On Saturday, thousands of medical workers from across Quebec attended the Bell Centre in Montreal. They took to the streets in protest against Bill 2—a newly adopted law that imposes a highly contentious salary structure on physicians. About 13,000 people marched for the rally. They were joined by supporters and healthcare advocates, all determined to show their opposition to the harmful legislation tabled by François Legault’s Coalition Avenir Québec (CAQ) government.
Last month, lawmakers unanimously passed Bill 2 into law. This new legislation connects part of physician’s pay directly to performance metrics, such as how many patients they see and surgeries they do. The new structure has spurred powerful backlash from the medical community. Compounding this backlash is the very real risk of an exodus, as hundreds of doctors look for greener pastures in other provinces.
Concerns Over Performance-Based Compensation
Critics of Bill 2, including most every educator, zero in on the bill’s performance-linked pay structure. Public health advocates, including the American Public Health Association, say this approach is “dangerous and unacceptable.” Dr. Marc-André Amyot, president of the Fédération des médecins omnipraticiens du Québec (FMOQ), expressed this feeling clearly at the podium on the day of the rally.
“I’ve never seen a mobilization of this scale,” Amyot stated. “But I’ve never seen a law as bad as the one we’re seeing now.”
The Quebec College of Physicians echoed these concerns, suggesting that the law undermines the quality of care by prioritizing quantity over patient health. Dr. Vincent Oliva, speaking on behalf of the medical specialists, struck at the heart of the matter. It’s more than just a failure to meet performance targets—it’s about the enormous chasm of under-resourced needed to do so.
“We need resources so that we can treat our patients,” Oliva explained. “What we want is a commitment from the government.”
Government’s Response and Ongoing Negotiations
In order to suppress the anger, the Quebec government decided that it would suspend two concrete provisions from Bill 2. Medium-term, the focus of this decision is to help spark better negotiations with doctors’ federations. This decision follows continued and sustained advocacy by medical providers who have been calling for a review and rollback of the harmful and controversial law.
The government maintains that the intent behind linking compensation to performance is to incentivize physicians to see more patients, particularly benefiting the approximately 1.5 million Quebec residents who currently lack a family doctor. Yet physicians across the country are saying that it is impossible to meet these targets without being properly staffed and resourced—which indeed jeopardizes patient care.
The rally underscored the strength of the opposition, but united healthcare professionals on the ground with many sympathetic lawmakers inside the ruling CAQ party. Lionel Carmant, a minister, recently left the CAQ caucus to sit as an independent after his daughter openly criticized Bill 2 in a letter. On top of that, legislator Isabelle Poulet has made headlines by openly critiquing how the party has handled the legislation.
The Future of Healthcare in Quebec
This unrest over Bill 2 is symptomatic of widespread dissatisfaction with the state of healthcare in Quebec.
Performance Measures
Physicians are increasingly nervous about providing the best care possible with new performance measures and value-based contracts. Yet they too are grappling with severe staffing shortages and lack of resources.
Both Dr. Oliva and Dr. Amyot have stated that significant improvements in healthcare delivery will not occur unless the government suspends Bill 2 altogether. As this negotiation process plays out, medical professionals continue to watch closely. Collectively, they fight tooth and nail against misguided policies that would undermine their bottom line and the value of patient care.
