Quebec Healthcare-Bill 15/Bill 2 August 2024-

Written by Diana Thebaud Nicholson // November 4, 2025 // Health & Health care, Québec // No comments

Quebec Healthcare/Bill 15 October 2022-July 2024

2 August
Quebec health-care language directive open to constitutional challenge: Frédéric Bérard
“You are dividing people who do not need to be divided. It makes me sad,” Montreal law professor says.
One of Quebec’s leading constitutional scholars has come out against a controversial linguistic directive regulating the province’s health care in English and other languages apart from French, warning the new rules are divisive and open to legal challenges before the courts.
Frédéric Bérard, co-founder of the Observatoire national en matière de droits linguistiques and a professor of law at the Université de Montréal, said the July 18 directive issued by Quebec’s Health Ministry likely violates both the Canadian and Quebec charters of rights and freedoms.
… Bérard suggested, the language directive could be struck down in court, even though the Coalition Avenir Québec government invoked the notwithstanding clause preemptively in the Canadian Constitution to shield Bill 96 from anticipated judicial challenges. Although Bill 96 overhauled the Charter of the French Language, Bérard maintained what is at stake is not Bill 96 itself, but a linguistic directive.
9 December 2023
Quebec adopts sweeping health-care reform bill [Bill2]*
* Bill 15, Act to make the health and social services system more effective
(CBC) The bill contained nearly 1,200 articles, making it one of the most imposing bills in Quebec history.
It will make way for the creation of provincial agency, Santé Québec, which will oversee all activities related to the public health-care system, including providing services and facilitating access. The Health Ministry will provide the agency’s guidelines.
Santé Québec will become the sole employer, integrating the CISSS and CIUSSS networks. Union accreditations will be merged and a single seniority list will be established, allowing staff to move from one region to another.

4 November
Quebec offers olive branch to disgruntled doctors by suspending parts of Bill 2
Quebec Treasury Board president France-Élaine Duranceau says she’s inviting doctors to return to the bargaining table.
On the same day as medical students opened their court challenge of Quebec’s doctor remuneration law, Treasury Board president France-Élaine Duranceau said it’s time to cool down the atmosphere.
“The premier (François Legault) has asked me to resume contact with the federations, the FMSQ and FMOQ, to find some common ground,” Duranceau told reporters Tuesday with Health Minister Christian Dubé standing at her side.

29 October
One-fifth of doctors at Queen Elizabeth clinic plan to quit Quebec over new law
“This is the best gift to Ontario they’ve had since the first (Quebec sovereignty) referendum,” Dr. Mark Roper says.
‘Call 1-800-DOUG-FORD,’ Ontario premier tells disgruntled Quebec doctors
“Call me on my cellphone. We’ll have you working real quick,” Doug Ford said.
Doctors’ anger continues to grow in Quebec after the adoption Saturday of Bill 2, imposing a remuneration plan on the province’s 23,500 GPs and medical specialists. The salary plan includes pegging wages to new performance standards.
The law includes penalties and fines for infractions of the new law.
On Tuesday, the association representing medical specialists, the Fédération des médecins spécialistes du Québec (FMSQ), announced plans to challenge the law in court and accused the Coalition Avenir Québec government of trying to stop doctors from leaving the province — or even complaining about the law.

23-24 October
Quebec brings hammer down on doctors by adopting special law to force deal
The CAQ invoked closure to fast track Bill 2, which includes a new salary structure for physicians and imposes stiff penalties for pressure tactics.
Unable to reach a negotiated deal over a new salary structure with doctors, the Coalition Avenir Québec government Friday played hardball, adopting legislation imposing an agreement on them that includes stiff penalties for any retaliatory pressure tactics.
Quebec’s doctors, however, are enraged and vowed to use the courts to fight the law they consider an violation of their rights by a government they are calling authoritarian and Soviet-style. Some say they will retire or leave the province as a result.
“This is headed directly into the courts,” Québec solidaire health critic Vincent Marissal said emerging from the all-nighter. “What does this do in the end for patients? Nothing at all. It de-motivates even more (the workers). This is just another kick at the health-care beehive that was already not running very well.”
“Once again, we see a sad spectacle of a government on the wrong track,” said the Liberal health critic, Marc Tanguay. “This will increase the administrative burden (in the system), it will lead to legal battles and more resources not going into the network to open operating rooms.”
… First, it puts and end to pressure tactics designed to slow the system, which doctors launched as a protest against the government’s reform plan. More significantly, it integrates wide swaths of previous Bill 106, which linked 15 per cent of doctors’ pay to performance standards, including the number of patients under their care.
Doctors over 63 years of age are exempt from the plan, a government response to the threat of mass retirements as a result of the changes. Twenty-two per cent of Quebec doctors are over 60.
The bill gives Quebec sweeping powers over the medical system and its doctors, which previous Quebec governments wanted, but never dared impose, fearing a backlash. It allows Quebec, for example, to set targets for the numbers of patients treated by doctors on a provincial, regional and local basis and impose standards.
Special law will force doctors out, opposition parties charge. Legault says he won’t back down
CAQ government says doctors would need to take significant steps to get the government to stand down on special law.
ension between Quebec and the province’s doctors continued to escalate Thursday, with the government sticking to its hardline plan to legislate a wage formula and force an end to the dispute.
Not even an announcement by general practitioners in the Fédération des médecins omnipraticiens du Québec (FMOQ) that they would end their pressure tactics was enough to put out the fire, with Premier François Legault writing to the president of the legislature Thursday asking for the house to sit exceptionally on Friday to adopt the special legislation.
The government will invoke closure, a parliamentary tool that allows it to skip the normal steps of the legislative process and fast-track a bill into law.
The legislation is expected to include most of the original content of Bill 106, which proposed linking 15 per cent of doctor salaries to performance standards. That means Quebec will do away with the current system of pay per medical action, and replace it with pay based on the number of patients cared for and how vulnerable they are.
The government will get the power to set performance targets. The bill could also include language ending the pressure tactics launched by the FMOQ and the Fédération des médecins spécialistes du Québec (FMSQ). On Thursday, Legault revealed there would also be unspecified measures to stop any potential exodus of doctors.

