Quebec minister Lionel Carmant resigns amid furor over doctor payment bill

Social Services Minister Lionel Carmant has announced his resignation amid an uproar over a recently passed law that imposes a new payment system on the province’s doctors. 

Carmant announced his resignation from the governing party this morning, accompanied by Premier François Legault. 

“The last few weeks have been difficult and have led me to refocus my priorities,” he told reporters in Quebec City. “I have always believed that political engagement should be exercised with balance, clarity, and honesty towards oneself and others. I am choosing my family, the family that my wife and I have built together.”

Carmant was first elected when the Coalition Avenir Québec formed government in 2018. He was named social services minister in 2022. Carmant will remain an Independent member of the provincial legislature. 

Carmant expressed discomfort earlier this week with the new law, which ties part of doctors’ remuneration to performance targets. The law, known as Bill 2, also prohibits them from using pressure tactics in protest. Physicians have been in uproar since the government rushed the bill through the legislature last week.

On Tuesday, Carmant said his wife and daughter, both doctors, were angry. “It’s not easy at home,” he said. 

Carmant’s daughter, a physician, has published an open letter criticizing the new law, which ties part of doctors’ remuneration to performance targets. 

Laurence Carmant, a maternal-fetal medicine specialist who is preparing to return to Quebec from Toronto, said the government is blaming individual doctors for a lack of productivity that is actually the result of a “profoundly broken system.”

On Thursday, Legault thanked his longtime colleague — but avoided addressing the law that prompted the now former minister’s departure.

Legault said he understands that Carmant has to put his family first. “Today is not the day to talk about Bill 2, but I understand that there are some very emotional reactions, and I think that’s normal,” he said. 

Moments later, sparks flew in the national assembly — opposition members accused the CAQ government of ignoring its own experts and the people inside Quebec’s healthcare system.

“The minister of health did not listen to the experts, did not listen to his colleagues in the caucus, and did not listen to his department employees who lost their jobs,” said Marc Tanguay, Quebec Liberal Party MNA and official opposition critic for health.

“Does this interfere with the way doctors are doing things at the moment? The answer is yes, but we have a duty not to accept the status quo,” said Christian Dubé, Quebec health minister.

The new law links a percentage of physicians’ pay to performance benchmarks such as appointment and surgery numbers, with the intent of encouraging physicians to take on more patients. It was forced through by the government last week after months of resistance by the province’s doctors. 

The bill also includes measures to prohibit boycotts that could affect patient care. According to the legislation, doctors could face fines of up to $20,000 a day if they take “concerted actions” such as deciding in groups of three or more to refuse to teach students or to leave the province.

Doctors immediately began protesting the new law. The province’s federation of medical specialists filed a legal challenge of the bill in Quebec Superior Court this week. The federation’s president, Dr. Vincent Oliva, on Thursday called on Legault to “halt this catastrophe unfolding before our eyes.”

Oliva said the open letter penned by Carmant’s daughter was “powerful,” and he understands Carmant’s decision. “We all saw that he was torn between his professional life and his personal life,” he told reporters in Sherbrooke, Que. 

Interventional cardiologist Dr. Raja Hatem says the move reflects how Quebec isn’t listening to its doctors

“Dr Carmant is the only physician in the government of the CAQ, and he’s the only person who has worked in the field,” said Dr. Hatem. “Doctors have been removed from circles of decisions, and this is what ends up happening.”

Meanwhile, the Federation of Medical Specialists of Quebec (FMSQ) — held a press conference Thursday confirming their lawsuit against the province will be heard next week in superior court.

The FMSQ says the law encourages a culture of silence – and violates basic rights and freedoms.

“In the English version, it says “two or more.” this means that a couple of doctors who, for example, discuss changing or redirecting their practice in a different way could be fined,” said Dr. Oliva.

“I saw a lot of my colleagues in distress, not being able to perform,” said Dr. Hatem. “We agree that there is a problem. Just listen to us and give us the tools we know are needed on the field.”

—With files from The Canadian Press