Christian Dubé ready to “wean” the healthcare network from the private sector

Photo: Jacques Boissinot The Canadian Press In Quebec, about 3% of the 20,000 doctors practice privately “and often sporadically,” said Christian Dubé. “Before it becomes 4, 5, 6%, that’s when it’s time to say: enough is enough!”

Isabelle Porter in Quebec City

Published at 9:58 AM Updated at 11:25 AM

• Québec

Health Minister Christian Dubé does not intend to simply slow the exodus of young doctors to the private sector. He is now talking about the need to “wean” the health network from the private sector by launching a much broader discussion on the role of the private sector.

“We are very close to gradually weaning ourselves off the private network,” the minister said during a discussion in the Red Room of Parliament on Tuesday morning.

“It’s not too late to reverse the trend,” he added later. In Quebec, about 3% of the 20,000 doctors practice privately, “and often sporadically,” he said. “Before it becomes 4, 5, 6%, that’s when it’s time to say: enough is enough!”

The minister was taking part in what is called an “interpellation,” a question-and-answer exercise on the place of the private sector in health care initiated by Québec solidaire MNA Vincent Marissal.

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Mr. Dubé said he was “open” to discussing the back-and-forth of doctors between the public and private sectors when some doctors temporarily disaffiliate from the Régie de l’Assurance maladie du Québec (RAMQ) to perform surgeries in the private sector.

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A partial withdrawal

A little earlier, MNA Marissal had told how his orthopedist in the public network had suggested that he come see him in the private sector so that he could operate on his hips more quickly at great expense.

In his questions, the MNA for Rosemont also pointed out that the minister already had powers that allowed him to stop the exodus of doctors to the private sector. He also mentioned that this exodus also affected specialized nurse practitioners (SNPs).

On Sunday, Minister Dubé announced that he intended to legislate to force medical school graduates to practice in the public network during their first years in the profession.

According to him, around fifty young doctors move to the private sector each year. The Coops de l’information also revealed in October that more than 2,300 doctors trained in Quebec were practicing in Ontario.

On Tuesday, Minister Dubé showed himself to be aware of the issue of the exodus of IPSs, but did not want to say more, claiming that he would be exposed to parliamentary contempt if he gave too many details on the content of his bill.

Concerning the role of the private sector, he nevertheless repeated that the withdrawal would be “partial” and that we should not be “dogmatic.” It is not a question, said Mr. Dubé, of completely abolishing recourse to the private sector as was done for the agencies.

Family medicine groups (GMF), for example, are private companies that are affiliated with the RAMQ and their existence is not in any way called into question. “I strongly believe that there are good practices in the private sector that can be implemented in the public sector,” he said on this subject.

During the interpellation, the deputy government whip, Geneviève Hébert, took advantage of each of her interventions to emphasize the importance of the private sector in health.