Canadian Medical Association

As the National Assembly’s parliamentary session draws to a close, the tabling of Bill 15 to “improve the efficiency of the health care system” has been one of the most talked-about bills so far this year. Within minutes of its presentation by Health Minister Christian Dubé, opposition parties, labour organizations and stakeholders in Quebec’s health ecosystem commented publicly on its contents. Some were critical of the 300-page document’s direction and suggested improvements to the minister, but all agreed that the status quo is no longer sustainable.

An efficient system — when you can access it

Everyone agrees that the health care system, although severely compromised, still manages to treat seriously ill patients. In fact, the network performs well once patients are in care. The challenge for patients is getting their foot in the door when their condition is not a matter of life and death. At this point, it’s essential to come to terms with the reality of our access to universal health care. Access is becoming increasingly difficult, and even if the health care system accounts for 42.6% of Quebec’s 2023–2024 spending, it is not guaranteed to be efficient.

We know that bottlenecks, especially on the front lines, must be addressed once and for all. Of course, achieving this will take time. Patients should be looked after by care teams, not just by family physicians. It’s also urgent that we improve the image of family medicine, which has been avoided by medical students across Canada because of its cumbersome nature and growing administrative burden. In Ontario, the School of Medicine at Queen’s University recently opened a satellite campus dedicated to training future family physicians. The first students will start in September. Their goal is clear: to address the shortage of family physicians in southeastern Ontario. Let’s take inspiration from what’s being done elsewhere — it can only benefit our cause.

Putting people at the heart of our network

I’ve been a family physician in Val-d’Or for over 30 years, so I’ve seen my share of health care reforms! Every health minister since I started practising has recognized that the system is not optimal and has been eager to improve it. But the stakes are high, and each era brings new challenges. The well-being of the medical workforce, across all professions, is perhaps one of the most pressing issues today. Let’s not forget that the greatest asset of the health care system is its people — the happier the workforce, the healthier the population. This reform must avoid introducing burdensome procedures that would have the unwelcome effect of causing staff to leave the system for other environments, particularly the private sector. Instead, we need to create healthy workplaces that attract people to the public health care network and, just as importantly, motivate them to remain in it.

One thing is certain: the success of this latest reform depends on the good faith and cooperation of all players, whether they are managers, physicians, allied health care providers or other health system employees. As health care professionals, it is our duty to do everything we can to give the population the system it deserves, even if it means doing things differently.

Dr. Jean-Joseph Condé
Francophone spokesperson and CMA board representative for Quebec

This commentary was initially published in Le Soleil

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