22 October
The Fédération des médecins spécialistes du Québec (FMSQ) rejected the Legault government’s fourth offer on the same day it was presented, on Wednesday.
“We received this morning a proposal that is a declaration of war, which is an ultimatum (…), we are facing an affront,” said FMSQ negotiator Lucien Bouchard at a press conference in Montreal alongside the federation’s president, Vincent Oliva.
15 May
Lucien Bouchard to represent doctors’ federation in negotiations with Quebec government
The Fédération des médecins spécialistes du Québec (FMSQ) appointed lawyer and former premier Lucien Bouchard to represent the organization in negotiations with the government, turning to arbitration in the hope of reaching an agreement.
In a press release, the FMSQ, which brings together the members of 36 medical associations, explained it had called on Bouchard because of his “credibility and in-depth knowledge of the political system,” which made him “the ideal person” to take charge of the case.
The Federation acknowledged that negotiations with the government, which it describes as “difficult,” are “not going well,” pointing to the recent introduction of Bill 106 by Health Minister Christian Dubé.

15 October
Ottawa invests $52M to boost English-language health services in Quebec
Funding aimed at training bilingual staff, helping improve access to care
(CBC) The funding to improve English-language health services in Quebec is coming from the federal government’s previously announced plan to promote and protect official languages in Canada.
“I’ve heard multiple times from my constituents that they’ve gone to receive health services and unfortunately have not been able to get answers or be understood,” said Peter Schiefke, MP for Vaudreuil.
He said anglophone and allophone communities’ needs are currently not being met.
Health Canada says it is investing $52 million in programs across the province until 2028. Of that, $20 million will go to McGill University to help train health-care workers in English. The rest will go to the Community Health and Social Services Network (CHSSN) which does outreach and advocates for English-speaking patients.

30 September
Emergency wait times are a threat to our health
Andrew Caddell
(Hill Times) Health care is regularly in the headlines, for obvious reasons: it will cost $375 billion in 2025, more than two-thirds of that from taxpayers. About 6.5 million Canadians don’t have a family doctor, over 2.3 million of them in Quebec. This means many people, including me, must go to an ER for primary care or a severe health emergency.
In an unintended piece of investigative journalism, I spent close to a day in the emergency department of the McGill University Hospital Centre (MUHC) in Montreal.
… What I learned from this experience is to prepare for the worst at an ER.
I would support the idea of clinics to deal with non-acute medical emergencies, as is the case in many European countries. That way, CT scans would be available before 7:00 a.m. Nurses in ER should also have the power to tell a patient their status. And we need more family doctors to take the pressure off ERs.
All the patients I spoke to were aware the system has difficulties, and dealt with them stoically. The doctors, nurses and staff were calm and professional. But it was clear everyone knew we could do a better job of caring for people in need.

18 September
Almost half a million Quebecers left ERs without being treated last year, study finds
(CTV) Nearly 430,000 Quebecers were forced to leave a hospital’s emergency room without receiving treatment last year, according to a new study by the Montreal Economic Institute (MEI).
“These patients are not leaving because they feel better, but because the system is failing them,” said Emmanuelle B. Faubert, an economist with the MEI and author of the report. “Thousands of Quebecers are being denied access to care each year.”
The study finds that in 2024, Quebec recorded more than 3.7 million emergency room visits.
The study notes that most patients leaving an emergency room untreated in Quebec are classified as either P4 or P5, representing semi-urgent or non-urgent cases.
“Because they are deemed low priority, these patients are pushed to the back of the line and face some of the longest ER waits,” the study notes. “This testifies to a lack of access to primary care.”
The researcher emphasized that patients forced to delay or forgo care often end up suffering from worsened conditions, which can complicate their cases.

