The Legault government will require Quebec-trained doctors, both general practitioners and specialists, to work in the public health-care system for the first five years of their careers, under threat of stiff fines.
A bill to this effect was introduced at the National Assembly Tuesday afternoon by Health Minister Christian Dubé. It will be studied in 2025.
“We are giving ourselves the means to ensure that the population has access to the care for which they pay,” Dubé said in a news release.
Bill 83, titled An Act to Foster the Practice of Medicine in the Public Health and Social Services Network, includes fines for violators ranging from $20,000 to $100,000 per day, with repeat offences incurring fines of $40,000 to $200,000.
On Tuesday morning, the three opposition parties expressed an agreement in principle, but said they would need to examine the bill in detail before taking a stance.
In a recent statement, the Quebec College of Physicians also argued that new medical graduates should not be allowed to practise privately at the start of their careers.
Its president, Mauril Gaudreault, suggested a potential 10-year prohibition, though he said the exact length would need discussion.
By taking this approach, Quebec aims to curb the growing trend of doctors leaving for the private sector.
Currently, 775 of Quebec’s 22,479 doctors work exclusively in private practice — a 70 per cent increase since 2020, according to the Ministry of Health and Social Services.
Premier François Legault has long considered barring new doctors from working privately.
Santé Québec will manage all health-care establishments in the province but workers and community groups are worried the change in hierarchy will cause concerns and confusion.
While serving as education minister under Parti Québécois premiers Lucien Bouchard and Bernard Landry, Legault proposed requiring new doctors who moved to Ontario or the United States to reimburse their training costs.
However, this conflicted with Section 15 of the Canadian Charter of Rights and Freedoms.
Moving away is still something the province is concerned about. In a news release, the government says, “a significant number of physicians trained in Quebec are leaving the province for other jurisdictions. This phenomenon is once again significant among new physicians.”
Last month, the premier hinted that his government might need to pre-emptively invoke the notwithstanding clause to achieve its goals.
However, this constitutional provision is not mentioned in the eight-page legislative document presented by Dubé on Tuesday.
Training a doctor, including residency, costs Quebec taxpayers between $435,000 and $790,000. For this reason, Dubé said he believes the public has the right to expect new graduates to spend some time working in the public system after completing their education.
“Our government is taking the necessary steps to ensure the commitment of doctors to the population and the public network,” he said in a news release.
The minister has pledged that by the summer of 2026, all Quebecers will be under the care of a health professional.
The introduction of this bill coincides with ongoing contract negotiations between the government and two major doctors’ unions and follows the recent launch of the new Santé Québec agency.
