(Quebec) Newly graduated doctors will be forced to practice five years in the public sector before moving to the private sector. Christian Dubé also pulls out the stick: financial penalties of up to $200,000 “per day and per act” are planned for those who contravene the law.
Posted at 2:55 p.m.
Updated at 5:42 p.m.
The Minister of Health tabled Bill 83 on Tuesday aimed at promoting the practice of medicine within the public health and social services network.
“I think it is a minimum to ask students who end up in medicine, in our large universities […] to have this obligation,” explained Christian Dubé on Tuesday.
My objective is not to harm doctors, my objective is very clear, it is to strengthen the public system.
Christian Dubé, Minister of Health
Mr. Dubé announced his intention to legislate in November to curb the exodus of new doctors trained in Quebec universities to the private sector. The number of mandatory years remained to be determined.
The Minister of Health therefore sets the obligation at five years. This means that a doctor who begins his practice will have to choose the public network and Quebec – we also want to prevent doctors trained here from choosing to work in Ontario, for example. The law targets family doctors and specialists.
The legislative text provides that the government can require medical students and residents to “sign a commitment to practice medicine in Quebec” before the start of their training or residency. This contract will be accompanied by a penalty clause, we write.
What happens to those for whom their training or residency is already underway? What obligations will these contracts contain? These questions will be discussed during special consultations on the bill next year.
These terms – which will be at the heart of the debates – then risk being decided by regulation, which gives more power to the minister. “I want to listen to the people in the network, I want to listen to our partners, then we will keep what we call regulatory powers to finalize,” explained Mr. Dubé.
According to Mr. Dubé’s office, Quebec trains approximately 1,000 new doctors per year. Around fifty choose the private sector at the start of their career. The data provided shows 136 family doctors who left the public plan during the first years of their practice, between 2020 and 2024. This number is 57 among specialist doctors for the same period.
The Federation of Resident Physicians of Quebec deplores the use of the “legislative weapon” while the situation affects “a tiny minority of doctors”. The minister should instead try to understand why they decide not to “pursue their career within this system”.
The Federation of Specialist Physicians of Quebec sees this as a bill that “seems to have serious consequences for young doctors” and the Federation of General Practitioners of Quebec questions “the addition of constraints” in a context of shortage.
In November, the Quebec Student Medical Federation for its part deplored that this decision “would create two classes of doctors with different rights”.
The College of Physicians, which pleads for an end to the expansion of private healthcare, says it is “favorable” to this measure “which reinforces the social responsibility of doctors towards the population”.
Hefty fines
Under the agreements, financial penalties will be imposed on doctors who do not respect their commitment.
Fines range from $20,000 to $100,000 per day per act and, in the event of a repeat offense, from $40,000 to $200,000. The amounts may apply each time the professional contravenes his obligations to practice to the public, we write.
In November, François Legault raised the scenario of asking a student to reimburse his tuition fees, if he chooses the private sector, which would have justified the preventive use of the exemption clause, according to him. However, the government has ruled out this avenue (2).
According to the minister’s office, the training of a doctor costs, including residency, between $435,000 and $790,000 for Quebec taxpayers.
