Dubé presents Bill 106 to change the way Quebec doctors are paid

The CAQ government wants to link doctors’ remuneration to performance indicators with the aim of having them treat more patients.

On Thursday, Health Minister Christian Dubé tabled Bill 106 in the midst of negotiations to renew the framework agreement with the two medical federations.

At a press conference, Dubé called the bill a big change that would connect every Quebecer to a healthcare professional.

“The good news is we will assign all Quebecers, even though they are in good health, to a [healthcare centre], either a clinic or a GMF,” he said referring to the system where a patient is assigned to a group of family physicians who collectively offer care.

The bill has been poorly received by doctors, who have described it as a “special law.”

It was also not in alignment with recommendations by the government’s expert committee that specifically examined access to primary care, La Presse reported.

In their report, the expert committee called for more investment into primary care teams that included doctors, nurses and other healthcare professionals for increasing access to services. 

Mylaine Breton, professor of community health sciences at l’Université de Sherbrooke, one of the authors of the report said that focusing on doctors alone would be insufficient and that changing their compensation model was not one of their recommendations.

“It’s not only family physicians, it’s investing in primary care teams, where you have nurse practitioners, where you have nurses, social workers,” Breton said.

Another author of the report Dr. Élise Boulanger, family physician and co-founder of Clinique Indigo, said that staffing of primary care teams has been an issue and the focus should be on improving the stability of other healthcare workers that surround doctors.

“The positions are not fully filled or there’s a lot of rotation of the team. So there’s a lack of stability in the teams. And so there’s difficulty to really push forward this inter-professional work,” Boulanger said.

The official opposition in the National Assembly said it believes the government is looking for “negotiating leverage.”

Dubé said that based on their data, he was confident that the new bill will ensure that every Quebecer will be linked to healthcare professionals in just over a year.

“We have access to all the information that the doctors see and given that law, all the transparency of data that has been put, we can find out by GMF, by clinics, how many people are being seen,” Dubé said. “So I think we have the information now that allow us to make sure that all Quebecers will be seen.”

Approximately 1.5 million Quebecers do not have a doctor or regular health professional, which corresponds to 17 per cent of the population, according to the government.

–This report by La Presse Canadienne was translated by CityNews