Latest news with #Bill106
Yahoo
10-07-2025
- Health
- Yahoo
Family doctors in the Outaouais considering their options under Bill 106
Some family doctors in the Outaouais are threatening to pack up and move to Ontario if the Quebec government follows through with plans to legislate how health professionals are compensated, while others are considering early retirement. That's according to the president of the association representing about 450 family physicians in the region, and who says the uncertainty and discourse around Bill 106 is pushing doctors away. "Some have already decided to leave, unfortunately," said Dr. Guillaume Charbonneau, president of l'Association des médecins omnipraticiens de l'ouest du Québec. "We want to work quickly to make sure that those who are [thinking about leaving] don't go." Bill 106, tabled in May, would tie up to one-quarter of physicians' pay to their performance in an effort to encourage them to take on more patients. The bill proposes a mixed model of remuneration for family doctors including "capitation payments" (an annual flat rate per patient based on their level of vulnerability), an hourly rate for time spent with patients, and a fee for service. Part of each doctor's pay would also be tied to their collective performance based on targets set at the provincial and local levels. Those targets aren't specified in the bill, but aimed at improving wait times, absenteeism rates and overall quality of care, according to comments made by Quebec Health Minister Christian Dubé during legislative hearings around the bill. 'Fast food' medicine Charbonneau, who practises as a family doctor in Maniwaki, said working under such performance measures can have drawbacks. "Family doctors don't want to work like a fast food medicine — they want to have time with their patients and do good medicine," he said. "They want to work to improve [care], but not at the cost of quality of medicine." Those concerns are echoed by Dr. Mélanie Lacasse, who practises family medicine in the Buckingham sector of Gatineau. She said some physicians in the region are considering early retirement, and at least one doctor she worked with has already made the move to Ottawa. "I can't see how it is possible for physicians to continue if they start to increase the amount of work that they want us to do," said Lacasse, who also drew a comparison to fast food. "We won't have the time because they want to take everybody under our care, which is impossible." She worries the problem could snowball if the bill passes and more physicians leave the profession or the province. Lacasse and three other doctors from the region who are demanding the withdrawal of Bill 106 met with the minister responsible for the Outaouais, Mathieu Lacombe, in June to discuss the subject. Lacombe didn't answer questions from Radio-Canada, but Lacasse said the minister was sensitive to their concerns. A spokesperson for the Quebec health minister's office told Radio-Canada in French that they will be spending the summer analyzing feedback on the bill and discussing any necessary improvements. Dr. Pierre Villemaire, who's nearing retirement, said he'll be watching closely. "I'm waiting to see how I'll survive emotionally to all this, and whether I can keep on going, whether I need to slow down more quickly because I'm exhausted," he said. Villemaire, a family doctor for 30 years, said he worries about the future of family medicine in the province. "I think Bill 106 is a small part of a big, big issue. Health care on the Gatineauu side is just horrible," he said. "It's been going downhill for the last 25-30 years, and we're not getting ahead anywhere."
