L'Agora Clinic, vital healthcare center for Montreal's most vulnerable, says it will be forced to close on April 1 due to Quebec's new Bill 2.
Critics warn the law threatens to make it financially impossible for clinics serving patients with complex needs to operate. Under the legislation, doctors could take a cut of up to 15 percent of their pay based on yet-to-be-determined criteria, potentially impacting clinics that provide care to LGBTQ2 patients, sex workers and people experiencing homelessness, or patients who often require longer, more intensive care.
Founded in 2019, L'Agora Clinic serves approximately 6,000 patients, many of whom live with addiction, HIV, hepatitis or serious mental health problems. Some patients don't even have a RAMQ card, but the clinic's philosophy has always been to make them feel safe, welcome and cared for.
“The philosophy here is really to allow these patients, who typically have a hard time finding a place in the health care system, to feel at home and feel safe,” said Dr. Antoine Cloutier-Blay, a former co-owner of the clinic.
The clinic provides critical services including street outreach, sexual health support and follow-up care for people facing long-term consequences of substance use.
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“We have noticed that substance use disorders are not classified as a priority, homelessness is not considered a public health issue, and gender-affirming care is not recognized as a priority,” added Dr. Cloutier-Blay.
Bill 2 would tie a portion of doctors' salaries to the vulnerability of their patients, determined by a government-established color-coded system, raising concerns among health care workers.
“So now that we've failed them, we're going to treat them as a priority? It's just neglect,” Dr. Cloutier-Blay said.
The law has already forced Clinique L'Agora to stop accepting new referrals from homeless shelters and supervised injection sites, putting thousands of patients at risk.
“You don’t improve access by closing points of care,” he added. “Math is not mathematics.”
At the largest LGBT2 health conference in Montreal, experts and advocates spoke out against Bill 2.
“In the case of Agora, we are talking about 6,000 patients who need access to care, to a doctor they can trust, because they cannot rely on the mainstream health care system because of its shortcomings,” said Celeste Trainon, one of the conference keynote speakers and founding director of Clinic Juritrans.
Health care providers warn that the loss of clinics like L'Agora could lead to preventable health crises and even the deaths of people who are not affected.
Many clinics are calling on the government to reconsider Bill 2 before it comes into effect on Jan. 1, saying that otherwise Montreal's most vulnerable populations will lose access to essential health care.
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