This story was written by Trevor Greenway, editor at The Low Down newspaper, where it was originally published. We have republished it with permission as the issues in the story impact  Pontiac residents as well. 

A Wakefield doctor says she’s been fired by the province’s Ministry of Health for raising concerns about Bill 106. 

Dr. Emmanuelle Britton, who works at the Wakefield medical clinic, said she was fired by Quebec’s health ministry after relaying concerns from patients, colleagues and other physicians that Bill 106 would have detrimental impacts on the province’s health network. She was fired on June 20, following what she said she felt was a productive roundtable on Quebec healthcare reform.

“It has just been awful,” said Britton, who has been on a leave of absence since she was abruptly fired in June. “I cried. I mean, I had tears coming down my face. I was supposed to go on vacation the following week. I’ve been on leave from work since that time because it’s been so hard.” 

Britton, who lives in the des Collines region, was at a conference in Montreal in early June with shareholders and advocacy groups, discussing ways to improve the value of family medicine. These advocacy groups, other physicians and medical personnel brought up Bill 106 and the concerns they shared about the bill, which offers doctors performance incentives for seeing more patients. 

“So, of course, the parties brought forward Bill 106 as being a huge step back in all the initiatives we’ve been talking about to bring value to family medicine,” said Britton. 

She said that Health Minister Christian Dubé joined the meeting for about 30 minutes, virtually.

When Britton returned to present her findings, she was dismissed by her superior Dr. Stephane Bergeron from the health ministry via a virtual meeting from her home in the Outaouais.

“To my immense surprise and shock, I was told that it would be a difficult meeting,” said Britton. “He shared with me that I was the physician that seemed the most concerned and [who] raised the most . . . questions and clarification requests with regards to Bill 106, and he said that because of that and because he knows that my values and my convictions will never match what Bill 106 will be . . . that he had to put an end to all of my work at the Ministry of Health.”

Bill 106, tabled in May, has been largely criticized by physicians across Quebec, with many of them saying that the bill, which penalizes doctors who don’t see enough patients, will create “fast food medicine” on the front lines and will force doctors to rush their visits with patients in an effort to see more while devoting less time to deal with any given health problem. 

Britton, who was hired by the province to create a new model of family medicine in Quebec, said she and other doctors across the province learned about Bill 106 through the media. 

She said there was no consultation with doctors or on-the-ground advocacy groups, and said the “surprise” bill undermined all the work she and her colleagues had been doing on creating a new model of family medicine. 

“We found out about it at the same time as the public,” she said. “We found out about a bill happening through the media, even though I work in the Ministry of Health. We were working on access for care and family medicine and new models, so you can imagine we were quite surprised.”

Britton’s role as a family medicine consultant with the ministry required her to speak with patients, colleagues and other medical professionals, and to relay both the good and the bad to higher-ups so they could improve service. When Bill 106 became public, she did the same. 

“So, once it’s public and we can see it, we read it, we evaluate it and we provide advice or questions or clarifications,” added Britton. “And so in that capacity, internally, we asked questions, clarifications and also raised the concerns that were felt on the ground, be it by physicians or different groups.”

The ministry fired both Britton and her colleague, Martin Forgues, who together created the GAP model in Quebec, which allows patients without a family doctor to find an appointment. 

Quebec Health Minister Dubé declined an interview with the Low Down, however in an email to Radio Canada, the ministry confirmed they were both fired but denied that the two employees were terminated because of their Bill 106 comments. 

The email said, “The decisions taken in this context relate exclusively to organizational adjustments and the transformation of the MSSS.”

New family medicine model set to roll out

Dr. Britton and Forgues were on the verge of rolling out a new model of family medicine that she said she felt would have brought about a “culture change” in Quebec’s medical world.

She said interdisciplinary teams featuring doctors, nurses, pharmacists and medical experts were ready to begin rolling out the model in various regions to test it and gather data to tweak and improve it. Then Bill 106 dropped and with it went, Britton said, all the positives around the future of Quebec healthcare. She said “toxicity” is the new narrative in clinics across the province. She said the province “lost six to 12 months of positive, progressive change,” when it tabled Bill 106.

“Everybody’s demoralized,” said Britton. “The commentary that’s in some of the media by our government – it’s just created a climate that has become so toxic.”

The head of family medicine in the Outaouais, Dr. Guillaume Charbonneau, told the Low Down that Bill 106 has made doctors feel “undervalued” in Quebec, so much so that 33 physicians in the Outaouais alone have already ditched Quebec to work in Ontario. 

Under Bill 106, 15 per cent of physicians’ pay is linked to their performance in an effort to get them to take on more patients. With the province already short 2,000 family doctors, practitioners are preparing for another healthcare crisis in the region. 

“So with this bill, we feel that they will ask us to do fast food medicine, and we fear that we won’t be satisfied with the job that we do with the patient. And for us, that’s more important,” said Charbonneau about Bill 106 during an interview last month. “We want everybody to have access, but what is more important at the moment is the patient we have in front of us and that we feel we don’t want to risk his or her safety because we have pressure to see the next patient.”

Liberal MNA and former health critic André Fortin told the Low Down the fact that two Ministry of Health employees were fired for speaking about health concerns internally is “ludicrous.”

“These two got fired for speaking out privately, behind closed doors. That is absolutely ludicrous and counter-productive,” said Fortin. He said that when the CAQ came into power in 2018, the health minister at the time, Danielle McCann, said the province wanted whistleblowers to identify inconsistencies in policies, gaps in services and government bills. But he said these firings show that the CAQ is more about gag orders than about whistleblowers. 

“People shouldn’t be afraid to say what’s actually happening. And now you have the government doing exactly the opposite of that,” said Fortin. “People are being punished for speaking their mind and finding inconsistencies in government bills that will have an impact on the hundreds of thousands of Quebecers. So it is exactly the opposite of what any government should be doing.”

For Britton, while she’s not actively seeking a move to Ontario, she said the last few months have made her consider it as an option. She is still currently a doctor in Wakefield but she’s on indefinite leave.