The College of Physicians of Quebec wants to stop the expansion of private health care

2024-11-04 09:00:00

The growth of the private sector in the health field is of great concern to the professional order of doctors in Quebec.

In an unprecedented approach, the board of directors of the College of Physicians of Quebec (CMQ) adopted in recent days a position on the place of the private sector in health.

The CMQ demands that the expansion of the private health sector be suspended immediately.

A quote from Extract from the resolution adopted by the Board of Directors of the College of Physicians of Quebec

As the president of the College, Mauril Gaudreault, explains, we have been very, very concerned by studies which have demonstrated that financing a private health system does not improve access or reduce system costs.

Our mission is to protect the public by ensuring quality medicine, […] but that also means [s’assurer d’avoir] accessible medicine, adds the president of the College.

Access to surgeries

The latter is thinking in particular of the surgical waiting lists which remain at peaks despite the intentions repeatedly announced by Quebec to reduce them.

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During consultations regarding Bill 67 on the Professional Code, the College of Physicians called for more powers to ensure the quality of services offered to the private sector.

Photo : Ivanoh Demers

According to public data, more than 162,000 patients have been waiting months, if not years, for surgery.

We are not against that, the subcontracting of surgeries to clinics where it costs nothing to the patient [avec la carte d’assurance-maladie]but we advocate that it always be that in the private sector, that the patient does not have to pay.

A quote from Dr. Mauril Gaudreault, president of the College of Physicians of Quebec

According to a compilation by Radio-Canada, last year a dozen health establishments entrusted more than 600,000 medical procedures to the private sector for the next five years. The total value of these interventions reaches nearly $500 million.

Furthermore, the number of permits granted by Quebec to private surgery clinics (CMS) has almost doubled since 2017, to reach more than 80.

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The primary mission of the College of Physicians of Quebec is to ensure the protection of the public.

Photo : Ivanoh Demers

There are numerous examples, particularly in orthopedics, where patients resign themselves to paying large sums of money to avoid waiting.

The typical example, emphasizes Dr. Gaudreault, is when you need surgery on your knee. The orthopedist meets you here, at the CHUM, and tells you: “I can do that in 14 months. If you come to a private clinic, I can operate on you in a month. It will cost you 25,000 piastres.”

This is solicitation which, in our opinion, is questionable, not to say illegal. […].

Access to a family doctor also concerns the president of the CMQ.

Doctors have their share of responsibility

In the document consulted by Radio-Canada, we also note that the CMQ requests that existing private care be rigorously regulated and supervised by the government, in particular […] the procedures for changing the status of participating doctor to non-participating in the public system.

Currently, nearly 750 general practitioners and specialists make the jump temporarily during the year to practice privately, not counting those who only practice privately.

A doctor who decides to work in the private sector as a non-participating doctor must, in particular, inform the RAMQ, advise his patients that they must fully cover the fees and display the rates in the waiting room of his office.

According to RAMQ data, the trend has been increasing for around ten years and affects 3.5% of Quebec’s 21,333 doctors.

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Mauril Gaudreault has been president of the College of Physicians since 2018.

Photo : Ivanoh Demers

According to the president of the College, the medical community has its share of responsibility.

This is why we are talking about a social contract which is as if cracked, a social contract between the medical community and the population in the sense of individual and collective responsibility which is crumbling, affirms Dr Gaudreault.

In the discussions, the reflections that we had, we were worried, concerned about an increasingly significant exodus of doctors who are going into the private sector, he specifies.

In his opinion, new medical graduates should not be authorized to practice privately before 10 years for example, that will be up for discussion.

How could we make the young doctor [dont] Quebec society paid for his studies […] can then make a comeback.

A quote from Mauril Gaudreault, president of the CMQ

Meeting at his offices, the president of the CMQ will remind several times that it is necessary to ensure that it is the public which supervises the private sector.

For a universal and accessible network

The publication of guiding principles on the place of private health comes at a time when the two doctor unions are negotiating their employment contract with Quebec.

