The FMSQ's Reaction : "Bill 10 is unacceptable"

Montreal, October 20, 2014 – Appearing today before the Committee on Health and Social Services, within the framework of individual consultations and public audiences regarding Bill 10, the Fédération des médecins spécialistes du Québec (FMSQ) presented its preliminary reactions to the parliamentarians as it submitted its white paper.

To start with, the Fédération deplored the shortness of the delay granted to appear before the Committee on Health and Social Services. In view of the importance of Bill 10 for the healthcare network and for medical specialists, the Fédération had no choice but to comply with the schedule imposed on it last Friday. "Is the decision not to adequately consult the concerned stakeholders within the network an omen of what to expect if the Bill is accepted as it stands ?" asked the President of the FMSQ, Dr Diane Francœur.

Like many groups, the FMSQ denounced the government's eagerness in wanting to present, consult, adopt and implement such a significant reform at extreme speed. "The Bill was tabled on September 25, 2014. The parliamentary Committee started sitting today and we have already been told this Bill will be implemented by April 1, 2015. The Bill has not been subjected to any preliminary consultations or consensus within the network and the Minister must give the various stakeholders an acceptable period of time to analyze and consider it before going ahead with such a reform. The stakes are too important to act with such great haste," indicated the President of the FMSQ, Dr Diane Francœur.

"Since we had so little time, we have had to start by considering the impact of this Bill on specialized medicine. However, we are well aware that this reform has a much greater range and involves the other healthcare professionals with whom we work in close cooperation every day. An analysis with a wider scope is thus essential for the rest of the process."

"Over recent years, the Fédération des médecins spécialistes du Québec has campaigned in favour of reducing bureaucracy within the healthcare network, in particular by abolishing the health and social services agencies, a decision-making level we considered superfluous. Some may think that the nature of this Bill would make the Fédération happy, but this is not the case. By abolishing the 95 health and social services centres (CSSS), this Bill puts into question the local organization of health care and concentrates an excessive and unprecedented range of discretionary powers within the hands of a single person, the Minister of Health and Social Services. In these circumstances, we are calling for extreme prudence on the part of parliamentarians and we insist on the need to concentrate more fully on the potential impact of this Bill as well as on the irreversible measures it would introduce if it was adopted without appropriate amendments," continued Dr Francœur.

The FMSQ considers that too many questions remain pending. The merger of health establishments into a single regional establishment, the integrated health and social services centre (CISSS), generates several questions, on the administration plan for these new establishments as well as on the organization of care and the delivery of medical services. "Some regional establishments would bring together more than two thousand physicians, spread over a dozen different facilities, at times separated by several hundred kilometres and servicing, in some cases, a population of more than one million people, as would be the case in the Montérégie. Is this a guarantee of efficiency and effectiveness? Shouldn't there be criteria establishing minimum and maximum group sizes? Why are some university centres merged, as is the case in Sherbrooke and in Québec City, while others remain independent, as in Montréal? Shouldn't all specialized institutes remain autonomous based on their specific missions? How will such a network be medically managed ? These are questions that are still unanswered," added the President of the FMSQ.

The Fédération did a flash survey of its affiliated associations. Everyone seems to agree on one point: the merger of establishments worries them. There are still too many questions, too much vagueness, too many doubts and fears regarding the impact such a Bill would have if adopted. "The details we have at present are too fragmentary and don't allow us to measure the impact of this Bill on how care and services will be organized. The Minister needs to clarify his vision and gain consensus on the objectives to be targeted, the ways and means to be implemented in order to reach them. Moreover, he needs to consult and involve the main actors in the field : the physicians and other healthcare professionals," continued the President.

The FMSQ is of the opinion that, in its current state, Bill 10 is unacceptable. "We are asking the Minister to acknowledge that his Bill goes too far and that it needs to be clarified, amended and improved. He will then be able to count on our collaboration to take part in constructive and rigorous discussions, in the interests of the healthcare network and in that of our patients," concluded Dr Francœur.

The FMSQ's white paper which was filed with the Committee on Health and Social Services is available at

The Fédération des médecins spécialistes du Québec represents close to 10,000 medical specialists certified in one of the 53 recognized medical specialties.