15 September
Family doctors’ federation files legal action against Quebec
The legal action, filed Friday, is the latest chapter in rocky negotiations between the province and its two doctors’ federations. Health Minister Christian Dubé has sparred with doctors over a proposal to tie a portion of their pay to certain performance indicators, including a higher patient load for family doctors and lower wait times for surgery. In May, Dubé introduced Bill 106, which would circumvent negotiations and impose the contested pay model.
Now, the federation representing family doctors — the Fédération des médecins omnipraticiens du Québec (FMOQ) — is asking the courts to force the province back to the negotiating table and, should the parties fail to reach an agreement, order binding arbitration. According to the FMOQ’s filing, provincial negotiators have “adopted an uncompromising position” in contract talks, “refusing to consider the FMOQ’s propositions.” Quebec doctors have been due for a new deal since March 31, 2023, when the last contract determining their pay model expired.
Bill 106 came “without any negotiation or consultation with the FMOQ, even though (the FMOQ) believed it was engaged in a negotiation process … for the renewal of the general agreement,” the filing says. With the bill’s tabling, the association “understood why negotiations with the government party hadn’t advanced since August 2024,” it continues

21 August
A much better story when John Curtin recounted it on Wednesday Night
Montrealer says he was denied a blood test over minor administrative error.
His doctor’s office says it happens all the time
John Curtin said he’d fasted for 12 hours when he showed up at Notre-Dame Hospital in Montreal in early August for a blood test. He’d waited more than a month for the appointment, he said, finally landing a blood test Aug. 5.
But when he got to the hospital, Curtin said medical staff refused to administer the test, pointing to an administrative error on the form his doctor had filled out. Though all the other details were filled in, the doctor hadn’t copied down Curtin’s date of birth or RAMQ health insurance number.
Curtin shared a copy of the requisition with The Gazette, which shows the missing RAMQ number, but has the date of birth filled in. When staff told him the form was missing information, Curtin said he began to fill it out himself, before they told him to stop. A staff member attempted to call his doctor’s office, he said, but the office was closed. When he refused to leave, Curtin said staff threatened to call security.

19 August
Quebec blasts doctors for ‘total refusal’ to entertain pay changes
Quebec Health Minister Christian Dubé says neither the Fédération des médecins spécialistes du Québec nor the Fédération des médecins omnipraticiens du Québec have submitted formal counterproposals to Bill 106
Quebec’s health minister had strong words for the province’s doctors’ federations Tuesday, accusing them of refusing to entertain a proposed bill that would see up to 25 per cent of their pay leveraged against performance indicators. “Their position is a total refusal to discuss the method of payment” proposed under Bill 106, Health Minister Christian Dubé said at a press conference Tuesday.
In an open letter last week, FMOQ, Quebec’s family doctor organization, refreshed its criticism of the bill, dubbing the plan to tie pay to performance indicators “’fast food’ medicine” that would focus “not on the quality and and relevance of consultations, but solely on volume.”

4 August
Revealed: Exodus of Quebec doctors to private sector accelerates despite new law
By Aaron Derfel
More than three months after Quebec adopted a law [New doctors could face fines up to $200,000 for going private under Quebec bill] to reverse the exodus of family physicians and medical specialists from the public system to the private-for-profit sector, more doctors than ever have opted out of medicare — often to the detriment of patients who are waiting longer for treatment, a Gazette investigation has found. The latest figures by the Régie de l’assurance maladie du Québec (RAMQ), the provincial medicare board, raise questions about the effectiveness of Health Minister Christian Dubé’s reform known as Bill 83, suggesting that it may have backfired, at least initially. One theory advanced is that dozens of doctors in the public system rushed to go private in the weeks and months before Bill 83 was adopted at the end of April, but critics charge that the law itself is a “Band-Aid solution.”
The latest figures by the Régie de l’assurance maladie du Québec (RAMQ), the provincial medicare board, raise questions about the effectiveness of Health Minister Christian Dubé’s reform known as Bill 83, suggesting that it may have backfired, at least initially. One theory advanced is that dozens of doctors in the public system rushed to go private in the weeks and months before Bill 83 was adopted at the end of April, but critics charge that the law itself is a “Band-Aid solution.”

18 June
Santé Québec, Health Ministry squabble as heart patients die on wait lists
A record three dozen Quebecers have perished from sudden death since the start of the year while waiting for their heart operations, even as the Health Ministry and Santé Québec squabble over jurisdiction and resources, The Gazette can reveal.
Despite repeated warnings since last year from the leaders of the provincial associations of cardiologists and cardio-thoracic surgeons about abnormally long wait times for heart operations, no new targeted actions have been taken to address the crisis by either the ministry or Santé Québec. “We’ve heard nothing from Santé Québec,” Dr. Bernard Cantin, president of the Association des cardiologues du Québec, said in an interview, alluding to the Crown corporation that was set up on Dec. 1, 2024 to run the province’s $65-billion-a-year public health system.

