Quebec reaches tentative deal with family doctors

An agreement has finally been reached between Quebec and family doctors on the primary care access window, the Guichet d’accès à la première ligne (GAP).

Health Minister Christian Dubé wrote on X late Thursday afternoon that the progress made with the “gateway agreement for the GAP” will make it possible to preserve “certain important principles,” notably collective registration.

For her part, Treasury Board President Sonia LeBel wrote on the social network that the agreement will make it possible to maintain care for more than 900,000 patients.

“The work is not finished: now we will devote our energy to negotiating the renewal of the framework agreement,” she said.

Dubé addressed the Montreal Chamber of Commerce at noon on Thursday, talking in particular about the progress made in health care and the challenges he intends to address with the new Santé Québec agency.

In a press scrum, he stated that negotiations seemed to have broken the deadlock in recent days.

“From what I understood yesterday from our negotiators, there has been significant progress … We agreed that it would take a response today,” the minister said. The president of the Fédération des médecins omnipraticiens du Québec (FMOQ), Dr. Marc-André Amyot, acknowledged that discussions were going well.

“I think that if both sides put a little water in our wine, we could come to an agreement,” he said.

Dr. Amyot wanted to “give ourselves the time we need to reach a good agreement.” He maintained that “we negotiated very hard in the last few days” until late Wednesday evening.

By 2022, Dubé and the FMOQ had agreed that family medicine groups (FMGs) would take charge of patients without a family doctor. An annual premium of $120 was paid for each patient registered with an FMG through the GAP.

But this agreement expired on May 31, and the two parties were unable to agree on new terms for renewing the GAP. However, Dr. Amyot hinted on Thursday afternoon that the amount of the annual premium could be reduced: “It’s part of the discussions that are underway.”

Not as many appointments as before

This dispute has had consequences for patients. The number of appointments offered on GAP fell from 17,604 in the week of May 18 to 1,133 for the week of June 29.

Dr. Amyot said that, following the agreement, patients can expect to see an increase in the number of times they can see a family doctor, compared with “the current state.”

However, according to the FMOQ president, there will be no return to “the previous state of the GAP.” According to him, some doctors who had decided to postpone retirement to offer GAP services may have retired now “under the circumstances.”

He added that Ontario doctors who had come to help out in the Outaouais have now returned to Ontario.

Dubé pointed out that several doctors are currently continuing to offer appointments.

“When people call GAP, there’s definitely less service than before … I want to thank the doctors who have decided to continue taking appointments.”

“At the moment, emergency is unfortunately the alternative taken by many,” said Dubé, but he recommends that people continue to use the GAP since they can be referred to other health-care professionals as needed.

To welcome Dubé to the Palais des congrès, health and social services union organizations were on hand to remind the minister that “his reform is everything but health.”

Around 100 demonstrators chanted several slogans, including “Who’s top gun: we’re top gun” and “Stop treating us as if the private sector is going to save us all.”

This report by The Canadian Press was first published in French on June 13, 2024. The Canadian Press health content is funded through a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for editorial choices.