Montreal

GPs reach partial deal as Quebec's ban on extra health fees takes effect

Groups representing health care providers across Quebec spent Thursday in last minute negotiations with the Quebec government as the province's ban on extra health-care fees came into effect.

Sticking points remain on some issues, service could be affected, group says

Quebec's Federation of General Practitioners announced what it called a partial deal with the government on Thursday. (Christopher Furlong/Getty Images)

Groups representing health care providers across Quebec spent Thursday in last minute negotiations with the Quebec government as the province's ban on extra health-care fees came into effect.

Effective today, patients won't have to pay auxiliary fees for a range of products and services covered by the Quebec's health insurance board, the Régie de l'assurance maladie du Québec (RAMQ).

Quebec's Federation of General Practitioners (FMOQ) announced what it called a partial deal with the government on extra fees, but warned grey zones in the rules remain and could affect the provision of services.

Dr. Louis Godin, president of the FMOQ, announced that general practitioners will absorb the fees associated with minor surgeries, such as vasectomies and the removal of cysts.

Godin said an agreement was also reached that will allow general practitioners to continue furnishing medication and vaccinations covered under public or private health plans.

Ban could affect services

But not all vaccinations are covered, and Godin said the ban on supplementary fees means people requiring some vaccines, like the one for shingles, will have to get it themselves at a pharmacy and bring it to a clinic to be administered.

"We have a problem with the handling of the vaccine between the pharmacy and the clinic. Especially if this vaccine has to be conserved at a specific temperature," he said.  

"The government tells us it's not a problem, the pharmacists will tell the patient what to do."

Godin also said a wide gap remains between the general practitioners's position and the government when it comes to blood samples taken by medical clinic staff.

Before the ban on auxiliary fees, clinic staff could take a blood test and charge of $20 or $30 for the service.

Godin warned the ban on such fees could result in those services, and others, no longer being provided.

"The patient had the choice and made the choice to have the services in the clinics, and now it's impossible. It's prohibited. So it's not a step ahead to improve access, to improve and modernize our health-care system," Godin said.

'A new era': Barrette

Quebec Health Minister Gaétan Barrette said resistance from health care providers to the ban on auxiliary fees is understandable, but the ban responds to public demands.

"Some dissatisfaction is likely, and that's normal — we're going from a for-profit model to a non-profit, or at least not as substantially profitable. But it's a new era," he said.

"We've listened to the people. They wanted accessory fees abolished."

In November 2015, the Quebec government passed Bill 20, a controversial health reform law which included an amendment to permit and regulate auxiliary fees — a move which groups such as Quebec Doctors for Medicare said violated the Canada Health Act.

'In medicine, we shouldn't be talking about a business model. It should be about a model of patient care," said Dr. Isabelle Leblanc, president of Quebec Doctors for Medicare

Partly in response to Bill 20, last May a coalition of health groups launched legal action against the federal government to compel it to enforce the Canada Health Act.

Last September, Barrette backed down, announcing that an end to user fees "illustrates our commitment to the accessibility of our health care network."

with files from Elias Abboud

now