It also comes one month before the deployment of the new Santé Québec agency, whose management the CAQ has entrusted to two entrepreneurs from the private sector (Christiane Germain as president of the board of directors and Geneviève Biron as president and CEO).

Prime Minister François Legault has already said that 80% of the solutions to improve the health system come from the public, but there is approximately 20% that comes from the private sector.

Dr. Gaudreault emphasizes that we also have a greater power of influence than before […] and the College will make the necessary representations so that these guiding principles are taken into account by decision-making bodies in order to ensure universal access, equity and sustainability of the Quebec public health network.

In his latest budget for the 2024-2025 financial year, Finance Minister Eric Girard plans to allocate $54 billion to health and social services.

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**Interview ‍with Dr. Mauril Gaudreault, President of the College‌ of⁢ Physicians of Quebec**

*Date: November 4, 2024*

**Interviewer:** Thank you for joining us today, Dr. Gaudreault. Let’s dive right into the‌ pressing issue of private-sector involvement⁣ in healthcare, especially ‌in light‍ of recent​ announcements from Ontario.​ What is ​your main concern regarding the expansion of private clinics in Quebec?

**Dr. Gaudreault:** Thank ⁣you for having me. Our main concern is that the ​expansion of the private health sector does not necessarily lead​ to improved access or lower costs in the public system. We’ve seen studies indicating that financing a private health system often ‍fails to enhance the overall healthcare experience for patients. Our mission at the College is to protect the public ‌by ensuring that medical services⁢ are ⁢both accessible and of ⁢high quality.

**Interviewer:** You mentioned the alarming number of ​patients waiting for surgeries. Can you elaborate on this issue?

**Dr. Gaudreault:** Absolutely. Currently, there ‍are over 162,000 patients on waiting lists in Quebec, some waiting months or even years for essential surgeries. While there is a ‌demand for quicker access, we ​are committed to ensuring that any surgeries done in⁤ private​ clinics ⁤do‍ not impose additional costs on⁣ patients. We assert that patients should not have to choose between timely care and⁣ financial⁤ burden.

**Interviewer:** What steps is the⁤ College taking regarding this situation?

**Dr. Gaudreault:** Recently, ⁤we adopted a resolution requesting‍ an immediate suspension of⁤ private ⁤sector expansion in healthcare. ‌Additionally, we advocate​ for greater regulatory powers to oversee⁣ the quality of services in private facilities and ensure that ‌they align with public health standards.

**Interviewer:** Do you see a difference in quality between​ public and private ⁢healthcare ‌services in Quebec?

**Dr. Gaudreault:** That’s a complex issue. While some private ‍clinics may provide timely care, the overarching concern is that ‍the‌ model encourages a two-tier system, which can lead to inequalities in access. Our focus should remain on strengthening the public system rather than diverting resources to the private sector.

**Interviewer:** Some⁣ argue that private clinics help ​alleviate pressure from​ the public system. What is⁤ your take ⁢on‍ this perspective?

**Dr. ⁤Gaudreault:** While​ it might seem like a quick​ fix to⁢ offload surgeries to private‍ clinics, ​the⁣ long-term impacts could be detrimental. If we allow more operations to occur privately, we ​risk undermining ⁤our⁣ public system, which should be our primary concern. We need to⁢ ensure that all patients, regardless of their financial means,⁢ have access to timely and⁢ quality healthcare.

**Interviewer:**⁣ Lastly, what do you envision for the future of Quebec’s healthcare system?

**Dr. Gaudreault:** ⁤Ideally, we would like to see a renewed focus on the ⁤public system where resources ‌are allocated to improve access and reduce waiting times. I believe it’s‌ crucial for the medical community and‌ policymakers ‍to come together to restore the social contract with ⁣our patients, ensuring that healthcare remains a‌ right for ‍everyone, not just those who can afford to pay.

**Interviewer:** Thank⁢ you,⁢ Dr. Gaudreault, for⁣ sharing your insights on this ⁣vital issue.

**Dr. Gaudreault:** Thank you for having me. It’s essential to keep this‍ conversation going ​for the benefit of all​ Quebecers.