CAQ tables bill rolling back more chunks of controversial doctor law
The agreement with the FMOQ sets a target of 500,000 more patients to have access to a family doctor by June 30.
Last updated 1 hour ago
QUEBEC — Sonia Bélanger, the new health minister, has presented legislation rolling back most of the remaining controversial clauses of Quebec’s doctor salary reform legislation, Bill 2.
With former Coalition Avenir Québec health minister Christian Dubé — who authored the original bill — looking on as an independent MNA, Bélanger tabled Bill 19 on Wednesday, putting in place more modifications to Bill 2.
That bill, adopted by the National Assembly in October using the rules of closure, was designed to bring the hammer down on doctors and impose a new wage system. It drew the ire of many of Quebec’s doctors and destabilized the CAQ government.
Bélanger’s new bill reflects a last-ditch agreement reached in December with family doctors who are members of the Fédération des médecins omnipraticiens du Québec (FMOQ), which put the war with doctors on hold.
Quebec’s family doctors overwhelmingly voted in favour of that deal. The agreement obtained 97 per cent support.
Quebec had already dropped many of the negatively received clauses in Bill 2, including punitive measures. It also delayed application of Bill 2, but only until Feb. 28.
Bélanger’s bill eliminates that deadline and is designed to entrench the agreement reached with the FMOQ, which softened much of the original bill.
It withdraws the powers the Health Ministry had given itself to impose a change in the way doctors are paid, and others allowing it to impose financial penalties for failure to reach medical targets.
Quebec also dropped the power it had given itself to determine the level of vulnerability of patients, which would have been applied using a colour-coded system.
While Bill 19 opens the door to replacing the current system of payment per medical service with a capitation system — with a set amount for each person enrolled with a health-care provider — it does not impose such a change. The bill states Quebec "may provide for remuneration methods that include capitation remuneration".
The proportion of pay to be determined by capitation still has to be negotiated with the FMOQ; the government is aiming for 50 per cent. Quebec has already struck a transition committee to conduct the talks.
In a news conference at the legislature, Bélanger — who took over from Dubé after he quit the CAQ in December as he watched his original Bill 2 get dismantled — insisted the new proposed legislation is in the interests of all.
Former social services minister Lionel Carmant also quit over Bill 2, but Bélanger said she is focused on the future, not the past.
"We are doing this for patients," she said. "Every action has one goal: Better access to care. The most vulnerable people come first. Doctors agree with this. My role as health minister is to make this agreement (with the FMOQ) work."
Bélanger said the deal was an acceptable compromise.
"We were told we were too harsh (with Bill 2)," she said. "After that, we were told we were too soft. I find today we are in the middle, that we are in the right place and this will make a difference for Quebecers."
She said the good news for the government is that it is achieving its goal of making the capitation system obligatory for front-line doctors working in clinics. The agreement with the FMOQ, however, provides for a long list of exceptions, including doctors near retirement age, young doctors and those working in emergency wards or end-of-life clinics.
In the long run, more Quebecers will have access to medical professionals, Bélanger added. The agreement with the FMOQ sets a target of 500,000 more patients to have access to a family doctor by June 30.
Of that total pool, the goal is for 180,000 who are considered vulnerable and in need of extra care.
On Tuesday, Quebec announced 78,000 orphaned patients had been notified they were enlisted with the Guichet d’accès à la première ligne in January. Known in English as the Primary Care Access Point, the system is reserved for people who do not have access to a family doctor or nurse practitioner in primary care.
"This is concrete," Bélanger said. "It’s a rapid front door into the network. We have to be happy about this. It’s a start. We are really aiming to attain our target."
Parallel to the new bill, Bélanger said an overhaul of the existing model for family medicine groups is in the works. She said those changes will be announced in April.
But while Quebec is moving ahead with family doctors in the FMOQ, it has yet to cut a deal with the other medical federation that has been up in arms over Bill 2, the Fédération des médecins spécialistes du Québec (FMSQ).
"They have returned to the table," Bélanger said. "You know the faster we have an agreement with the FMSQ, the sooner we can act with a bill."
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