In its rush to pass the controversial Health Services and Doctors' Remuneration Bill 2, Quebec has created a wave of confusion over salaries in the health-care system. This is where sharp disagreements arose between doctors, the Legault government and its minister Christian Dubé.
The College of Physicians is absolutely right to demand the immediate suspension of the Medical Services and Remuneration of Physicians Act 2, which the Legault government recently passed under a gag order.
This is a poorly designed law that creates a lot of confusion regarding physician compensation.
In my Saturday column: “Unpleasant squeeze for doctors“I indicated that physicians would suffer, compared to 2024-25, a noticeable decline in wages starting in FY 2025-26 (-$330 million) and that they would worsen over the next two fiscal years, i.e. 2026-2027 (-$1.24 billion) and 2027-2028 (-$1.27 billion).
Minister Dube's office disputes this claim. He argues that doctors' salaries will not be cut if they meet performance targets that will allow them to receive a 15 percent bonus. For specialists, Dubé's office says, that equates to an annual amount of $700 million for 2026-27 and 2027-28, and for general practitioners an amount of $300 million.
We understand that we are talking about a hypothetical size of the potential premium. To receive this 15 percent bonus, doctors will still have to meet performance targets set and monitored by the government. We look forward to seeing how many of the approximately 22,000 doctors working in the public health system will receive the full bonus.
GUESS THE GAME
In the summary of Law 2 published by “Your Government”, the amount reserved for this bonus (effective from 1is January 2026) is not included in the “overall budget package” of physician remuneration that the Legault government established for either the 2026-2027 and 2027-2028 fiscal years, or for the last quarter of 2025-2026.
Question: Why did you write “The bill sets the overall budget package for physician compensation” at such and such an amount for each of the five years covered by the agreement, if the specified budget envelope published in the Bill 2 summary does not include all compensation?
Another confusion
The total amount of the general budget for doctors' compensation for 2023-2024 and 2024-2025, published by the government in Law 2, is lower than the amount published for the same years in the annual report of the Régie de l'assurance santé du Québec (RAMQ) for 2024-2025. The gap is $112.1 million for 2023-24 and $159 million for 2024-25.
Who's right? Law 2 or RAMQ?
SCALPEL CUT
The Legault government reduced the automatic 30% increase in rates that GPs in GMF (Group Family Medicine) received to pay for support (secretary, office, IT, nursing, etc.).
For what? Because “for many years, GMFs have competed, especially in terms of fees charged to doctors,” Christian Dubé’s office explains, even suggesting that in GMFs with lower fees, “the interests are not aligned and the patient suffers.”
The Legault government will transfer $300 million from the rate increase to the GMF support program.
“This way,” the office explains, “we ensure that the money is actually used to hire specialists, improve patient care and support physicians. This also means that family physicians will no longer have to pay 'rent' to their GMF.”
What a sign of trust in general practitioners!
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