Montreal Gazette
06-06-2025
- Politics
- Montreal Gazette
As session wraps up for summer, Legault vows to lead CAQ into 2026 election
Quebec Politics QUEBEC — Facing criticism over reforms on everything from doctors' salaries to the CAQ government's energy policy and with Quebecers feeling the pinch in their pocketbooks, Premier François Legault vowed on Friday to soldier on and seek a new mandate in 2026. 'It's not easy for all governments in the world,' Legault said at a news conference wrapping up what has been a rocky winter sitting of the National Assembly. 'It's not easy. Its easy to say it's the fault of the government. 'I think it's normal. But when you look at the facts, we did better than Ontario and the rest of Canada for increases in salaries and disposable income. But people don't feel it. They say 'I don't feel I have more money. I count on you to explain.'' Referring to his other challenges, Legault said: 'What's important for me is not popularity. It's about results. I'm proud of the results.' Legault was responding to a series of rocks falling on his administration from all sides — from the powerful medical and labour union movements and the opposition parties, who spent the morning painting the Coalition Avenir Québec government, which is nearing the end of its second term in office, as tired and washed up. Parti Québécois Leader Paul St-Pierre Plamondon went so far as to say at his end-of-session news conference that Legault no longer has the 'democratic legitimacy' to govern and called on him to call an early election. 'I think he has to take a long walk on the grass,' interim Liberal leader Marc Tanguay added, in a reference to former prime minister Pierre Trudeau's famous walk in the snow in February 1984 where he decided to resign. 'I don't think he is the man of the situation. I think his time is past. François Legault needs to examine his conscience this summer.' Legault was ready with an answer. He's staying and so are his ministers because he is not planning a summer cabinet shuffle. 'We got a strong four-year mandate,' Legault said at a news conference in the lobby of his office. 'There will be another election in October 2026. It will be up to Quebecers to choose. 'There won't be any walk (in the grass or snow). I will be candidate in 2026, and I am going to win a third majority mandate.' Referring to Health Minister Christian Dubé's battle with Quebec's medical specialists and GPs over Bill 106, which would peg part of their wages to their performance, Legault said he's ready to fight. 'The easy thing to do is what other governments did, including that of Mr. Couillard, and backtrack,' Legault said. 'But I think for Quebecers it's key for the efficiency of our health-care network that we change the way we pay the doctors. 'It won't be an easy battle, but it is necessary. I won't backtrack, never.' He had the same tough talk to respond to those who said the government's fresh attempt to reduce the number of permanent and temporary immigrants in Montreal and Laval goes too far. On Thursday, Immigration Minister Jean-François Roberge called on Ottawa to cut in half the number of temporary immigrants in Quebec at the same time as tabling a consultation document in which Quebec proposes to drastically reduce the immigration category it controls. 'I know Québec solidaire and the Liberals are going to say we are blowing on the embers of intolerance,' Legault said. 'Listen, Quebecers are a welcoming people. We understand many people want to come and live here to improve their lives. 'But we have moved beyond our capacity to integrate. If we want to protect our language and our values, we have to reduce the number we have in Montreal and in Laval.' Legault also tried to shift the focus away from the gloomy economic picture by arguing his government has the courage to face the turmoil, including that created by U.S. President Donald Trump with his trade tariffs. He said Quebecers need a government that makes the economy a priority, with ministers who know which 'buttons to push.' 'More than ever, we need a nationalist government focused on the economy,' he said. He argued that his new, excellent relationship with Prime Minister Mark Carney, a man he has praised because he cares about the economy, can help get more job-creation projects off the ground. While political leaders indulged in fun banter in wishing each other well for the summer — it was Tanguay's last day on the job because the Liberals will elect a new leader June 14 — the session ended on a sour note with the government invoking closure to fast-track its energy legislation, Bill 69, into law. Here are a few of the major take-aways from the winter sitting of the legislature: New laws adopted: Despite almost constant friction with the three opposition parties, the government did push through several key pieces of legislation during the session. Top of the list was Bill 84 on the integration of immigrants. Also passed was Bill 89, the law to shorten and limit strike actions considering the needs of the population; Bill 98, which amends the Election Act to preserve the integrity of the electoral process; and Bill 90, an act to recognize ice hockey as the national sport of Quebec. The government decided to delay the adoption process of Bill 106 on doctors' wages until the fall. Also left hanging at the committee stage for clause-by-clause study was Bill 94 expanding the ban on religious symbols to all the employees in schools. Work on those bills will resume in the fall. Many sideshows: Current and incidental events rapidly derailed a parliamentary session that was supposed to be focused on secularism and language issues. It was not to be. Instead, the session was dominated by public squabbling between the government and Quebec's medical specialists and GPs over Bill 106. There were also almost daily shocking revelations from the Gallant Commission looking into the SAAQclic fiasco and even more shocking headlines on the state of the Maisonneuve-Rosemont Hospital. Bad financial news: In March, Finance Minister Eric Girard presented his spring budget, one that confirmed Quebec's bleak financial picture. Arguing Quebec had to boost infrastructure spending to save the economy from Trump, Girard announced a historic deficit of $13.6 billion for 2025-2026. Three weeks later, the respected Standard & Poor's (S&P) lowered Quebec's credit rating from AA- to A+. It was the first time in 30 years that Quebec got a downgrade. Opposition party ups and downs: The Québec solidaire opposition again found itself mired in controversies and dissent in the last few months. In March, after signalling for weeks his frustration, party co-spokesperson Gabriel Nadeau-Dubois stepped down from that role, saying he was worn out by the constant struggles within the party. 'The successive crisis have left scars,' a tearful Nadeau-Dubois said. Things got worse for the party. In the March 17 byelection in Terrebonne riding, the QS candidate, Nadia Poirier, bagged less than five per cent of the vote. Disillusioned that not a single MNA helped her during the campaign, Poirier defected to the PQ. The PQ itself ended the session on a high note, leading the pack in public opinion polls, but it emerged during the federal election that there was friction between it and its cousins in the Bloc Québécois. The Liberals end their session with high expectation that the new leader they pick June 14 helps them move out of the political hinterland. The legislature resumes sitting Sept. 16. This story was originally published June 6, 2025 at 4:37 PM.
