2023-10-27 20:34:03
(Montreal) The Court of Appeal has ruled, the distribution plan for family doctors and the method used by the minister are valid. The Dr Mark Roper and his lawyer, Me Julius Grey, therefore did not convince the judges that there was a real injustice towards the population of Montreal.
In a reaction sent by email to The Canadian Press, Me Gray says he is disappointed and mentions that he is considering turning to the Supreme Court.
In the judgment signed by judges Stephen W. Hamilton, Martin Vauclair and Frédéric Bachand, the court maintains the first instance decision rendered by judge Dominique Poulin. We also underline the “careful” nature of the judgment in the Superior Court.
The thesis defended by Me Gray and the Dr Roper alleges that Montreal is at a disadvantage compared to the majority of regions in Quebec according to the method used to establish the Medical Workforce Distribution Plans (PREM).
All family doctors who practice under the Quebec public plan are required to hold a notice of conformity allowing them to practice in a region determined by the Ministry of Health and Social Services (MSSS). This authorization comes with the obligation to spend “at least 55% of their billing days” within this zone.
According to the figures of Dr Roper, Montreal has the worst rate of registration with a family doctor, with 68%. Quebec’s target is 85%. Despite this gap, the minister uses his discretionary power from one year to the next to deprive the metropolis of new doctors in favor of other regions.
For comparison, Montérégie has the second worst rate at 75%. The regions best served according to this criterion are Saguenay–Lac-Saint-Jean at 91% and Gaspésie–Îles-de-la-Madeleine with 89%.
The applicants maintained that the system used was “unreasonable” and that it even violated the Canadian Charter of Human Rights and Freedoms.
However, the judges of the Court of Appeal reached the same conclusions as Judge Poulin, that is to say that the insufficient number of front-line family doctors “does not result from the distribution of staff carried out by the minister, but rather the insufficient number of doctors to meet the needs at the provincial level.
In defense, Me Amélie Bellerose, who represented the Attorney General of Quebec, rightly argued that family doctors do not only provide front-line consultation. An even more striking reality in remote areas. This is what forces the minister to deploy more resources in these regions, even if the rate of patients registered with a family doctor is higher.
“Nothing is lost, nothing is created,” she said at the opening of her presentation to the Court of Appeal on Thursday morning. “We also need doctors in CHSLDs, in emergency rooms, in the short term,” she added.
Me Bellerose recognized that the method was not perfect and could be improved. She even described the caller’s approach as “noble” since it comes from a desire to improve health care coverage.
But the reality remains that the inability to offer more general practitioners to the people of Montreal is explained by the lack of doctors.
“We make do with what we have. What we have are family doctors who do CHSLD, obstetrics, emergency,” she insisted, concluding that there was a gap between supply and needs. throughout the territory.
In his request, the Dr Roper also denounced the fact that the calculation used for the distribution of staff did not take into account the registration rate nor the actual pool of patients served by Montreal when we limit ourselves to the number of inhabitants.
The judges, however, recalled that it was not the role of the courts to replace the legislative, executive or administrative powers in this situation.
In the government camp, we reiterate that the minister annually develops the distribution of family doctors taking into account the requests and needs of all establishments.
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