19 April
Quebec says no special recruitment measures to attract U.S. doctors, researchers
(CTV) Santé Québec, the agency that manages health-care in the province, also stated in writing that no additional measures are currently planned by the agency to facilitate the recruitment of American doctors.
The agency specified that doctors who completed their training in the United States have access to the regular permit from Quebec’s College of Physicians and must immigrate to Canada like any other person from abroad.
Recruiters have said there’s been a surge of interest from American doctors considering moving to Canada since the election of U.S. president Donald Trump in November.
Unlike Quebec, other Canadian provinces — Ontario, British Columbia, New Brunswick, Nova Scotia, and Saskatchewan — have decided to facilitate the recruitment process to cash in on the potential surge in interest.

27 February
Hanes: Doctors call for abolition of PREM physician allocation system
Instead of forcing medical school graduates trained in Quebec to work in the public health system for five years, a group of Montreal doctors is proposing a solution for alleviating the shortage of family physicians that is simpler, easier and more effective. The Association des médecins omnipraticiens de Montréal (AMOM) is calling on Health Minister Christian Dubé to scrap the system of permits that determines where — down to the postal code — new doctors can practice.
…after more than two decades, PREMs [Plans régionaux d’effectifs médicaux] have not only become “obsolete,” according to AMOM, they’re a major deterrent for medical students choosing family medicine. They’re also a catalyst driving a growing number of new graduates out of the public health system, or out of Quebec entirely. A “quadruple exodus,” which includes fed-up older physicians retiring, is aggravating a chronic family doctor shortage in Quebec. “The PREM system was supposed to improve access to services. In 22 years, it has only deepened regional disparities and discouraged both new graduates and practicing doctors. PREMs are not just ineffective; they are harmful,” states AMOM, in an open letter it published Thursday, signed by 699 Montreal family doctors. “The PREM system must be abolished and replaced with alternatives that work everywhere else in Canada.”
The bureaucratic micromanagement has fuelled an unprecedented flight to private medicine, which is also unique to Quebec. Nearly 750 doctors have opted out of public health care in the province, further exacerbating the crisis. This includes 505 general practitioners or five per cent of family physicians, according to AMOM.

6 February
Hearings begin on Quebec bill that would force new doctors to practice in public sector
Consultations on Bill 83, aimed at curbing the exodus of doctors to the private sector, began on Thursday at the Quebec legislature.
Bill 83, tabled on Dec. 3 by Health Minister Christian Dubé, would require new doctors trained at Quebec universities to spend the first five years of their practice in the public sector.
Since 2020, around 800 of Quebec’s 22,000 doctors have opted to go into private practice, Dubé pointed out at a news scrum on Thursday.
He also pointed out that no fewer than 2,300 doctors trained in Quebec are currently practising in Ontario. Conversely, only 500 doctors from Ontario are practising in Quebec, he said.

2024

13 December
‘I wouldn’t be alive today’: Patients decry impending loss of MUHC addictions program
In just over a week, the McGill University Health Centre (MUHC) addiction day program will close its doors, leaving many people recovering from addictions with nowhere to go. The Gazette spoke with two of the program’s patients who said that while they had received instructions to seek out other resources, they will essentially be cut loose from their main source of addiction support when the program ends Dec. 20.
Hanes: Quebec’s home-care cuts are hurting the most vulnerable
Hugo Vaillancourt, who focuses on home-care issues at Ex aequo, a Montreal-based community organization that advocates for the rights of people with mobility limitations, said stealth cuts to Chèque emploi-service are a huge mistake. “It’s the biggest home-care program that no one has ever heard about. The first and longest-standing users of this program have been adults with disabilities who have fought for a long time to be able to self-manage their care because otherwise they were stuck with services that were completely inadequate from CLSCs that they have very little control over,” he said. “It’s also a very cost-effective way for the government to provide home care.” Vaillancourt said the program delivers about 39 per cent of all the home-care hours provincewide yet accounts for only nine per cent of the overall home-care budget. In Montreal, he said, it’s higher: 47 per cent. So putting Chèque emploi-service on the chopping block is short-sighted.

4 December
New doctors could face fines up to $200,000 for going private under Quebec bill
By Philip Authier,
Health Minister Christian Dubé wants to oblige new doctors and medical specialists to initially practise in the public system after graduation or face stiff financial penalties. Dubé tabled legislation, Bill 83, in the National Assembly on Tuesday that would require students who studied medicine in a Quebec university to devote the first years of their professional lives, as general practitioners or specialists, to working in public institutions instead of leaping to more lucrative jobs in the private system. The minimum period in the public system will be five years, according to the bill, titled An Act to Foster the Practice of Medicine in the Public Health and Social Services Network.

1 December
Quebec launches new health-care agency in bid to improve services, reduce wait times
(Globe & Mail) A new Crown corporation has officially taken the reins of Quebec’s health-care system as part of the provincial government’s effort to reduce emergency room wait times and surgery wait lists.
The agency, called Santé Québec, will manage all health-care facilities in the province and will become the sole employer of 330,000 health-care workers.
The agency is a key part of the Quebec government’s plan to reform the province’s health-care system and improve access to services.
Geneviève Biron, president and CEO of Santé Québec, says in an open letter that she plans to “optimize” the network by reducing the duplication of work and sharing tools and best practices between institutions.
But the agency has also been tasked with eliminating a $1.5-billion deficit in health-care spending, which Health Minister Christian Dubé has acknowledged will affect services.