CTV News
02-06-2025
- Health
- CTV News
Quebec pediatricians sounding alarm over Bill 106
Quebec pediatricians say that children are being forgotten in Health Minister Christian Dube's Bill 106.
Montreal Gazette
30-05-2025
- Politics
- Montreal Gazette
Letters: Health care isn't an assembly line
I think we should be very concerned that Bill 106 proposes to link up to 25 per cent of a doctor's pay to various performance objectives. As a student, I worked on an engine assembly line. The salary was indirectly tied to the number of engines produced. That measure seems reasonable for industrial production. However, I become nervous as a patient when a doctor, in analyzing our health issues, is pressured by performance objectives. Humans are different, and symptoms and conditions are not the same for all. Our daughter graduated almost 10 years ago as a doctor specializing in anesthesiology. Quebec had no residency available for her, but she was offered one in Alberta. She preferred to work instead of waiting another year and hoping for an opening here, so off she went out west. She could come home to Quebec, but would earn less than in Alberta, be chided by politicians to work more, and have no work-life balance. Why should she consider it? Ragnar Radtke, Beaconsfield Democracy in decline under CAQ Re: ' Dubé's bill could push physicians out, doctors warn ' and ' French-language sign rules kick in June 1, and non-compliance penalties are stiff ' (The Gazette, May 28) I wonder just when it was that our governments — and the Coalition Avenir Québec in particular — decided it was their responsibility to arbitrarily impose legislation and regulations onto the backs of taxpayers they purportedly have been elected to represent and serve. Aren't our doctors and retailers significant enough stakeholders in society to be encouraged rather than punished by the province? Unfortunately, under Premier François Legault, Quebec seems to have adopted an Orwellian 'Big Brother knows best' authoritarian mode of government with its unilateral implementation of whatever the CAQ decides is in the best interest of Quebecers. As a result, democracy — famously defined by Abraham Lincoln as 'government of the people, by the people, for the people' — appears to be rapidly disappearing in Quebec. One can only hope that next year's provincial election may help remedy the situation. Eric Bender, Kirkland Grand adventure in art of listening Re: ' N.S. man embarks on 'listening tour' across Canada ' (The Gazette, May 20) As a former oncology social worker at a major teaching hospital in Montreal, I can well appreciate the value of compassionate listening and how it can bring untold benefits to the heart, mind and spirit of someone who desperately needs to be heard. The art of listening is a gift. Too often, people and patients who earnestly wish to express deeply held emotions are cut off by those being spoken to with the offer of deceptive comfort — 'don't worry, everything is going to be all right.' Retired social worker Paul Jenkinson has embarked upon a 'listening tour' across Canada. He creates a safe space and listens to those who need to speak their mind, providing a most meaningful example of catharsis. The Dalai Lama effectively sums up Jenkinson's 'grand adventure' with his quote: 'Love and kindness are not a luxury, but a source of health and happiness for others and ourselves.' Brahms E. Silver, Côte-St-Luc Submitting a letter to the editor Letters should be sent by email to letters@ We prioritize letters that respond to, or are inspired by, articles published by The Gazette. If you are responding to a specific article, let us know which one. Letters should be sent uniquely to us. The shorter they are — ideally, fewer than 200 words — the greater the chance of publication. Timing, clarity, factual accuracy and tone are all important, as is whether the writer has something new to add to the conversation. We reserve the right to edit and condense all letters. Care is taken to preserve the core of the writer's argument. Our policy is not to publish anonymous letters, those with pseudonyms or 'open letters' addressed to third parties. Letters are published with the author's full name and city or neighbourhood/borough of residence. Include a phone number and address to help verify identity; these will not be published. We will not indicate to you whether your letter will be published. If it has not been published within 10 days or so, it is not likely to be.
