Doctors remuneration | The old demons of François Legault

“There has been no government for 23 years that has had the courage to change the way doctors pay […]. I will not go back, unlike other governments that have always backed away with the union of doctors. »»

Posted at 5:00 a.m.

Prime minister François Legault was probably talking about himself when he commented on his bill to “establish collective responsibility and the accountability of doctors”.

Because the present confrontation between the government and the doctors, who already brandish the means of pressure, resonates like a powerful echo of the past. And the challenge in question is more important than it seems in the political journey of François Legault.

To understand this, you have to go back in 2002, on the night of June 19 to 20.

Claude Dufresne collapses at his home in Shawinigan. His wife calls the ambulance. We do not transport her husband to the city hospital which is nevertheless a few steps from the house. For what ? Emergencies are closed for the night, due to a lack of doctors.

The 51-year-old man dies of a heart attack in the ambulance towards Trois-Rivières.

History is scandalous. François Legault was then Minister of Health, under Bernard Landry. He had a special law adopted to maintain open emergencies 24 hours a day, forcing doctors to be present under penalty of financial sanctions. Some are even summoned by bailiff.

Doctors accuse François Legault of having an “authoritarian” approach. His special law poisons the negotiations underway with medical federations.

Two words come back at the time to designate the priorities of François Legault: “performance” and “accountability”.

Do you sound a bell?

Let’s continue. The experience of the past is instructive.

“The arm in the twist”

In 2002, François Legault’s position on the remuneration of doctors, but also on the distribution of medical staff in the regions, raised the anger of the federations. Specialist doctors are mobilizing and holding “study days”. More than 3000 of them meet at the Olympic stadium.

What does François Legault do? He ends up going back. He throws ballast and improves his offer. The context is important: Bernard Landry is preparing to trigger general elections.

Specialist doctors affect a 7 % increase in two years. Above all, Mr. Legault signs a letter of understanding in which the government undertakes to correct the remuneration gap between Quebec specialists and their colleagues from the rest of Canada. He puts us “arm in the twist”, as Philippe Couillard will say for years later. Doctors specialists will indeed obtain generous increases over the years, under the Liberals.

Today, François Legault assures that he will not back up when doctors denounce his “special law”, but how far is it ready to go?

After all, it is not the first time that he has said in substance, as today, that “it will brew” with the doctors and that he will stand up to them. In 2018, he undertook to reduce the annual envelope of compensation for specialists by $ 1 billion. The agreement concluded with the Federation of Doctors Specialists from Quebec (FMSQ) Thereafter is light years of this promise. “It’s the best day of my mandate!” »Even launches the D^re Diane Francœur in front of its members after the conclusion of the agreement.

In the manifesto of the CAQ

As we can see: the Legault government’s intention to link a share of the compensation of doctors to achieve performance objectives simply does not pass. Doctors specialists are considering means of pressure. The electoral “ICT-TAC” is heard: Quebecers will be called to the ballot boxes in less than a year and a half … and the results promised by the government in access to health care is slow.

If François Legault is so insistent about the method of remuneration for doctors, it is because it is not an issue like any other for him. It is little known, but he is one of the “four major fields of action” that he had identified when he returned to politics in 2011.

In his founding manifesto of the Coalition Avenir Québec (CAQ), François Legault talks about concluding a “new pact with doctors” and developing “performance indicators”. Let us remember that the following year, he recruited as candidate Gaétan Barrette to reform the health system.

Then became Minister under the Liberal banner, Gaétan Barrette has law 20 adopted which fixes performance targets to doctors. But the settlement to impose sanctions on doctors in the event of failure is never deposited because Gaétan Barrette loses the support of Prime Minister Philippe Couillard.

Christian Dubé’s bill also requires the filing of a settlement to be implemented. And these regulations will come at the end of negotiations with the federations, according to the minister.

Negotiations have the annoying habit of being long. And time is running out.

If the past is the guarantor of the future, a healthy skepticism is to start the government’s strategy.

François Legault thinks that the balance of power has changed over the years. In the past, “there were God and afterwards, there were the doctors. They have less support from the population [à la suite des] 50-60 % increases they have had in recent years, “the Prime Minister said The press. However, its own popularity rating is today at the lowest depending on the polls.

The battle of public opinion promises to be entertaining.