26 November
‘Autonomous’ health-care: Quebec group turns to astronauts in new pilot
The West Island Regional Health Agency has launched a pilot project, opening an innovative Teleheath Station in a local community service centre (CLSC).
The project was inspired by medical initiatives used by the Canadian Space Agency.
“Patients on the waiting list can do a routine check up via a station that works for astronauts,” said Dan Gabay, the CEO of the CIUSSS de L’Ouest-de-I’ile-de-Montreal.
“Something that would be alarming would trigger the nurse to just see if everything is ok. If there is any area of concern the CLSC will intervene first. If a doctor needs to be seen, we connect you.”
The Telehealth Station is a small room equipped with a high-end Canada-health certified Connected Care Medical Module, or CCM2.

22 November
Santé Québec considering “a selective reduction of services” to cut costs: source
Even in the absence of direct cuts to services, health-care managers have expressed concern that any dramatic reduction in spending would inevitably result in problems with access.
Aaron Derfel
In a statement posted to the Bluesky social media platform (and emailed to The Gazette on Friday afternoon), Santé Québec confirmed a report last week by the newspaper that it has ordered hospitals and other facilities to chop nearly $1.5 billion from their budgets in the coming months — an amount that would be 50 per cent greater than previously known.
“The accumulated deficit at mid-year (was) $1 billion,” Santé Québec noted in the statement. “Looking ahead to the end of the fiscal year in March 2025, the projected deficit could rise to as much as $1.5 billion if nothing is done.
… The austerity measures are being driven by worries in the Legault government that U.S. bond-rating agencies might lower Quebec’s credit rating, which in turn could drive up the interest on debt payments by the provincial government. Quebec’s spending on health and social services has climbed to $60 billion in 2024-25 from about $35 billion six years ago, while the government has posted a record deficit of $11 billion this year.

17 November
Explainer: How will Quebec’s new health-care agency change the system?
Here are three things to know about Santé Québec.
Jacob Serebrin
(Montreal Gazette) Starting next month, Quebec’s entire health-care system, currently managed by more than two dozen organizations, will come under the control of a single agency: Santé Québec
Starting next month, Quebec’s entire health-care system, currently managed by more than two dozen organizations, will come under the control of a single agency: Santé Québec
For the vast majority of Quebecers, health care is governed by 23 regional health authorities, known by the French acronyms CIUSSS, CISSS and, in the northern Jamésie area, CRSSS.
Several major hospitals and specialized institutes, which serve patients from across the province, are independent of those agencies.
On Dec. 1, all the health-care facilities managed by those regional authorities and the independent institutions will become part of Santé Québec.
In Montreal, that includes five CIUSSS, three independent hospitals — including the McGill University Health Centre — and the Montreal Heart Institute.
But there have been fears about what the takeover of independent university-affiliated hospitals, hospital networks and institutes will mean for the quality of those institutions. Last year, six former Quebec premiers, both Parti Québécois and Liberal, wrote an open letter criticizing the takeover of those institutions, whose work combines research and innovation with health care.
Santé Québec CEO Geneviève Biron has also said she plans to find “efficiencies.” During a recent series of media interviews, she said her first job is to find $1 billion in savings.
Under the new system, the health ministry will be responsible for policy and strategic planning, while Santé Québec will be responsible for day-to-day operations.
… The reform will also see all health-care facilities get an on-site manager — something that was cut during a 2015 health-care reform led by then-Liberal health minister Gaétan Barrette — which is intended to fix issues that emerged during the COVID-19 pandemic, when individual facilities were unable to adapt to a rapidly spreading virus as they waited for instructions.
The reform will also put all health-care workers under a single employer and reduce the number of union bargaining units from 136 to four. That means workers will be able to transfer between facilities more easily without losing their seniority, Dubé has said, and patients can be offered appointments at any public facility in the province, such as one that used to be in a neighbouring CIUSSS, as well as in private facilities.
What are the concerns? …

