Special law will force doctors out, opposition parties charge. Legault says he won’t back down
QUEBEC — Tension between Quebec and the province’s doctors continued to escalate Thursday, with the government sticking to its hardline plan to legislate a wage formula and force an end to the dispute.
Not even an announcement by general practitioners in the Fédération des médecins omnipraticiens du Québec (FMOQ) that they would end their pressure tactics was enough to put out the fire, with Premier François Legault writing to the president of the legislature Thursday asking for the house to sit exceptionally on Friday to adopt the special legislation.
MNAs are expected to turn up Friday at 8 a.m. for a special sitting and will likely sit well into the wee hours of Saturday to adopt the legislation, which Legault promised Wednesday evening in a video message.
The government will invoke closure, a parliamentary tool that allows it to skip the normal steps of the legislative process and fast-track a bill into law.
The legislation is expected to include most of the original content of Bill 106, which proposed linking 15 per cent of doctor salaries to performance standards. That means Quebec will do away with the current system of pay per medical action, and replace it with pay based on the number of patients cared for and how vulnerable they are.
The government will get the power to set performance targets. The bill could also include language ending the pressure tactics launched by the FMOQ and the Fédération des médecins spécialistes du Québec (FMSQ). On Thursday, Legault revealed there would also be unspecified measures to stop any potential exodus of doctors.
He did not sound hopeful that a last-minute deal could be reached with either medical federation that would prompt him to stand down on the special law. He said Quebec has been talking about this subject for 25 years and it is time to act.
“If there are significant advances with the FMOQ or the FMSQ, we are ready to move,” Legault told reporters on his way into question period in the morning.
“But for the moment, there have not been any advances.”
The decision to proceed with a special law has left Quebec’s doctors fuming. On Thursday, both medical federations vented their anger.
The FMSQ described the government’s move as nothing less than a “frontal attack on specialized medicine in Quebec” and a “slap in the face.”
“The last few months, including the mediation in good faith, was nothing but a masquerade aimed ultimately at the adoption by closure of an unjustified and counterproductive law,” the specialists said in a statement. “The government never had any intention of listening or truly negotiating, either with the FMSQ or any other party. The tabling of this bill is the uncontestable proof.
“Today, the government’s approach could not be clearer: imposition, coercion, special law and too bad about democracy.”
On Wednesday, the FMSQ rejected the government’s fourth and final settlement offer.
“What Mr. Legault did (Wednesday) was spit in the face of medical specialists,” FMSQ president Vincent Oliva told 98.5 FM radio host Patrick Lagacé. “We are freezing you, we are cutting, but keep working and shut up.”
The FMOQ, however, announced it was heeding a suggestion from Quebec Liberal Leader Pablo Rodriguez to end their pressure tactics, which included boycotting teaching programs for medical interns.
The FMOQ also said it was ready to pursue negotiations with the government even though the federation is “very disappointed” Quebec is proceeding with the law.
“The FMOQ would have liked to see Mr. François Legault fully play his role of premier, by getting personally involved in the discussions to reach an agreement or to mandate an independent arbitrator,” the FMOQ said in a statement.
At their morning news conferences, Quebec’s opposition parties blasted away, saying a special law is not the best way to settle the dispute and accusing the Coalition Avenir Québec government of acting out of partisan political reasons, given its low standing in the polls.
“François Legault needs to have adversaries; he needs to be fighting against a category of the population,” said Liberal health critic Marc Tanguay. “If it’s not the unions, it’s immigrants.”
“François Legault wakes up at night to hate doctors,” Québec solidaire health critic Vincent Marissal told reporters, referring to Legault’s comments in the past that too many governments have caved in to the medical lobbies.
“It’s been 25 years that (Legault has) been saying he wants to break the doctors. He might end up doing it, but at the same time he will break the health system.”
“Where is the urgency?” asked Québec solidaire co-spokesperson Ruba Ghazal. “His objective is to show he took a stand against the doctors.”
The opposition parties said the special law risks sparking an exodus of doctors, either into retirement or out of Quebec.
“Doctors will continue leaving the system for the private sector,” said Parti Québécois health critic Joël Arseneau. “Some will also leave to retire.
“(Legault) has chosen to provoke a crisis to then present himself as the great pacifier, that he is the one to settle the crisis he himself fomented.”
But Legault said it has been two years since the agreements with the federations expired and 25 years since a commission recommended Quebec changes the way it pays doctors.
The whole summer went by with doctors saying they would be willing to talk as long as Quebec does not change the way it pays physicians, Legault said.
The government’s proposal to peg 15 per cent of their salaries to performance standards remains “reasonable,” he said.
“It’s normal that there is a certain resistance (to change),” said Health Minister Christian Dubé. “I am counting a great deal on the sense of duty of doctors. I am counting on this because I know many doctors who say we need to change the way we do things because the status quo is not acceptable.”
He, too, expressed doubts about giving negotiations more time.
“I say this because there have been numerous times when they said we will discuss, but we landed in mediation with offers (from them) that were so far out, they impaired the law.
“It’s true what we are asking doctors is big: changing the way they are paid. If it is little changes (they propose) to again delay the process by two or three weeks, we are not there.”
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