Quebec doctors cautious as Bill 2 revisions expected ahead of Feb. 28 deadline

After weeks of pushback from doctors, the government delayed the implementation of Bill 2 at the end of December. A legislation that would have linked physician pay to performance targets.

The province has also agreed to backtrack on some of the bill’s most controversial elements, with changes expected before a new Feb. 28 deadline.

The controversy around Bill 2 was followed by the departure of health minister Christian Dubé, who cited difficult negotiations with doctors’ unions as a key factor in his decision. Sonia Bélanger has now taken over the file.

CityNews spoke with Montreal family doctor Dr. Michael Kalin, a Montreal family doctor in Côte-Saint-Luc and local coordinator for the Montreal Department of Family Medicine about what lies ahead for Quebec’s health-care system as the province enters 2026.

At this point, 2026, we’ve got a delay and proposed changes. How reassured are doctors in Montreal and across Quebec?

Great question. So at the end of 2025, Bill 2 was basically rescinded, but we don’t know what comes next. And the vote that was passed by 97% of family doctors gave our union, the FMOQ, carte blanche, the opportunity to negotiate on our behalf a new agreement.

What will that be? We don’t know. We’re obviously frightened. We’re obviously a little bit nervous about this. But the fact that Bill 2 is gone is reassuring. We can only hope that from now going forward, a better agreement will be negotiated. And certainly the signs on the ground are that the government is prepared to sit and talk this time, which is reassuring.

Christian Dubé cited difficult negotiations with doctors’ unions as a key factor in his decision for stepping down. What did you make of him leaving? Is it too late? Has the damage already been done?

Great question. So it was time for a minister to leave. We need a fresh face, a new approach. So I’m optimistic that he is gone. Yes, the damage has been done. Some doctors have left. Some clinics have closed. They’re not coming back.

We know that fewer graduating doctors have applied to work in Quebec or to work as family doctors. So the damage has been done.

We need to see what we can do now to fix it and to move forward. And there’s a lot that needs to be done. The new health minister has picked up a file that’s a mess, in my opinion, and needs to be re-looked at in so many ways, not just for family doctors.

It’s also for specialists, also for medical students, but also for Santé Québec, which has this whole bag of problems, including the debacle of the electronic medical records, which will remind people of the whole SAAQclic fiasco, with cost overruns and a product that is still not ready, despite a lot of promises.

As we approach the February 28th deadline, what changes need to be made? What do you need to see on the table?

Oh, there are so many things that need to be done. But the first thing I’d like to see done is that the government rescind some of the punitive measures that they passed last year. For example, the ridiculous penalties on new graduates, up to $100,000 a day for a new graduate who leaves Quebec, is not the way to entice people to work in your province.

Number two, the government passed legislation to reduce paperwork for doctors but doesn’t enforce it. Well, we need that. We need legislation that allows family doctors to spend more time with patients and less time doing paperwork.

As well, we need the PREMs licenses to be rescinded. It’s ironic: the government says to newcomers, “we’ll fine you if you don’t stay here,” but at the same time, they won’t offer you a job. The PREMs have been around for 25 years. They don’t work. They’re ancient. We need to be done with them so doctors have an opportunity to settle and open practices.

We also need to get rid of the A&Ps, the activities family doctors are mandated to do. The government is quick to say that family doctors don’t spend enough time seeing patients, but they always conveniently omit the fact that 30% of our time is mandated elsewhere. If we had 30% more time to work in the community seeing patients, wouldn’t this solve a lot of the problems?

It seems like the band-aids that have been accumulating over the last 25 years are part of the problem. I hope the new health minister, instead of adding more bandages to this growing wound, will actually remove them and get to the core problem. At the end of the day, we want family doctors seeing patients and working in the community, yet the legislation moves us further away from that. There’s a lot to be done. There’s a lot of optimism. I think it’s good that Minister Dubé has moved on. I wish him the best, and I hope the new health minister will come with an open mind and work collaboratively with family doctors and specialists.