François Legault, leader of Quebec’s Coalition Avenir Québec government, comes by his reputation as an authoritarian honestly. Over the past seven years, he has repeatedly used extraordinary parliamentary tools to consolidate power and sidestep democratic scrutiny. The premier has invoked the notwithstanding clause to shield two major laws from Charter challenges—effectively placing them beyond judicial review—and has relied on closure to ram through contentious legislation by cutting off debate. Most recently, the CAQ used closure again to fast-track Bill 2, a move that underscores Legault’s preference for control over consultation.
The CAQ argues its new legislation is about wresting control from a fragmented, ineffective system to ensure equitable access for all Quebecers. It tries to do this by completely overhauling the way doctors are paid, tying compensation to performance metrics that doctors call unrealistic, especially after the government’s own $1.5 billion in health care cuts led to the very shortages and delays it now claims to want to fix. These cuts have severely compromised the system’s efficiency and have left staff with fewer resources and restricted access to medical care—problems well beyond doctors’ control. Even more alarming, physicians warn, the new law threatens their constitutional right to dissent, imposing fines of up to $20,000 per day for public protest.
In 2018, one of the CAQ’s main electoral promises was that all Quebecers would have access to a doctor. Seven years later, roughly 1.5 million Quebecers still remain without a family physician. Premier Legault now believes he can get every Quebecer access to a health care professional by 2026 (coincidentally a provincial election year), even though access to a general practitioner remains difficult, wait lists to see a specialist have almost doubled in the past five years, and surgery wait lists remain high, with nearly 30 percent of operating rooms in the province’s public network closed in 2024 due to staffing shortages.
Doctors say Bill 2’s oppressive requirements penalize them for the governments’ own failings. “They tabled a bill that affects our remuneration without even consulting us while we’re in negotiations,” Véronique Godbout said back in June, when I interviewed her for Cult MTL. A practising orthopedic surgeon and the president of the Quebec Orthopedic Association, she calls the government’s actions “disrespectful and denigrating.”
She’s not the only doctor who’s furious. Andrée Vincent, the lead physician at a Montreal-based network of family doctors called Groupe de médecine de famille (GMF), is a franco-Albertan who fell in love with Quebec during her medical residency at McGill and decided to stay. Now she’s considering a move back west. She says the government is pushing through legislation built on false premises. “The facts were wrong right from the start,” she says. “The bill works under the assumption that there are enough doctors and enough resources, but there aren’t. We already can’t meet the demand, and many of us are already working way more than forty hours per week. It’s still not enough.”
Quebec health minister Christian Dubé insists the reforms would improve access to health care by incentivizing doctors to take on more patients. Francine Goldberg, owner of a multi-disciplinary GMF clinic, says the move will accomplish the opposite. “Minister Dubé does not have a good grasp of what’s happening on the ground and on the front lines.” Vincent rejects accusations of entitlement levelled by Dubé and Legault. “They accuse us of being lazy and not wanting to work,” she says. In reality, explains Goldberg, doctors feel trapped by a system that is stripping away their professional autonomy. She points to the specific benchmarks set by the new centralized agency, Santé Québec—such as the number of patients treated, appointment availability, follow-up rates, and efficiency measures—which she says override doctors’ ability to decide how best to treat patients and manage their workload.
The result, she says, will be predictable. They will simply walk away. “Clinics are going to lose doctors; therefore, patients are going to lose access to specialists, and family doctors can’t keep up with everything. I’m going to spend days vetting angry phone calls from sick patients who can’t access health care, and I won’t be able to do one single thing to help them.”
The backlash has been unprecedented. Two Quebec federations representing the province’s medical specialists and family doctors have filed a lawsuit to challenge the legislation. One-fifth of doctors at Montreal’s Queen Elizabeth Family Medicine Group plan to quit Quebec, according to the Montreal Gazette. Three chief physicians with western Quebec’s health authority in Outaouais have already resigned.
Many doctors staged a clinical work stoppage last month, further reducing access for patients, while students at all four medical schools have voted to strike. The Montreal Gazette reports that nearly 400 doctors have already applied for licences in other provinces, with Ontario and New Brunswick seeing a significant uptick in applications.
The CAQ’s own ranks haven’t been spared in the public fallout. After Social Services Minister Lionel Carmant’s daughter, a specialist in maternal-fetal medicine, published an open letter in Le Devoir, saying she might move elsewhere in Canada if the government does not “allow her to practise freely,” Carmant resigned, explaining he was “choosing his own family.” He now sits as an independent.
Days later, CAQ member of the national assembly Isabelle Poulet would be ousted from the party caucus by Legault after she openly criticized Bill 2 and was looking to cross the floor and join the Quebec Liberal Party.
While internal conflict erupts within the CAQ, other provinces are actively trying to poach Quebec doctors. Ontario premier Doug Ford even encouraged the exodus of Quebec physicians, jokingly inviting those interested to call “1-800-Doug-Ford” and reach out to him on his cellphone during a press conference. “We’ll have you working real quick,” he said. “Come by. We’ll roll out the red carpet for you.” The move angered Legault, who called Ford’s statement “totally unacceptable.”
A province with a rapidly aging population and a worsening doctor shortage can ill afford to lose more physicians. The new legislation could also deter medical students, residents, and early-career doctors from choosing Quebec as a place to train or practise, as the province’s reputation suffers from what critics call overreach and control. Doctors already resent being micromanaged, especially under such strained conditions and mounting administrative burdens that have left many feeling stretched to the limit.
Many questions also remain about the legislation. Performance indicators are determined at the government’s discretion and can vary by region. There is, as yet, no transparent, standardized system for how these targets are calculated or communicated. “Who decides if a doctor is doing enough? Bureaucrats who’ve never treated a patient?” says Goldberg. “The metrics are not defined. Would you sign a contract where the clauses are not defined? That’s what they’re doing to doctors.”
Ultimately, Goldberg says, the bill penalizes Quebecers the most. “Highly coveted professionals can—push comes to shove—leave,” she says. “They can leave and hang their shingles elsewhere. The government is punishing the public.”
While Legault continues to play hardball, there are signs he might be bending to public pressure. The CAQ has suspended two key parts of Bill 2 that would have eliminated bonuses for doctors and invited them back to negotiations. It’s a move Vincent isn’t certain will be enough to pacify the medical community. “At this point, it would be a consultation, not a negotiation,” she says. “Because the law has already been written.”
Beneath the anger and disillusionment lies deep concern about the future of Quebec’s health care system and what that could mean for a public already having trouble accessing medical services. “If this were to truly happen,” says Vincent, referring to the law, “I wouldn’t want to get sick here in the next year.”
