Private Clinics Expand; Doctors Gain Flexibility

Summary#

This bill aims to remove rules the sponsor says slow down Quebec’s health system. It gives doctors more freedom to work inside or outside the public plan and lets private surgical clinics expand their services.

Key changes:

• Ends the rule that doctors must do “particular medical activities” (like assigned ER or on‑call shifts in the public system) to join agreements with the Health Minister.
• Stops using province‑wide and hospital‑level staffing plans that set where and how many doctors can work.
• Creates a new “mixed practice” status so a doctor can work partly in the public plan and partly outside it (private pay). The public insurance agency will set the exact conditions by regulation.
• Repeals a law that required doctors to get permission from Santé Québec before practicing outside the public insurance plan.
• Authorizes “mixed” specialized medical centers (private surgical clinics) and removes limits on their number of beds and the 24‑hour cap on hospital stays.
• Allows the government to require medical students from outside Quebec to sign a return‑of‑service agreement (up to 4 years) to work in a specified region or establishment if they later practice in Quebec.
• Existing agreements tied to the old rules end within 3 months of the law taking effect. The law must take effect no later than one year after it is passed.

What it means for you#

• Patients

  • You may see more private surgical options, including overnight stays, at specialized medical centers (private clinics that do surgeries and advanced treatments).
  • Wait times for some procedures could fall if more surgeries move to these centers. If you choose a doctor or clinic outside the public plan, you would pay out of pocket.
  • Doctor availability may shift by area and hospital because the government would no longer use strict staffing plans or require certain public shifts.

• Doctors and other health professionals

  • More freedom to split work between the public plan and private pay (mixed practice), subject to rules set by the public insurance agency.
  • No obligation to perform assigned “particular medical activities” to take part in agreements with the Health Minister.
  • Fewer penalties tied to participation status and staffing plans are removed in several laws.
  • If you studied medicine outside Quebec, you could be asked to sign a return‑of‑service deal (with a penalty clause) to work up to four years in a set region or facility if you practice in Quebec.

• Hospitals and clinics

  • Public hospitals lose staffing‑plan tools that set quotas and distribution of doctors. Recruiting and scheduling may become more flexible but also less predictable.
  • Specialized medical centers can expand (more beds, longer stays). Centers where participating, non‑participating, and mixed‑practice doctors work together will be allowed (“mixed” centers).
  • Administrative tasks tied to making and following staffing plans are reduced or eliminated.

• Rural, northern, and Indigenous communities

  • Several rules linking staffing to regional plans are removed in laws that apply to Inuit, Naskapi, and Cree services. This may change how doctors are assigned to these regions.

Expenses#

No publicly available information.

Proponents' View#

• Cutting red tape will speed up access to care and reduce administrative work for doctors and managers.
• Letting private surgical centers add beds and keep patients overnight will increase capacity and help clear surgical backlogs.
• Mixed practice will help retain and attract doctors by giving them flexibility, while still allowing them to serve in the public system.
• Ending strict staffing plans and mandatory special shifts will reduce burnout and allow local teams to organize work more efficiently.
• Return‑of‑service for out‑of‑province students can help place doctors where they are most needed.

Opponents' View#

• Allowing mixed public‑private practice could pull doctors and nurses toward private work, making public‑system wait times worse.
• Removing required “particular medical activities” may reduce coverage for ERs, long‑term care, or other hard‑to‑staff services.
• Ending staffing plans may worsen doctor distribution, especially in rural, northern, and Indigenous communities.
• Expanding private surgical centers (more beds and overnight stays) could siphon staff and resources from public hospitals and create more two‑tier access based on ability to pay.
• Repealing permission requirements and softening penalties may weaken the government’s ability to ensure doctors meet public‑system needs.