new doctors could face fines up to $200,000 for going private under quebec bill
health minister christian dubé's bill would force graduating doctors to work in the province's public system for at least five years.
4 minute read
we apologize, but this video has failed to load.
try refreshing your browser, or
tap here to see other videos from our team.
tap here to see other videos from our team.
quebec — health minister christian dubé wants to oblige new doctors and medical specialists to initially practise in the public system after graduation or face stiff financial penalties. dubé tabled legislation, bill 83, in the national assembly on tuesday that would require students who studied medicine in a quebec university to devote the first years of their professional lives, as general practitioners or specialists, to working in public institutions instead of leaping to more lucrative jobs in the private system.
the minimum period in the public system will be five years, according to the bill, titled an act to foster the practice of medicine in the public health and social services network.
the government may also, “if it considers it appropriate,” require student doctors to sign a formal commitment at the start of their education to practise in quebec for the given period.
the bill includes stiff fines for non-compliance. a doctor refusing to follow the rules would face fines of between $20,000 and $100,000 a day and per insured act. a repeat offender would face fines ranging from $40,000 to $200,000.
tabled in the last week of the sitting of the legislature, the bill will not be adopted immediately. the house recesses for the holidays friday.
advertisement
the bill also does not stipulate exactly when it would come into force. dubé said that decision will follow hearings on the proposed legislation in february.
“my objective is not to hurt doctors,” dubé said at a news conference to explain the bill. “my objective is very clear: reinforcing the public system.
“it’s not just the fact that people are going private that is the problem. it’s that it took us eight years to educate them.”
quebec considers doctors opting for the private system to be a growing issue even if they represent a small minority.
among the 22,479 doctors licensed in quebec, 774 are working exclusively in the private health network — a 70 per cent increase since 2020, data supplied by the health ministry indicates.
a total of 136 family doctors left the public system in the first years of their practice between 2022 and 2024. fifty-seven specialists did the same thing.
some have also left the province. the government estimates that 2,300 doctors educated in quebec in the last 20 years are now working in ontario. it does not have a number for the united states.
there is also the cost issue. the ministry has indicated the cost to quebec taxpayers of training a doctor, including residency, is between $435,000 and $790,000. at the same time, the number of spots to study medicine in quebec’s education system is limited.
advertisement
it can take as long as 10 years to educate a person seeking to become a doctor.
“we are giving ourselves the means to ensure the population has access to the care that they are paying for,” dubé said. “the great majority don’t need this law. i think we are just aiming at the ones who, within the first five years, are going to the private (system). the message is we need them in the public.”
reaction to the bill was swift.
the collège des médecins du québec welcomed the legislation, which it had been lobbying for. it had proposed a 10-year period in which doctors would have to work in the public system.
“we are in favour of a measure that reinforces the social responsibility of doctors toward the population,” the collège said in a statement.
the fédération des médecins spécialistes du québec (fmsq), representing 11,000 specialists, was more cautious, saying the government needs to take the necessary time in adopting a bill that could have serious effects on the careers of young doctors.
“we remind the government that the best way to retain medical specialists is to give them the means to exercise their profession in the public network,” the fmsq said in a statement. it added that if the government is taking this action for doctors, it should impose the same obligations on other health professionals.
advertisement
the fédération des médecins résidents du québec, representing residency students, said it has serious concerns about the bill and questioned the legality of a law that could discriminate against its members, particularly young doctors.
it accused the government of using a “legislative weapon” to counter the actions of a tiny minority, adding 100 per cent of its 4,000 members practise medicine in the public system.
meanwhile, quebec’s main opposition parties said they support the legislation in principle, but are anxious to examine the bill’s wording.
“if it has come to this and the minister feels obliged to have recourse to coercion, it’s the government’s own fault for favouring the private (sector) since arriving in power,” québec solidaire health critic vincent marissal said in a statement.
dubé’s bill follows his comments last friday that quebec’s powerful professional federations of gps and specialists are not being flexible enough to improve health care in quebec.
share story
