Quebec’s medical specialists say change in health minister led to deal

Quebec’s medical specialists say a change in health minister led to a breakthrough in negotiations with the provincial government.

On Thursday evening, the Federation of Medical Specialists of Quebec (FMSQ) voted more than 80 per cent in favour of a new contract with the government after more than a year of stagnant talks. Former health minister Christian Dubé tabled a series of controversial health care bills linking doctor pay to performance, which was met with outcry from the medical community and ultimately led to Dubé’s resignation.

“With Dubé, we weren’t going anywhere,” said Dr. Arsène Basmadjian, a member of the FMSQ’s board of directors. “We were at the opposite ends of the spectrum,” saying the previous leadership put up several road blocks.

He said talks started moving once Sonia Bélanger took over as health minister.

“Things started to definitely improve, talks wise, when we had different people in front of us. Madame Bélanger and (Chair of the Conseil du trésor France-Élaine) Duranceau have been very positive. It’s been a turn.”

Last spring, Basmadjian felt that talks were going well, and believed an agreement was close at that time.

“Then, basically we were blindsided by Bill 106, which just came out of nowhere, really, and was a slap in our face. There was no way we were going to accept that,” he said, adding things only got worse with Bill 2, which felt like “a police state for physicians.”

New agreement terms

The new agreement allows for compensation increases based on performance targets, rather than a pay cut, according to a press release from the Cabinet de la ministre responsable de l’Administration gouvernementale et de l’Efficacité de l’État.

Targets include increasing appointment slots for specialist consultations, reducing the surgery wait list from 4,000 to under 1,000 within two years, and reducing the number of patients waiting for priority cancer surgery from 325 to less than 50.

Health care spending is set to increase by a minimum of 9 per cent by March 31, 2028, and possibly by up to 11 per cent, conditional on achieving the various performance targets.

One per cent is dedicated to improving doctor retention in rural areas, 3 per cent is earmarked for clinic overhead, including rent, staff and clinic fees, and 5 per cent is to close the pay gap between specialties, particularly specialties that are dominated by women.

“There’s certain specialties that have higher incomes on average than others. And it’s obviously been a point of discontent within the federation,” Basmadjian explained.

Reaching an agreement after all this time was a victory for both doctors and the government, but Basmadjian points out that it came with concessions.

“We were hoping at the beginning to get the same thing as other workers in the health field, which was 17 per cent (increases),” he said. Ontario and New Brunswick have received “much greater” pay increases than Quebec.

“By accepting this deal, that means we accept to be lower-paid physicians than our neighbours.”

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