13 November
Quebec slashes thousands of health-care workers’ hours
“This situation is worrisome because, in the end, there will be fewer nursing resources available.”
Update: After publication, Santé Quebec said that according to its ongoing analysis, 1,307 health workers are impacted by the measures outlined in this story. The Fédération de la santé et des services sociaux (FSS-CSN) said it was advised that a “few thousand” are affected.
Quebec health workers holding down two jobs are being stripped of their extra hours — a move critics warn could tip an already fragile system into further turmoil. …
4 November
Quebec College of Physicians wants expanded private medical care halted
The group warns that accessibility to health care and services, guaranteed by law, is being compromised.
(Montreal Gazette) The request is one of six guiding principles established by the College during a regular meeting of its board of directors Oct. 25. The principle aim is to rethink the role of the private sector in health care to ensure the sustainability of an accessible and universal public system.
Quebec wants to force new doctors to work in public system after graduating
Training a physician costs Quebec taxpayers between $435,000 and $790,000, Health Ministry says
Quebec plans to force new doctors to stay in province and work in public health care system
(Canadian Press via Globe & Mail) The provincial government says it will force new doctors trained in Quebec to work in the province’s public health care system for the first years of their practice.
Health Minister Christian Dubé told a Montreal radio station this morning that those who want to leave Quebec or work in the private system will face “consequences.”
The minister announced Sunday evening he plans to table a new bill to force new family physicians and specialist doctors to start their careers in Quebec.
The government estimates it costs between $435,000 and $790,000 to train a doctor, including during their residency.
It says there has been a 70 per cent increase in the number of doctors working exclusively in the private system since 2020, adding that the trend is especially notable among new doctors.
Dubé has not said how long new doctors would have to remain in Quebec, or what consequences they could face if they leave.

10-17 October
Allison Hanes: We should all be outraged by the latest idea for solving Quebec’s family-doctor crisis
Taking away people’s GPs and reassigning them to the most vulnerable patients would only worsen the health of all Quebecers.
… It is estimated the province is lacking 1,500 family doctors, while more than two million Quebecers are orphans, dependent for all their health needs on walk-in clinics, emergency rooms or a new triaging hotline that will find you a one-time appointment with a random physician.
Losing your GP is stressful and the long wait to find a new care provider is frustratingly long. But all Quebecers should be extremely worried about the plan in the works to resolve the scarcity of family physicians once and for all: cutting loose all the people in decent health and assigning only vulnerable patients with chronic conditions to dedicated doctors.
The news trickled out last week with the release of a study by the Institut national d’excellence en santé et services sociaux, which suggested that 1.5 million medical appointments a year used up by Quebecers in decent shape visiting their physicians could be reallocated to some 500,000 stray patients with moderate to serious health problems. Everybody else would just book an exam as needed through the Guichet d’accès à la première ligne (GAP), the new central booking service that matches unattached patients with vacant appointments.
… Whether you have a family doctor or are hoping to find one, all Quebecers should be outraged.
The abrupt severing of the relationship between six million Quebecers and their trusted physicians will not help those on waiting lists. The inconvenience of having to see a different primary care provider at a different clinic each time you have a medical problem will not improve anyone’s health — just ask those stuck in limbo right now. The complete abandonment of preventive medicine will lead to more sick people in the long run. …

Quebec studying reassigning family doctors based on person’s health
(CTV) The François Legault government could withdraw no fewer than 1.5 million medical appointments from people who have family doctors and redistribute them to people who do not.
This is one of the options proposed by the Institut national d’excellence en santé et en services sociaux (INESSS) in a study on primary care published this week.
Under this option, only the most vulnerable people with health problems would be assigned to a family doctor, to the disadvantage of healthy people. The Coalition avenir Québec (CAQ) had originally promised access to a family doctor for every patient(opens in a new tab).
During question period on Thursday, Health Minister Christian Dubé referred to new “vulnerability criteria” for care that had been defined by INESSS.
“Doctors have asked us to revise the criteria for patient vulnerability. It’s not done like that, by shouting with scissors,” he said.
“We will present this list of new criteria to my colleague [Treasury Board President Sonia LeBel] who is negotiating with the doctors, and we will be able to find solutions so that doctors … are obliged to take on vulnerable patients.”
These scenarios are part of the negotiations to renew the agreement with the Fédération des médecins omnipraticiens (FMOQ).
Quebec mulls scrapping family doctors for healthy patients
Scenario would have only those deemed more vulnerable assigned a family doctor
(CBC) … A report by the Institut national d’excellence en santé et en services sociaux (INESSS), commissioned by the government and made public on Wednesday morning, lays the foundations for such a model.
This INESSS report indicates that 500,000 sick Quebecers do not have a family doctor, and suggests transferring up to 1.5 million annual appointments from patients who have a doctor to those who do not.
Of the 2.1 million Quebecers who were not registered with a family doctor in 2022-23, INESSS estimates that nearly half a million have major or moderate health problems. These patients are classified in the red and orange categories by INESSS.
These categories include, among others, people with depressive disorders, anxiety disorders, cancer, dementia, eating disorders and acute palliative conditions.

