Julius Grey challenging in court how family doctors are distributed in Quebec

Julius Grey, the lawyer specializing in the defence of human rights, continued his battle against the system of distribution of family doctors in Quebec.

Grey will be heard by the Court of Appeal Thursday morning in Montreal, in the hope of having the measure deemed unreasonable.

All family doctors who practise under the Quebec public plan are required to hold a notice of conformity allowing them to practise in a region determined by the Ministry of Health and Social Services (MSSS). This authorization comes with the obligation to carry out “at least 55 per cent of their billing days” within this zone, it says on the government website.

It’s what’s known as “regional medical workforce plans” (PREM).

With this system, the government seeks to balance the presence of general practitioners in all regions to achieve a coverage rate of 85 per cent.

However, according to Dr. Mark Roper, represented by Grey, the calculations used by Quebec are simplistic, unrepresentative and based on erroneous data.

Consequently, the island of Montreal would find itself at a great disadvantage.

According to the tables presented by Roper during a conference held this week, Montreal had the lowest rate of registration with a family doctor among all regions of Quebec as of Dec. 31, 2021.

For comparison, the registration rate in Montreal was of 68 per cent compared to 75 per cent in Montérégie, which had the second lowest rate. The best served regions, according to Roper’s criteria, were Saguenay—Lac-Saint-Jean at 91 per cent and Gaspésie-Îles-de-la-Madeleine with 89 per cent.

At the sub-region level, the five worst registration rates are located on the island of Montreal. The metropolis even occupies eight of the last 10 places among the 129 Quebec sub-regions.

However, these are not the figures that the MSSS uses to determine its distribution of medical staff. The government simply bases itself on the population living in a region and the number of doctors practicing there. According to Grey, this reasoning is downright “absurd”.

He criticizes Quebec for ignoring patients’ right to mobility. Patients are free to consult a doctor in the region of their choice, regardless of where they live. So Montreal, which attracts thousands of workers from the northern and southern suburbs, is seeing its patient pool swell. The lawyer also emphasizes it is necessary to take into account the presence of tourists, diplomats and refugees who sometimes need care.

In an interview with The Canadian Press, Grey says he wants to attack the PREM system on two fronts.

First, by trying to demonstrate that it is an “unreasonable” administrative decision by relying on the criteria set out by the Supreme Court in the Vavilov decision. The court determined that an administrative decision must be understandable, reasonable and taken in accordance with the rules of natural justice.

Then, from another angle, he alleges the current version of PREM contravenes section 7 of the Canadian Charter of Rights and Freedoms which protects the “right to life, liberty and security of the person.”

–This report by La Presse Canadienne was translated by CityNews