Prime Minister François Legault threatens to legislate in the short term to force family doctors to take care of a greater number of patients.
In his inaugural speech on Tuesday, he said he was getting impatient and Wednesday, in the press scrum, he went on to say that the legislative route would soon be considered, if the doctors do not comply quickly.
A few months before the election deadline, a tug-of-war is therefore shaping up between the Legault government and the Federation of General Practitioners (FMOQ), which refuses the hard way.
This is not the first time that the tone has risen and that Prime Minister Legault threatens to wave the legislative stick if the doctors do not submit to Quebec’s ultimatum, except that this time time is running out, the government being in the last year of office, while the situation has continued to deteriorate.
In 2018, François Legault’s Coalition Avenir Québec (CAQ) committed to providing a family doctor to all Quebecers before the end of their mandate. There were then 400,000 patients on the waiting list. There are currently double the number, over 800,000, making the pledge difficult, if not impossible, to keep by October 2022.
To hope to reverse this trend, the Prime Minister says he is ready to go “as far as a bill”.
The fewer patients have a family doctor, the more congested hospital emergency rooms and walk-in clinics.
In the past, waving the stick rather than the carrot in front of doctors, however, has yielded few results, apart from mutual mistrust and a climate of growing tension between Quebec and the medical profession. Former Minister of Health Gaétan Barrette adopted Law 20 in 2015, providing for financial penalties imposed on doctors who did not meet the government’s productivity targets.
To explain the constant increase in the number of orphan patients, the FMOQ defends itself by arguing in particular that there is a shortage of around 1,000 family physicians in Quebec, that general practitioners are required to work in CHSLDs and in hospitals, which correspondingly reduced their availability in practice, not to mention that retirements are increasing. She adds that it is wrong to suggest that the productivity rate of physicians is low, when on average they work about 45 hours per week.
Family physicians take between 1,000 and 2,000 patients under their wing. However, having your name on a doctor’s patient list does not automatically guarantee access to care or an appointment at the desired time.
At the same time, the government wants to impose soon on doctors a transformation of their method of remuneration, where fee-for-service would give way, in part, to the number of patients registered on their list. Quebec believes that this method could also help facilitate access to a family doctor.