(Quebec) Christian Dubé wants to “gradually wean” the public health network from the private sector. Maximum prices, doctors coming and going between the two regimes and the contribution of surgery clinics, the Minister of Health wants to review the contribution of the private sector.
Published at 9:40 a.m.
Christian Dubé took the example of his commitment to abolish the use of labor placement agencies in the public network by 2026 to explain his “vision” for the place of the private sector in the Quebec system of health. “I think we are gradually weaning ourselves off the private sector network,” declared the minister during a questioning at the Salon rouge on Tuesday.
« [Le privé] will always remain complementary [au secteur public]but perhaps not up to the level of what it is today,” argued Mr. Dubé. He also added that the debate in the coming months could make it possible “to agree on the transition period that we should have” to reduce the contribution of the private sector.
An interpellation is a parliamentary procedure during which a minister answers questions from the opposition for two hours. The exercise on “the rise of privatization in health care in Quebec” comes at the right time as the College of Physicians asked the Legault government on Monday to immediately curb the expansion of private health care.
On Sunday, Christian Dubé also revealed his intention to present a bill this session to force new doctors to begin their practice in the public network. On Tuesday, the minister argued that this will be a first element of his strategy. Mr. Dubé added that his upcoming bill could also be “stronger” than announced and contain other means of slowing down the development of the private sector.
“It’s really a social debate that we are having,” argued the minister, recalling that consultations will take place this spring following the tabling of the legislative text.
The Minister of Health mentioned that “it is obvious” that the rules allowing doctors to move back and forth between the public plan and the private sector “must be corrected.” Since March, Mr. Dubé has had in his hands a draft regulation approved by the RAMQ to increase the time required to disaffiliate from the public plan. Currently, a doctor can do this up to 19 times a year.
“I am surprised that we did not use this means to send a message,” said the member of Québec solidaire, Vincent Marissal, who asked the minister why he had still not presented the draft regulation to the council of ministers. Minister Dubé repeated on more than one occasion that he did not want to “contempt” parliament by giving too many details on the content of the bill.
“Reverse the trend”
Christian Dubé says he wants to slow down the exodus of doctors to the private sector. He also mentioned the imposition of maximum prices for private clinics. “It is not too late to reverse the trend,” added the minister. In 2023-2024, 888 doctors disaffiliated with the RAMQ. The minister recalled that this is around 3% of doctors and that they sometimes do it “sporadically”.
Before we are at 4, 5 or 6%, it is [maintenant] that we must say that it is enough. At 3%, we should be able to correct the situation fairly quickly.
Christian Dubé, Minister of Health
On the contribution of specialized medical clinics (CMS) which contributes to catching up in surgery since the pandemic, the minister exercised caution. “There is a minimum of privacy that we must maintain,” he said. Christian Dubé added that he does not regret having increased their contribution during the health crisis, recalling that Quebecers use the sun card for these surgeries.
“We will look in the coming months [comment] this combination [public-privé] can” continue to serve patients, he explained.
In September, Minister Dubé also presented a draft regulation to add around twenty specialized services which could be added to those already offered under the Regulation respecting specialized medical treatments provided in a specialized medical center.
