Bill 20 : The FMSQ insists on guaranteed access to technical resources and asks for the Bill to be withdrawn

Montreal, March 17, 2015 – Taking part today in the private consultations and public hearings of the Committee on Health and Social Services on the subject of Bill 20, the Fédération des médecins spécialistes du Québec (FMSQ) provided parliamentarians with an overview of its observations, commentaries and criticisms regarding Part I of this Bill, on the issue of access to specialized medicine services.

"This Bill is unacceptable as much in its form as in its purpose." This is the conclusion delivered to parliamentarians by the President of the FMSQ, Dr Diane Francœur, after an exhaustive study of the proposed text, a text she demonstrated as being contrary to the reality of the situation.


Improve access to health care ? Medical specialists are first in line to ask for it ! But, they denounce the conditions prevailing in hospital centres that negatively impact their productivity. Hospital centres impose limits to their productivity and recurrent budget cuts result in medical specialists not having all the necessary leeway to increase their offer of services. Nothing in Bill 20 provides a guarantee to physicians that they will have the means to do more. In specialized medicine, the capacity to produce is modulated by the means of production that are made available. How can a medical specialist reduce delays if operating rooms close at 4 p.m., technical staff is cut back, broken equipment is not replaced and hospital beds are not available for patients after surgery ?

The President of the Federation has challenged the Minister of Health to implement solutions to extremely well-known problems. "The Federation demands that the Minister of Health, Gaétan Barrette, guarantee the following to medical specialists : access to appropriate resources for the dispensation of care such as operating rooms, equipment in working order, hospital beds and trained personnel – and this, in all hospital centres and all regions of Quebec."

According to the FMSQ, this is where the real guarantee of better access lies. It is the only way the Minister of Health and his government can honestly claim that they truly acted to improve access to care. Rather than wasting his time legislating, the Minister should have started by dealing with the "real" issues. Medical specialists refuse to be the patsies for the failings of a healthcare system that daily rations their means of production and restricts their capacity to care for more patients.

Moreover, Dr Francœur reminds us all that the private offices of medical specialists are complementary to hospital centres. Patients can see their physicians outside hospital walls and such consultations contribute to improving access to care. And yet, the Minister of Health has chosen not to settle the issue of accessory charges, a situation he had so often denounced in the past. This inactivity on the part of the government may force many medical specialists to reduce their office activities, or even to abandon them. Nothing in Bill 20 aims at settling this issue in spite of its being at the crux of the matter.


A coercive, unilateral, excessive and abusive approach

Under the pretext of wanting to improve access to health care for the benefit of patients, Bill 20 sets aside negotiations and a partnership with medical specialists, and adopts a coercive approach by imposing unilateral obligations, quotas and penalties. The Minister's approach rests upon false premises, partial data and a defective analysis and shows him snapping his fingers at reality.

The coercive approach advocated by Bill 20 mocks the right of medical specialists to negotiate their conditions of practice and their remuneration. The Bill challenges their professional autonomy, sets aside their collaboration and imposes a regime of unilateral obligations, quotas and penalties. Thus, the Minister could, unilaterally and at his sole discretion, impose modifications to agreements validly reached between the government and medical specialists; he could also proceed in spite of the regulatory approval process laid down in the law and without any consultations, simply by publishing these modifications on the website of the Régie de l'assurance maladie du Québec. The FMSQ considers that such powers in the hands of the Minister of Health are excessive, dangerous and must be withdrawn. The crisis at the Centre hospitalier universitaire de Montréal (CHUM) proves it, concludes the President of the FMSQ.

The FMSQ's white paper may be accessed here.

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