26 September – 1 October
Allison Hanes: MUHC blood-test restrictions are another obstacle for doctors and patients
Starting Tuesday, the McGill University Health Centre’s blood-testing services are not only inaccessible for people who don’t live on the island of Montreal, but also for the patients of family doctors in the city, including those working in the neighbourhoods close to the hospital.
The move is intended to unclog the busy testing centre for those seeking specialized care or receiving emergency treatment at the MUHC. However, some fear the policy will erect new barriers for patients and further complicate the work of family physicians.
…as of Oct. 1, 2024, the blood collection centres at the Royal Victoria Hospital (Glen site — adults) and the Montreal General Hospital will mainly serve patients with requisitions prescribed by an MUHC prescriber.”
The change will not affect the blood testing services offered at the Montreal Children’s Hospital and Lachine Hospital. And it does not cover tests like X-rays, obstetric ultrasounds, mammograms, or more complex diagnostics like cardiac MRIs.
MUHC requesting off-island patients go elsewhere for some services
The MUHC is asking off-island physicians to refer their patients to centres in their region rather than to MUHC centres.
(CTV) The McGill University Health Centre (MUHC) is trying to reduce congestion at its major hospitals by not accepting off-island requests for blood tests and imaging examinations.
MUHC spokesperson Gilda Salomone said that the blood collection centres at the Royal Victoria Hospital and Montreal General Hospital will “mainly serve patients with requisitions prescribed by an MUHC prescriber,” as of Oct. 1.
“At present, people have to wait about three to four months to get an appointment for a blood test at one of Quebec’s blood collection centres,” she said. “Many local service points within CISSSS and CIUSSS are open and available, offering the Quebec population the possibility of having an additional blood sampling service.”
Salomone said that the change would not affect the Montreal Children’s Hospital or the Lachine Hospital.

12 September
MNAs unanimously adopt motion saying Quebecers don’t need certificates for English health care
The Liberal motion in the National Assembly came in response to fear and confusion caused by a July government directive.
“This is a significant step,” said Eva Ludvig, president of the Quebec Community Groups Network (QCGN). “It may have little force in law and I’m told the minister could theoretically choose to largely ignore it, but this full expression of the assembly’s view is an important statement.”

12-17 August

Aaron Rand and Bill Brownstein chat with Eric Maldoff, lawyer and political advisor and Sylvia Martin-Laforge, Director General of the Quebec Community Groups Network (QCGN) on The Corner Booth at the Snowdon Deli on Friday, August 16, 2024

‘Every 4 to 6 months, they pick an issue and attack the English-speaking community’
Quebec’s directive on language in the health care system is just another example of political pandering, says lawyer Eric Maldoff.
(The Corner Booth) Earlier this week, Quebec French Language Minister Jean-François Roberge said there were “huge misunderstandings” surrounding his directive on the use of languages other than French in the health care system. …Eric Maldoff doesn’t buy it.
“This is not a friendly, good-faith, accidental matter. This is deliberate, conscientious — they do wanna wipe English off the map as a public, as a legitimate language in Quebec,” he told Aaron Rand and Bill Brownstein in this latest episode of The Corner Booth.
Maldoff was joined by Sylvia Martin-Laforge, director general of the Quebec Community Groups Network, who said the messaging she’s received from Quebec officials has not assuaged her concerns.
“Either the left hand doesn’t know what the right hand is doing or there’s serious obfuscation here about their intentions around the English-speaking community,” she said.

Some anglophone groups refused to meet with Quebec’s language minister. Here’s why
The QCGN and Director General Sylvia Martin-Laforge showed “a lot of chutzpah” by turning down a meeting with Quebec French Language Minister Jean-François Roberge to discuss directives around language in health services, says Andrew Caddell, president of the Task Force on Linguistic Policy. “Why sit down,” he asks, “when it’s going to be another one of those consultations like Concordia and McGill, where basically they (the government) are telling them what the conditions will be rather than holding a genuine consultation?”
Roberge pledges new health-care language directive after meeting anglo groups
But he said the existing directive will be in force until the updated version is ready. The QCGN, which was not invited to the meeting until the last minute, countered that it “must be suspended immediately.”
(Mtl Gazette) “Health care and social services are accessible for the English-speaking community, no questions asked. They don’t have to show any documents, any certificates at all,” says Quebec French Language Minister Jean-François Roberge.
“We are coming with a new way to formulate it, with new wording, which will be more clear that you don’t have to have your life at risk” to receive services in English, he said, adding that people can receive care in English for any health concern.
Roberge said he met Tuesday with a provincial committee on social services and health care; Seniors Action Quebec; 211 Montreal; the Cummings Centre, a community centre for adults over 50 in Montreal; as well as committees from Jeffery Hale — Saint Brigid’s, a Quebec City health-care institution serving the English community, to discuss the directive. …
Quebec to replace directive on language in health care after original sparked confusion
(CBC) Roberge isn’t reassuring anxious English-speaking community, says Townshippers’ Association director
Minister of the French Language Jean-François Roberge met with some groups of Quebec’s English-speaking community to clarify the directive on the use of English in hospitals
Roberge met with stakeholders of Quebec’s English-speaking community on Tuesday to hear concerns about how the province’s language law would be applied in a health-care setting.
The meeting comes days after Liberal MP Anna Gainey called for detailed explanations on the Health Ministry directive, saying constituents worry it will interfere with their ability to get care in English.
Following what Roberge called a “pretty cordial” meeting with six health and social services groups, he told CBC News that the government started clarifying the directive a few days ago. He would not provide a time frame for when the revised instructions would be published.
Key anglo leaders excluded from meeting with Roberge on Tuesday about health-care rules
Health Minister Christian Dubé and Eric Girard, in charge of anglophone relations, will not attend the meeting on the directive that appears to limit the use of English in health care.
Several anglophone leaders have expressed disappointment that Tuesday’s meeting will only be with French Language Minister Jean-François Roberge. “It is vital that (Health Minister Christian) Dubé be present. This concerns his ministry,” said the Quebec Community Groups Network
Anglophone leaders are outraged that French Language Minister Jean-François Roberge has decided not to invite several prominent community representatives to a meeting Tuesday, and two other government ministers will not attend as promised to address concerns about a new directive that appears to limit the use of English in health care.
“We were not surprised to be left off the list of hand-picked invitees for a meeting about language directives in the health-care system by … Roberge’s office,” the Quebec Community Groups Network (QCGN) declared in a statement Monday afternoon.
Andrew Caddell, president of the Task Force on Linguistic Policy and a councillor in the town of Kamouraska, said he had contacted Roberge’s office last week but was not invited either.

