The MP for Pontiac, Liberal André Fortin, deserves an award of excellence for his spectacular demonstration, in full parliamentary committee, of the difficulty of making an appointment with a doctor.
Under the eyes of the Minister of Health, Christian Dubé, Mr. Fortin tried in vain to obtain a consultation with his family doctor through the Rendez-vous santé Québec site. His assistant, who does not have one, tried his luck with the First Line Access Counter (GAP), without further success. In politics, where we are used to living in half-truths, being contradicted by reality is a frequent thing, but we don’t get used to seeming crazy.
Mr. Dubé had no other option than to recognize the ineffectiveness of his system, but he suffered the blow.
He had accomplished a feat by succeeding in convincing Quebecers to trade their right to a family doctor, which the Coalition Avenir Québec had promised to guarantee, against access to a health professional (whether a doctor, a nurse or a pharmacist) as part of a family medicine group (GMF).
There are, however, limits to passing bladders off as lanterns. He could have expected the doctors to help him sweeten the pill rather than put obstacles in his way. However, he is not the first – and he will certainly not be the last – to note that, in their minds, the system must be at their service and not the other way around.
Mr. Dubé has clearly had enough of being the joke’s turkey. Since half of the new patients registered with GAP have not been seen once in two years by the doctor who was supposed to take care of them, he decided to abolish it as of 1er May the bonus of $120 paid for each new registration.
Unsurprisingly, the Federation of General Practitioners (FMOQ) contests the interpretation of the ministry’s data, not all new registrants necessarily need to see a doctor, and it argued that the minister’s decision risked harming the accessibility and to encourage GMFs to lay off nurses. “Maybe that’s what he wants,” even insinuated his president, Dr Marc-André Amyot.
This is not the first time that the support premium has hit the headlines. In 2014, former Minister of Health in the Charest government Yves Bolduc had to repay part of the $215,000 he received for recruiting 1,500 patients in 18 months when he temporarily left politics, after the Liberal defeat. of 2012, patients that he had to abandon after being elected again and appointed to Education by Philippe Couillard.
The existence of this bonus, which had been maintained despite the outcry, greatly bothered the former Quebec Solidaire MP Amir Khadir, himself a doctor. “We must stop creating conditions where doctors can be ashamed of their profession. The image that this sends to the public is that they want to have more to do the work for which they are already paid,” he declared.
The latest episode is part of the negotiations for the renewal of the framework agreement between the Ministry of Health and the FMOQ, which was concluded in 2015 for a period of eight years and which expired on 31 March 2023. Frighteningly complex, it oversees 56 specific agreements, one of which deals specifically with GMF and still bears the signature of François Legault, who was Minister of Health when it was concluded in 2002.
Whether with specialists or general practitioners, each round of negotiations inevitably turns into a standoff from which the doctors ultimately emerge victorious. Regardless of the loss of prestige that their rapacity may have caused, they retain a formidable balance of power.
It’s been a bad week for Christian Dubé. The rejection by the nurses of the agreement that the management of the Interprofessional Health Federation had nevertheless accepted was another hard blow. The President of the Treasury Board, Sonia LeBel, nevertheless declared that the government’s objectives “will remain the same, particularly in terms of flexibility.”
All this portends difficult months ahead and will not facilitate the “refoundation” of the network on which Mr. Dubé has now been working for two years. He will be able to find the top gun most effective to lead the new Santé Québec agency, the collaboration of the different actors remains essential to the success of the operation, but it is as if they had given themselves the word to make it abort.
Of all the members of the Legault government, he is undoubtedly one of the few who still inspire confidence. It would be regrettable to see him fail in his turn, but the real turkey in this sad farce would once again be the population.