Sunday’s snowfall was no deterrent to the crowd of Pontiac residents determined to voice their dissent to the Quebec government’s latest healthcare legislation.
Over 100 people gathered outside the Pontiac Hospital to protest the province’s Law 2, set to come into effect in January, that will tie doctors’ pay to performance metrics including the number of patients they see, and how vulnerable they are.
The province has positioned these new regulations as necessary to getting 1.5 million Quebecers, currently on waiting lists for family doctors, connected with primary care.
But as the law was being drafted over the summer, and since it was forced through the National Assembly in late October, doctors have been outspoken about their criticism of its approach to healthcare reform, which they say would push them to perform what has been called “fast food medicine”, prioritizing volume over quality of care.
In the past month, hundreds of Quebec doctors have applied for permits in New Brunswick and Ontario, and several doctors’ associations have announced intentions to take the government to court over these new rules.
And on Sunday, these doctors found a small but vocal contingent of allies in the province’s westernmost corner, convened by local healthcare advocacy group Pontiac Voice.
“People were asking for [a rally],” said the group’s spokesperson Josey Bouchard. “They were saying we want to show that we’re part of the Outaouais and that we’re also concerned about what is happening.”
Among the people in attendance was Danielle Romain, the coordinator for the Pontiac GMF that manages family medicine across the county, including ensuring there are enough doctors to meet the population’s needs.
She said the Pontiac network, stocked with 25 family doctors, currently has no orphan patients, which means that while not all have been matched with a doctor, they can access primary care through the GMF system.
But she said since the introduction of Law 2, she has had six doctors indicate plans to close their practice, or take it elsewhere.
“Some as soon as Jan. 1, because of this law,” she said, noting two are taking early retirement, one is not coming back after leave, and the remaining three are looking at moving to Ontario.
“With those six, if they actually do leave, 35 per cent of my patients will lose their family doctor. And there’s more that are talking about it. And I don’t blame them, because I wouldn’t want to stay and be treated like this. But then also I cry, because what will our communities do?”
She said as she sees it, the law puts an unfair onus on doctors to fix a broken system.
“I understand the need to be able to organize so that more people have access, but it’s just so coercive, and performance-based is not realistic. [ . . . ] Especially here in rural areas where [doctors] do all kinds of activities – they have to be in the ER for a shift, they do in-patient care, the care for patients in the long-term facilities, so they have different types of call that limit their capacity in the clinics to see all the patients. It’s not that they’re lazy, or not putting in the hours.”
Dr. Thomas O’Neill, also in attendance at Sunday’s rally, has been outspoken about Law 2 since its early days, when it was referred to as Bill 106.
Himself nearing retirement after a career in the Pontiac, Dr. O’Neill warned the bill would not work to its desired effect and instead add more pressure to his already overstretched colleagues.
“This is my province. I would like to do the best I can for it. I think the problem we have at the moment is that the government is failing to realize the shortage of doctors is right across Canada, it’s not just Quebec. So they’re really encouraging my colleagues who I respect a lot, to move across the border,” he said Sunday.
“The big problem that I have is that for our doctors, who are being blamed by the government, who care for their patients. They’re being accused of deserting 1.5 million Quebecers, whereas in fact the reality is that they’ve never produced enough doctors to do that over the last 20 years. [ . . . ] The issue is a lack of respect for what they’re contributing. And the problem is the conditions at work, it’s not really a matter of pay.”
Last week, a month after the bill was passed and doctors walked away from negotiations with the province about the bill, they returned to the negotiating table to work out its fine print.
“If an agreement is reached, the government would accept amendments to Bill 2, knowing that part of family physicians’ compensation remains conditional on taking on an increased number of Quebecers,” reads a joint statement published Nov. 26 by Francois Legault and Dr. Marc-André Amyot, president of the Fédération des médecins omnipraticiens du Québec (FMOQ).
On Sunday, those protesting added their voices to those across the province urging the Quebec government to listen.
“The government needs to wake up and smell the coffee,” said Litchfield mayor Colleen Larivière. “I’ve known a lot of people that have sat in Quebec City and most of them listen. But these people are not listening, so you know, you get votes by listening to the people right. So start listening.”
Bryson mayor Joanne Ralston was also among those marching. She is retired from a career working as a manager in the local healthcare network, both before the centralization of services to create CISSSO, and after.
“It’s people far away making decisions on services. They do not realize how much is done here with a small basin of doctors and nurses, and we’re going to be losing even more,” she said.
“Especially here in the Outaouais where we’re underfunded already.”
At the Nov. 26 MRC Pontiac council of mayors meeting, council passed a resolution calling on Quebec premier François Legault to repeal Law 2 to protect access to healthcare in the region.
A petition submitted to the National Assembly calling for the law to be repealed has to date gathered 53,358 signatures. It closes on Dec. 9.