Montreal Gazette
29-05-2025
- Health
- Montreal Gazette
Bill 106 will not boost productivity of doctors: health policy expert
By There is scant evidence that the Quebec government's proposed bill to tie doctors' pay to their performance will lead to more patients being treated, argues a prominent health policy expert. Damien Contandriopoulos, a professor of public health at the University of Victoria who had previously taught at the Université de Montréal, is highly critical of Bill 106, which proposes linking up to 25 per cent of a doctor's pay to performance targets as an incentive for them to take on more patients. 'It's a government that likes the notion of direct control, top-down, all the way from the ministry to the worker,' Contandriopoulos said in an interview Wednesday after he testified on Bill 106 at a National Assembly hearing. 'Centralized systems, data collection, heavy monitoring, and this kind of top-down, direct-control approach is generally not a great fit for super complex, extremely large systems like the health-care system,' he added. Bill 106 has sparked an intense backlash in the medical community, with physicians charging that the legislation would drive some doctors away from the profession or the province — and worsen patient care. The bill follows Health Minister Christian Dubé's creation of Santé Québec in December to run the province's $65.5-billion-a-year public system. Despite opposition to Bill 106, Premier François Legault has said the Coalition Avenir Québec government intends to have the legislation adopted. Dubé tabled the bill on May 8 amid contract negotiations with two Quebec federations representing physicians. The 25-per-cent pay figure tied to performance targets was calculated in a mathematical formula that Contandriopoulos described as 'complete nonsense.' Even if the performance targets aren't met, doctors would still receive 10 per cent, according to the formula written in the bill. In Contandriopoulos's report on Bill 106, he wrote similar past incentives in Quebec have not notably increased doctors' capitation — which is the term used for the number of patients a physician has on their roster, and the new rules would only make it harder for them to do their jobs. He illustrates that financial incentive systems are prone to 'gaming,' meaning doctors will try to exploit the system's flaws to their advantage. He cited a recent initiative in Quebec, the 'Guichet d'accès pour la clientele orpheline,' which tied a payment incentive to the registration of new patients. Because of a flaw in the system, he suggested many doctors retroactively enrolled patients who had already been treated. This gave physicians the financial benefit despite the fact they didn't take on additional patients. He also suggested that with Bill 106, doctors may be less motivated to take on complex cases that require extra attention and expertise if their remuneration were based largely on the number of patients they see. As a result, doctors may flood their schedules with patients who could be treated by nurses, social workers or other health professionals on their team as a way to maximize their patient load and increase their remuneration, Contandriopoulos said. If a doctor delegated their straightforward patients to nurses and social workers, 'then they would be stuck with demanding, challenging, long visits,' he explained, adding that this approach would be effectively penalized under Bill 106. 'They would go bankrupt because the system doesn't reward them to do so. So if we want physicians to really focus on the work that they are the best trained to do and where the benefit for society is the highest, we need to incentivize them to really focus on (these complex cases), which we do not.' Dubé said during a scrum Tuesday afternoon that Bill 106 won't be adopted this session of the National Assembly and he would like for discussions to continue. Amid the hearings on Bill 106, Dubé reiterated he wants 100 per cent of Quebecers to have access to a health professional by the summer of 2026.
