Gaétan Barrette: Doctor incentive program flawed
Quebec health minister says Yves Bolduc followed the rules, but program merits review
Health Minister Gaétan Barette talks to Daybreak's Sonali Karnick about Quebec's general practioner's incentive program, the ethics of politicians taking on patients, and why he believes Yves Bolduc shouldn't resign.
Here are some excerpts from that interview:
Question: Claude Castonguay has asked for Yves Bolduc’s resignation. Do you think he should resign?
Answer: Obviously not and I’m surprised that he didn’t ask for the resignation of Dr. [Amir] Khadir, who is also in the opposition and is also working as we speak. It was the same thing with Dr. [Hélène] Daneault from the CAQ when she was elected in 2012 and she kept practising medicine. She was a family physician also and she kept practising medicine during her mandate.
Q: And they have also taken advantage of the incentive program?
A: Well, not Dr. Khadir because Dr. Khadir is a specialist and that incentive is part of the general practitioners’ agreement.
Q: When you’re an elected government official, how do you think it looks when you are taking this kind of money?
A: The thing is he was entitled to have that kind of money because the rules said so. As I said many times, the rule was not eliminated by [former health minister] Réjean Hébert. When Hébert was in power with the PQ, the rule was there before them and they kept it because that rule was meant to diminish wait lists and to entice physicians to see more patients.
I think we need to see things in a different perspective.
When Dr. Bolduc was defeated, when the Liberal party was defeated in 2012, there was a law in Quebec stating that there was supposed to be fixed date elections and it was supposed to be every four years. Who could have predicted at that time that there would be an election 18 months down the road and that they would lose and we would win?
This is not exactly the way things were supposed to go in everybody’s mind at that time so I believe that [looking forward] in his mind at that time, if he wanted to give services to Quebec’s population, it was a reasonable thing to do, first.
And second, if we all listen to the views, we hear many, many times doctors who are retiring and they leave patient lists up to 3,000 people. For a doctor who is used to working hard, 1,500 patients is kind of a part-time job. I know for a fact and everybody knows in the field that Dr. Bolduc is that kind of a doctor, so he could do it as Amir Khadir is doing today and as others did in the past.
Q: He was already working as a politician full time…
A: Yes, but when you are in the opposition, it’s a bit different and, as I said, on the weekends, on nights, this is something you can do.
I’m not here to defend him, I’m just saying that for some people, it is possible. It was within the rules to have access to that. The rules also says that if you are leaving the patients behind after a short while, a year or so, there has be an investigation and you have to reimburse the government for the amount you have received.
As you probably know, Dr. Bolduc already asked to do this analysis and if he has to reimburse, he will.
Q: Under the incentive program, Bolduc is entitled to keep the money he received for each patient, up to $200, but was it ethical for him to take on those patients?
A: I’ll leave him to discuss that, but as a rule, for that incentive program, it is something that when I came into my position, I already announced that this rule would be revised. Maybe Réjean Hébert did not modify it properly. But after five years or so of experimenting with this incentive program, I’m not sure that it gave the effect that we wanted.
No matter what happens with this story, this incentive program will be re-evaluated.
Q: This program has cost the province $50 million in the past two years and it’s up for review this fall. Why not just use that money to directly fund getting more family doctors full time for Quebecers?
A: Yes, that’s exactly what we are getting at. What I said earlier when I got into my position, this is one of the things that I wanted to address because in my previous life I really criticized the measure strongly because of what you’re saying.
Money in many ways, has to be spent in a way that we have services and the criticism that we can address to this measure is well-founded and will be reviewed.
That’s something I decided when I got in, well before this Bolduc story came out. It will be reviewed and early this fall my conclusions will be divulged and we’ll see.