The fallout continues in Quebec after the Coalition Avenir Québec (CAQ) government invoked closure to force through a controversial bill changing the way doctors are remunerated.
Bill 2 was passed into law on Saturday, less than 24 hours after it was tabled by Health Minister Christian Dubé.
Under the legislation, doctors will see a portion of their compensation linked to performance targets relating to the number of patients they care for, particularly vulnerable ones.
Both New Brunswick and Ontario seem poised to benefit as more and more doctors say they will be leaving Quebec’s public health system in response to the special law.
Ontario Premier Doug Ford was quick to swoop in, telling reporters in Toronto when asked Wednesday that he’d love to increase recruitment efforts in Quebec.
“Call 1-800-Doug-Ford,” he said. “All the docs, come by, call me on my cellphone … we’ll have you working real quick.”
‘Not time to take shots at each other,’ Legault says
Later Wednesday, Quebec Premier François Legault called Ford’s comments unacceptable and blasted him for a “total lack of judgment.”
“It’s not time to take shots at each other. It’s time to work together,” said Legault, who insisted the health-care budget isn’t being reduced, but the ways it is spent needs adjusting.
“I understand the worry. It’s a big change,” he said.
Either way, if the number of applicants for licences is any indication, it doesn’t look like Ford will have much convincing to do.
As of Wednesday, more than 100 doctors had started the process of applying for licenses to practise in both provinces, with New Brunswick’s college of physicians saying it had received close to 40 applications so far in October and Ontario stating it had received 70 applications in the last five days.
In an email to Radio-Canada, the College of Physicians and Surgeons of New Brunswick said it normally receives around three to four licence applications per month from Quebec physicians, showing a significant jump.
Quebec’s Bill 2 ties a portion of doctors’ pay to collective performance targets, a measure that many doctors argue won’t have the intended effect. They’re also criticizing elements of the bill that could punish those who speak out or try to leave the province’s public system.
Meanwhile, a New Brunswick health authority, Vitalité, which oversees 11 French hospitals in the province, says it is also seeing a “wave” of inquiries from Quebec doctors.
Vitalité CEO France Desrosiers told Radio-Canada’s Tout un matin that in the last month alone, it had received 100 expressions of interest from Quebec physicians, including those asking about what positions are vacant and where, as well as obtaining information on workload and working conditions.
“It’s significantly higher than what we usually receive, despite the fact that Quebec is our primary recruitment target, outside of our students trained in New Brunswick,” Desrosiers said, adding Vitalité usually receives between 10 and 20 applications per year from doctors from across the country.
Derosiers said that while there are opportunities for family doctors and specialists from Quebec, it’s not a large number with a total of 500 doctors in New Brunswick who work in French.
“So when we recruit, it’s about 50 doctors and we lose about 15 to 20 per year through retirement or because they go elsewhere to work.”
‘Tragedy for patients,’ says Quebec federation of GPs
Dr. Marc-André Amyot, president of the Fédération des médecins omnipraticiens du Québec (FMOQ), which represents general practitioners, described the situation as a “tragedy.”
“A doctor leaving, whether for retirement or for another province, is a tragedy for patients,” he said.
“On average, each doctor has 1,000 patients. And imagine, those patients won’t find another family doctor. There’s already a shortage of 2,000 family doctors in Quebec. “
Speaking from Quebec City on Wednesday, Health Minister Christian Dubé said physicians and students need to take a step back.
“They need to have more information before they make their decision,” he said, adding the law was only passed on Saturday and there’s a lot to process.
Dubé also reminded the FMOQ and the federation of medical specialists of a 60-day delay after the law is passed in which they can “negotiate the remuneration.”
“So I think there will be some movement for the next few weeks if the federations are at the table,” he said.
On Tuesday, however, the federation representing medical specialists in Quebec said it was filing a lawsuit Wednesday to challenge the law. The Fédération des médecins spécialistes du Québec (FMSQ) will also request a stay of execution, adding that the “violation of individual liberties” will be at the heart of its arguments.
