Quebec government wants to restart talks with doctors over payment reform

QUÉBEC — Quebec Premier François Legault is extending an olive branch to the province’s doctors amid a fight over a new law that changes how physicians are paid.

Legault said Tuesday he wants to restart talks with doctors about the terms of his government’s payment reform bill, which was fast-tracked through the provincial legislature late last month.

The new law ties part of physicians’ remuneration to performance targets, and threatens steep fines for those who use pressure tactics to boycott the changes. Doctors have been up in arms since the law was adopted, arguing it muzzles them and could drive physicians out of Quebec.

Legault has been under pressure from within his party and from outside the province. On Tuesday, he expelled a member of his caucus who was apparently unhappy with the legislation. Last week, one of his longtime ministers resigned over the bill. And Ontario Premier Doug Ford has also jumped into the fray, promising to roll out the red carpet for Quebec doctors seeking greener pastures.

Speaking to reporters in Quebec City, Legault said he will not back down on payment reform for doctors. “It’s adopted and we won’t revisit it,” he said. But he added that he’s open to discussing the “terms and conditions” of the bill with physicians.

In a gesture of goodwill, Health Minister Christian Dubé said the government will suspend two elements of the new law that make specific changes to how physicians are paid, which he said “have caused a great deal of concern” among doctors.

Hours after that announcement, however, Legault declared he had expelled Isabelle Poulet, a member of his caucus who appeared to have been thinking of leaving. Poulet had been scheduled to speak with the media earlier in the day about her political future, before cancelling the press conference at the last minute and meeting with Legault this afternoon.

The new law on doctors’ remuneration was “the straw that broke the camel’s back” for Poulet, according to a source who spoke on condition of anonymity, as they were not authorized to speak publicly.

Before Legault’s meeting with Poulet, Liberal Leader Pablo Rodriguez told reporters that she had approached his party about crossing the floor, but said he wasn’t interested.

In a brief statement Tuesday evening, Legault said he expelled Poulet because he needs a united team. “You can’t be a member of one party while shopping around for another,” he said. “That’s a serious mistake.”

Poulet’s departure follows the resignation of one of Legault’s ministers, Lionel Carmant, who announced last week he was quitting the caucus after expressing doubts about the bill. Carmant’s daughter, a physician, also published an open letter criticizing the law.

Meanwhile, doctors seemed unmoved by Legault’s overtures on Tuesday. “The government does not appreciate the real underlying anger felt by family physicians at this time,” said the province’s federation of family doctors in a statement. The union listed several conditions it says must be met before it will return to the bargaining table. It wants the government to suspend the application of the law and abandon the use of performance indicators, which it says push doctors to practise “fast-food medicine.”

The Quebec federation of medical specialists said it’s waiting for “official communication from government negotiators.”

The new law links 10 per cent of physicians’ pay to performance benchmarks such as appointment and surgery numbers, with the intent of encouraging physicians to see more patients. Legault says it will benefit the 1.5 million Quebecers who don’t have a family doctor, but physicians say the payment reform will sacrifice quality of care in favour of volume.

According to the legislation, physicians could face fines of up to $20,000 a day if they take “concerted actions” to boycott the bill, such as refusing to teach students. On Tuesday, the Quebec federation of medical students asked a Quebec Superior Court judge to suspend those provisions of the law, arguing they are unconstitutional. The union of medical specialists will also challenge the penalties set out in the law in court on Thursday.

This report by The Canadian Press was first published Nov. 4, 2025.

– By Maura Forrest in Montreal, with files from Thomas Laberge and Caroline Plante in Quebec City and Pierre Saint-Arnaud in Montreal

The Canadian Press