Health Services face uncertain times

Doctors could take 30 per cent pay cut if Bill 20 stipulations remain unmet

The doctors at Concordia’s Health Services clinics may be affected by provisions in the provincial government’s new health care legislation, Bill 20, that could see their income cut by as much as 30 per cent.

The figures, quoted by both The Gazette and CTV, relate to the consequences of not meeting the bill’s provisions stipulating the number of patients doctors see regularly and the number of hours they spend working in a hospital.

To avoid any reduction of their income, doctors would have to balance the number of patients in their practice with the number of hours they work in a hospital or other public health establishment—like Concordia’s clinic.

It’s unclear if hours spent in Concordia’s clinic would count towards the requirements set in Bill 20.

“I don’t know how the bill works, I don’t think anybody is clear on how that is going to be implemented,” said Concordia’s director of media relations Chris Mota. “Do we fall into any of those categories? I don’t know.”

The role of students as patients is slightly more clear. “As for students, we believe yes, it would count for their target,” said Joanne Beauvais, the Minister of Health’s press attaché.

Bill 20 establishes a target number of patients for each doctor based on how long they have been practicing and how many hours they work in a hospital or clinic. The targets are as low as zero—for doctors in the very beginning and very end of their careers—and as high as 1500 patients, for doctors who have been practicing for 25 to 34 years. However, the targets are flexible. The letter noted that, for example, a doctor with 10 years of experience who worked more than the required number of hours in a hospital would have a lower target number of patients—750 patients rather than 1000 patients.

Unlike the nurses and health promotions specialists at the clinics, doctors are not Concordia employees. “They are here because they choose to come here,” Mota said. “They are independent of the university.”

Instead of being hired, Mota explained, doctors who want to work at the clinic sign a one-year contract with the university that can be indefinitely extended, circumstances permitting. Some doctors have their contract renewed many times—one has been working in the clinic for 10 years. Others just work at the clinic for a year before moving on.

Most Concordia students may not immediately notice any direct effects of Bill 20. “We will wait and see how this plays out and if there is any kind of an impact,” Mota said.

She went on to say that the provincially-mandated funding cuts to university budgets have not affected Health Services any more than other parts of the university.

“Are they affected? Probably, the same way that everybody else is. Certainly, they are not singled out in any way.”

No Health Services personnel chose to leave during the recent Voluntary Departure Program which ended in November.

Even if students don’t notice a change in on-campus health services, both supporters and detractors of the bill believe that effects will be felt widely across the province.

Some doctors’ groups believe Bill 20 will lower the quality of medical care.

The Quebec Federation of General Practitioners has an ongoing petition that calls for the bill to be scrapped. “Bill 20 would put an unheard of concentration of power in the hands of the health minister, and bring punitive consequences that go against Quebec values,” the petition states.

The provincial government believes Bill 20 will increase the number of people with a family physician as they are forced to work hours outside hospital settings and also decrease the number of people making unnecessary trips to the emergency room.

“Bill 20 sends a clear signal,” wrote Health Minister Gaétan Barrette in a letter sent out to doctors in the province. “This is not to abandon hospital practice, but to restore the balance between it and the work in the office. … Put simply, we do not ask doctors to change their daily rhythm of work, we simply ask them to maintain this pace five days a week.”

Bill 20 would also restrict the use of in-vitro fertilization (IVF) to women under the age of 42 who have undergone psychological testing. In 2010, Quebec became the first province to cover IVF as part of provincial health insurance.

Consultations are expected to continue concerning Bill 20 before a final vote is taken in the National Assembly.


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