Quebec physicians’ organizations divided over Bill 83

A doctor consults a file in a hospital. (Nathan Denette/The Canadian Press)

Quebec Health Minister Christian Dubé’s Bill 83, which aims to stem the exodus of doctors to the private sector, is creating a rift within the organizations.

On the one hand, the Quebec College of Physicians (CMQ) would like to see the status of non-participating physician abolished outright, while on the other, the Fédération des médecins de pratique privée du Québec and the Fédération des médecins spécialistes do not believe that Bill 83 will improve access to care.

Last week, Dubé presented several amendments to Bill 83.

Among other things, he proposed that doctors should obtain prior authorisation from Santé Québec to disaffiliate from the Régie de l’assurance maladie du Québec (RAMQ).

Dubé says that some 150 doctors are currently switching back and forth between the private and public sectors simply by informing RAMQ of their intention to do so.

The minister would like Santé Québec to assess the relevance of each request according to certain criteria. For example, that there is no shortage of doctors in public establishments in the region of the doctor applying to disaffiliate.

The CMQ considers this to be insufficient and is calling for a “more rigorous professional and legal framework” to be put in place for the private sector, given that there are more than 800 doctors working in the private sector in Quebec, compared with just a few dozen in the rest of Canada.

“We would have liked the government to go further and prohibit the movement of doctors between the public and private sectors, because this contributes to the shortage of staff in the public network,” wrote the CMQ on Bluesky last week.

The Fédération des médecins spécialistes du Québec (FMSQ) has a completely different view.

It said on Bluesky that PL83 looked like it had been “written on a corner of a table” and that it “completely missed the mark.”

On Tuesday, the Fédération des médecins de pratique privée du Québec (FMPPQ) also raised criticisms, saying the assessment criteria for authorizing disaffiliation from the RAMQ are “administrative and subjective.”

It also believes that this infringes doctors’ professional freedom and patients’ freedom of choice.

“Ultimately, it is patients who will suffer the consequences, in particular by having less access to care and having their surgery postponed, at least in the short term,” the FMPPQ said in a news release.

Dubé often repeats that the private sector must complement the public network. He pointed out that agreements have been reached with private clinics to ensure that patients continue to receive faster, free treatment.

This report by The Canadian Press was first published in French on April 8, 2024.

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