Legislation covers performance-based pay, severe penalties for collective resistance by doctors
The Quebec government has passed special legislation to impose a new compensation system on the province’s doctors, introducing performance-based pay and severe penalties for collective resistance.
Bill 2 was adopted in a special session of the National Assembly just before 4 a.m. on Saturday, following a call from Premier François Legault, reported The Canadian Press (CP).
The bill passed with a vote of 63 to 27, with Legault present. Health Minister Christian Dubé introduced the bill on Friday morning, expediting its passage. The legislation closely resembles Bill 106, tabled in May, but includes new provisions aimed at ending the ongoing labour dispute between the province and its family doctors and medical specialists.
Under the new law, a portion of doctors’ pay will be tied to performance targets, specifically the number of patients they care for, with a focus on vulnerable populations. Doctors who engage in “concerted action” to challenge the government’s policies could face fines of up to $500,000 per day, CP noted in the article published in Global News.
Alberta and New Brunswick have also previously launched new compensation models for doctors.
Doctors set to challenge Quebec’s new system
A couple of groups in Quebec are not happy with the new compensation model for doctors brought on by Bill 2 - An Act mainly to establish collective responsibility with respect to improvement of access to medical services and to ensure continuity of provision of those services.
And the province’s two largest doctors’ federations are now taking the provincial government to court over newly adopted legislation, according to a CBC report.
Dr. Vincent Oliva, president of the FMSQ, confirmed that the legal process is already underway. “It’s clear that there are legal elements in this that are absolutely ridiculous and questionable,” Oliva said, criticising the government’s approach and accusing Health Minister Christian Dubé of negotiating in bad faith.
“[Dubé] lured us to the negotiation table four times while he was working on a bill that he planned to adopt all along. That’s more than bad faith, it’s lying,” Oliva told CBC.
Shortly after, the FMOQ, representing family doctors, announced it would also challenge the law. FMOQ president Dr. Marc-André Amyot called the government’s approach “authoritarian” and warned that the new system would have “devastating effects on the accessibility of services for the population, demotivating effects for doctors.” He noted that Quebec is already short 2,000 family doctors and predicted the bill would worsen the shortage, potentially leading to early retirements and an exodus of physicians. “There is a shortage of 2,000 family doctors in Quebec and we are far from improving this shortage with a bill like this,” Amyot said.
Penalties for 'concerted actions'
The new law, which follows the framework of Bill 106 tabled in May, links 15 per cent of doctors’ annual salaries to performance indicators such as the number of patients seen and the complexity of cases, with collective monetary supplements for meeting targets.
The legislation also includes penalties for “concerted actions” like refusing to train future doctors, and imposes fines and loss of practice years for doctors who leave the province’s public network to practise elsewhere.
According to the Canadian Medical Association (CMA), the adoption of Bill 2 will have a detrimental effect on Quebec’s health network.
“The bill could worsen access to care and increase pressure on health professionals who are already stretched to their limits,” said CMA President Dr. Margot Burnell and spokesperson Dr. Jean-Joseph Condé in a press release. “It risks exacerbating the sense of discouragement and disengagement already felt by members of Quebec’s medical community. The resulting uncertainty could push many physicians to retire early or leave Quebec for other provinces, further weakening an already strained health care system.”
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