Health-care language directive fit for the shredder
Ministers have offered to “clarify” the new rules for when a language other than French may be use in medical settings. That won’t cut it.
André Pratte, chairperson of the Quebec Liberal Party’s policy committee
(Mtl Gazette) The government’s directive on the use of English in health care is a clear example of the fussy, dehumanizing approach feared when Bill 96 was adopted. However, a subliminal message emerges clearly: Even if it deals with Quebecers at a time in their life when they are most vulnerable, the health-care system is seeing francizing Quebec added to its primary mission.
In their open letter, the ministers say they are “open to clarifying the directive to make it clear that there will never be language requirements in Quebec to treat a patient.” That is not enough. The directive is a poorly conceived, poorly written document. The government should shred it.

9 August
Letter: ‘We are open to clarifying’ language directive, ministers say
“The government of Quebec’s intention has never been to restrict access to health care for English speakers in Quebec.”
Jean-François Roberge, Eric Girard, Christian Dubé
The government of Quebec imposes absolutely no linguistic conditions in health-care settings before providing health care in English to anyone who requests it. Every English-speaking individual in Quebec has the right to receive health and social services in English, as per Section 15 of the Act respecting health services and social services. This right is clear and in no way is being called into question.

7 August
Health-care language directive is immoral and dangerous
The CAQ government is prepared to sacrifice fundamental constitutional rights to life, liberty and security of the person to fulfil its language goals.
Julius Grey and Eric Maldoff
(Opinion Montreal Gazette) French Language Minister Jean-François Roberge has said he will meet with representatives of the English-speaking community to listen to their concerns about the government’s linguistic directive regulating the use of English and other mother tongues in health care.
Essentially, except in life-and-death emergencies, the government wants to restrict English health and social services to “historic anglophones,” now defined in the directive as “recognized English-speaking persons,” being those who are eligible for English education in Quebec and for whom an eligibility certificate has been issued, and to deny these services to francophones, “non-historic” anglophones and recent immigrants of all origins. Since there are major problems obtaining eligibility certificates because of additional overwhelming demand related to CEGEP admissions, the notion of English identity cards for those who qualify is both uncertain and very restrictive.
This is singularly inappropriate in the field of health and social services. There is considerable scientific evidence showing that the access to and outcome of care are seriously affected by the facility of communication with caregivers. Whether you are “historic” or not, whether you know how to speak French or not, it seems obvious that the choice of language belongs to the patient. It is not right for bureaucrats — who are not accountable for health and social service delivery and results — to intervene in the treatment and care of patients, to meddle in life-and-death situations or to decide to listen in as surgeons are operating.
New Quebec language directive undermines Canada Health Act: Gainey
Gainey’s invocation of the federal law sets up a potential clash between Ottawa and Quebec over linguistic matters that the Trudeau government has long sought to avoid.
Notre-Dame-de-Grâce—Westmount MP Anna Gainey has appealed to federal Health Minister Mark Holland to intervene under the Canada Health Act in a controversial new language directive in Quebec.
In an official statement posted on the X social media platform on Wednesday evening, the Liberal Member of Parliament said she had “serious concerns” about the directive issued on July 18 that restricts the use of languages other than French in the health sector to exceptional situations like emergencies. The 31-page directive by the Health Ministry also now requires of historic anglophones that they obtain an eligibility certificate from the Education Ministry to seek and receive medical services in English only.
Gainey suggested the directive may interfere with one of the five principles enshrined in the Canada Health Act (CHA) — that of accessibility, which guarantees that every Canadian “have reasonable access to insured hospital, medical and surgical-dental services on uniform terms and conditions, unprecluded or unimpeded, either directly or indirectly, by charges … or other means.”
Gainey has also been in contact “with a number of my caucus colleagues to ensure that the federal government, which is a major partner under the Canada Health Act, is aware of these concerns and prepared, if necessary, to step up and insist upon respect for its fundamental principles, in particular as it relates to universal access to care in both official languages.”