hire a doctor to be able to expand its offer of service and level of care from its two current locations in Howick and Saint-Louis-de-Gonzague. They are open to opportunities to grow should other local municipalities be interested in the concept.
Tolhurst recently stepped aside as head nurse to take on a consulting role to develop home health care and partnerships with other health co-ops, as well as work on attracting a doctor who is looking to work in an alternative setting that emphasizes a personalized approach to health care.
She has been replaced by Laurence Gingras, who previously worked for 11 years in a regional hospital and was about to quit the profession altogether.
“We can’t be good caregivers if we don’t look after ourselves, and I was ready to leave the public system for good. At the co-op, we have the time to work, listen, and understand, so now I feel reconnected with my profession, and I feel comfortable with what I do,” says Gingras.
The Ici Santé Co-op recently integrated its online reservations with the Clic Santé system, which has given it a lot more exposure and connections with other service providers. Tolhurst also participated in the annual conference of the Society of Rural Physicians of Canada in Edmonton, Alberta, and came home full of ideas and connections.
Her advice for those considering the establishment of a health co-op is not to be afraid.
“Jump in there! The co-op model is not in everyone’s wheelhouse, and, at the start, I received a lot of ‘deer in the headlights’ reactions, and not just from patients,” Tolhurst exclaimed. But then, you meet people like Laurence. She was ready to leave her job to start (with the co-op) the next day!”
Tolhurst says that in the public system there’s a division of priorities between the administrators and the money managers, whose training emphasizes profit at the end of the day. Health services, says Tolhurst, need financial stability.
“When we combine suffering and the bottom line it makes for difficult decisions. Health care professionals prioritize the needs of the patient, so the well-being of the community becomes the leader in how these two solitudes find common ground.” She adds that if both professions establish a forward-looking vision, as they are trying to do at Ici Santé, then investments can be made to create the stability that is currently lacking in the health-care system.
Gingras agrees. “What do you need, and we’ll adapt, and much quicker than the public system.” She concluded, “At the co-op, we work for you, not someone else.”
How does a health coop work?
A health coop is a user co-op—the patients who access the health services of the co-op can choose to become a member by purchasing a share. The co-op is governed by a board of directors elected by the membership at the annual meeting. Revenues are generated from an annual membership fee, currently $125, and from the services provided to patients. Any surplus that the co-op generates at the end of the fiscal year is reinvested in the co-op.
An ongoing priority for Ici Santé is to maintain its health care services at the lowest possible cost. This gives members free access to a number of general services, such as blood tests, consultations, and general nursing care. Other specialized services are available for a fee. The co-op also provides some services on behalf of the public system, including during mass vaccination campaigns. Non-members can also access the health co-op’s services and choose the services they need à la carte, but they have to pay a fee for all services received.
