Cut Red Tape, Expand Health Services

Summary#

• This Quebec bill updates how professional orders are regulated and widens what some health and social service professionals can do.
• The goal is to cut red tape, speed up rule changes, and improve access to care, especially in primary care and mental health.

Key changes

• Shifts more rule‑making and approvals from the government to the Office des professions du Québec (the provincial body that oversees professional orders).
• Creates a single, province‑wide process to challenge and arbitrate professional fees.
• Lets nurses prescribe some tests, medicines, and products (details set by future regulations).
• Expands midwives’ ability to provide contraception and test and treat certain sexually transmitted infections for anyone, not only pregnant patients.
• Allows optometrists to prescribe and administer more eye‑care medicines in primary care.
• Clarifies and updates dietitians‑nutritionists’ scope of practice.
• Lets marriage and family therapists practice psychotherapy without a separate permit (like psychologists and physicians). Eases recognition of psychotherapy permits from other Canadian provinces.
• Adjusts pharmacy rules to allow limited cases where a pharmacist with a small financial interest can prescribe or substitute a drug from that manufacturer, and allows manufacturers to pay certain dividends to pharmacy banners or wholesalers under set conditions.
• Adds more transparency to public registers of professionals (for example, practice sector and past permit revocations).

What it means for you#

• Patients and families

  • Easier access to primary care: nurses will be able to order more tests and prescribe some medicines once regulations are in place.
  • Midwives can offer contraception to anyone and handle screening and first‑line treatment for certain sexually transmitted and blood‑borne infections in people without symptoms who test positive.
  • Optometrists can treat more common eye conditions in primary care or as part of an ophthalmologist’s plan, which may shorten waits.
  • Dietitians‑nutritionists’ role is clearer and broader, focused on treatment plans to maintain, improve, or restore health.
  • You will have a clearer, standard way to contest a professional’s bill and seek a refund, interest, or an allowance if appropriate.
  • Public registers will show more about a professional’s practice and any past limits or revocations.

• People seeking mental health care

  • More providers can offer psychotherapy: marriage and family therapists can practice without getting an extra psychotherapy permit.
  • The province can more easily recognize psychotherapy credentials from other parts of Canada, which may increase the number of available therapists.
  • Trainees may be allowed to perform some psychotherapy activities during supervised training, if the Office sets rules.

• Nurses

  • You will be able to initiate and prescribe certain tests, medicines, substances, products, and dressings as set out in future regulations, with required training.
  • Rules that let non‑nurses perform certain nursing activities will be updated to match these changes.

• Midwives

  • You can prescribe and administer contraception and handle certain STI screening and first‑line treatment for any person, not only those who are pregnant or postpartum.
  • Some prescription form limits tied to 6 weeks after birth are removed.
  • Professional codes clarify that references to “woman” include any person you serve.

• Optometrists

  • You may prescribe and administer medicines and provide eye‑care treatment in primary care, or as part of an ophthalmologist’s plan. Extra training may be required if you do not already hold past permits.

• Dietitians‑nutritionists

  • Your scope is updated to emphasize treatment and intervention plans tailored to health needs, including symptom relief.

• Pharmacists and pharmacy chains

  • In limited cases, you may prescribe or substitute a generic or biosimilar drug made by a company in which you hold a non‑notable share interest, if no prohibited benefits are involved and other conditions are met.
  • Manufacturers may pay declared share dividends to intermediaries like banners or wholesalers under the drug insurance law, within set limits.

• Members of professional orders

  • More of your order’s internal regulations can take effect faster if they follow the Office’s guidelines.
  • Board members of orders will follow ethics and conduct standards set by the Office, which will also investigate and sanction breaches.
  • Calling an extraordinary general meeting will require a minimum number of signatures or 10% of members, whichever is higher.
  • Some governance structures (for example, in the agronomists’ order) will change on set future dates.

• Timing

  • Some parts start at the bill’s approval. Others need new regulations to take effect or have set future dates (some as late as April 1, 2027). Nurse prescribing powers, for example, begin only after new regulations are adopted.

Expenses#

No publicly available information.

Proponents' View#

• Reduces red tape so professional orders can update rules faster while still following province‑wide guidelines.
• Expands primary care capacity: more tasks can be done by nurses, midwives, optometrists, and dietitians, which may cut wait times and free up doctors for complex cases.
• Improves access to mental health care by letting marriage and family therapists practice psychotherapy and by recognizing permits from other provinces.
• Gives clients a clear, standard process to contest fees, which can build trust in professional services.
• Increases transparency by adding more information to public registers of professionals.
• Modernizes pharmacy market rules with clear conflict‑of‑interest limits and makes allowed financial benefits explicit and regulated.

Opponents' View#

• Moves too much power from elected government to the Office des professions, reducing democratic oversight of professional rules.
• Scope expansions could risk patient safety if training, supervision, or safeguards are not strong or consistent across settings.
• Allowing pharmacists to prescribe or substitute drugs tied to companies they partly own may create conflicts of interest and could influence drug choice.
• Letting manufacturers pay dividends to banners or wholesalers might steer purchasing toward certain brands and raise system costs.
• Ending the psychotherapy advisory council and broadening who can practice psychotherapy may lower standards or create uneven quality of care.
• Implementation will take time and resources; with many pieces dependent on new regulations, the transition could be confusing for the public and professionals.