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Montreal Gazette
06-08-2025
- Health
- Montreal Gazette
Hanes: A bitter pill to swallow as Quebec's family doctor shortage deepens
The lack of access to a family doctor is one of the Quebec health system's chronic problems. And despite all the government's attempts to cure the ailment, the prognosis only seems to get worse. The latest checkup by the Institut de la statistique du Québec revealed how much the situation has been deteriorating. It shows the proportion of Quebecers assigned to a family physician dropped to 72 per cent last year from 82 per cent in 2019. And that was actually a high for the decade. It had climbed steadily from 66 per cent in 2013, but then drooped again over the past five years. Like most chronic conditions, the causes are no mystery. According to the ISQ, the main reason is that there are still more physicians retiring or leaving the public health system than are being recruited into family medicine. But that doesn't tell the whole story. First off, newly minted doctors have other responsibilities the health system depends on, like working in long-term care, birthing centres or emergency rooms. So the new recruits being counted on to provide relief have less time to see patients in their offices. But beyond time constraints, young doctors have been giving family medicine the cold shoulder in recent years, despite the government opening up more residencies in the field. This year, 69 residencies in family medicine went unfilled in Quebec, out of 94 in Canada, after the annual matching process. Last year, 70 of 75 empty family medicine spots in Canada were in Quebec. Over time, those absences have added up to around 700 new recruits missing in action, by some estimates, out of a shortage of nearly 2,000 physicians across Quebec. While all provinces face challenges finding enough family doctors, there are other complications in Quebec. These include physicians having to perform those extra duties, known as Activités médicales particulières, as well as having to obtain a special permit (PREM) dictating where in the province new physicians can hang out their shingle. These extra hoops, which limit mobility and exist nowhere else in Canada, have become major deterrents for medical students choosing family medicine. So many fresh graduates end up leaving Quebec to practise, or go to work in private health care, in order to avoid the hassle. Many of the remedies the government put in place to improve access to a physician have actually compounded the scarcity. As the ISQ noted, the assignment of orphan patients to family medicine groups through the Guichet d'accès à un médecin de famille, or GAMF, has also contributed to the declining ratios. Those patients do have some access to appointments, but they don't figure into the tallies of Quebecers followed by a family doctor. On top of that, the Guichet d'accès à la première ligne (GAP), which allows orphan patients to find urgent appointments with a general practitioner rather than having to clog up the ER, is also sucking up physicians' time, depending on how many appointments they open up for walk-ins compared to their own patients. The GAP may give patients access to a doctor for their urgent health needs, but it has undermined the whole premise of family practice — not to mention preventive health care. This fast-food ethos has made family medicine even less attractive. But as efforts to resolve the chronic physician shortage falter or fail, the government of Premier François Legault has doubled down. These include legislation to force young doctors who train in Quebec to remain in the province to practise — or face hefty financial penalties. Along with the PREMs, some have likened the new constraints on doctors' autonomy and freedom of movement to a prison. Instead of slowing the flow, a Gazette investigation found that the new restrictions have only accelerated the departures, since the law didn't slam the door on the parallel private system. There are now just over 560 doctors who have opted out of public health care in Quebec, including 5.4 per cent of all family physicians, compared to 12 doctors in the rest of Canada. Yes, 12. If ever there was a clue Quebec is on the wrong track, that is pretty compelling evidence. The Legault government also presented legislation to impose a new remuneration mode on family doctors that will include a performance-based component. The move rankled young and practising physicians alike. Legault's strong-arm approach to dealing with doctors dates back to when he was health minister in a Parti Québécois government two decades ago. Legault was the one who introduced PREMs, after all, to ensure an even distribution of doctors across the province. But as the coercive measures have multiplied since his Coalition Avenir Québec came to power, morale among doctors has plummeted while anger and mistrust have risen. All of this has fuelled a quadruple exodus — avoidance of family medicine, hastened retirements, leaving the province and moving to the private system — the results of which the latest status report from the ISQ laid bare. The Hippocratic oath obligates doctors to do no harm. If only the Legault government would apply the same principle to its management of the health system. This story was originally published August 5, 2025 at 5:00 AM.
Montreal Gazette
31-07-2025
- Politics
- Montreal Gazette
Opinion: Accessible public transit? Montreal has let me down
I am a dual Canadian-American citizen studying in Ithaca, N.Y., during the academic year, but living in Montreal since May. Many services in Upstate New York lack full accessibility, including transportation. I thought relocating to Montreal would be different. Unfortunately, I was proved wrong. Though I have several disabilities, I am able to walk to work each day. But I rely on the métro to manoeuvre around the city on a regular basis, and this has made me realize that it must be near impossible for severely impaired individuals to get from Point A to Point B using Montreal's transit system. Only 30 of 68 métro stations qualify as universally accessible, being equipped with elevators. That means many people with physical hindrances more severe than mine cannot access over half of the underground network and are forced to find other means to get around, such as paying for potentially expensive private rides. A lack of accessible transportation affects and perpetuates wealth gaps. The wider economic impact should be of concern to all. According to federal and provincial statistics from 2022 and 2023, the employment rate of people with disabilities in Quebec was 44.6 per cent, while it was 62.1 for the general population. The Institut de la statistique du Québec reports that 21 per cent of the Quebec population 15 and over had a disability in 2022. Last December, when unveiling Montreal's Municipal Universal Accessibility Plan 2024-2030, Mayor Valérie Plante stated: 'We are taking an important step toward our goal of making Montreal a city that integrates universal accessibility into every stage of its decisions and the implementation of its activities.' But while the words and intentions may be well-meaning, it's hard to be optimistic given the reality on the ground, and the mayor's own frustrations about chronic underfunding of public transit by the Quebec government. Because the province is largely responsible for determining the funding of public transport, and because Quebec is not providing cities with sufficient money for accessible transit, Montreal's promised progress has stagnated, and people with hindrances are confined to limited areas of the transit network. If we want Montreal to live up to its big-city status, it's time for all of us to take an unequivocal stand against these discrepancies in treatment and advocate for more accessible transportation. We live in a time when we're seeing the rights of people with disabilities come under threat globally. In the U.S., the Trump administration's dismissal of diversity, equity and inclusion blatantly diminishes this community. In the U.K., The Guardian reports that people with disabilities are much more likely to struggle to heat their homes and may have to cut back on food more so than the average individual due to wealth gaps versus their able bodied counterparts. Whether our political leaders carry through on commitments to improve accessibility, in public transit and elsewhere, will determine what side of history Montreal and Quebec will end up on. We can collectively urge the provincial government to reconfigure its budget to help achieve the goal of a universally functional public transit system in Montreal. This would help local politicians keep their word and begin fulfilling the city's accessibility plan, including making public transportation more inclusive. Activism is essential if people with disabilities are to have their needs considered by governments. Citizens can voice their concerns about public transit to the Quebec Transport Ministry and the Autorité régionale de transport métropolitain, or speak out at city hall. It is urgent that we advocate for accessibility equality. Change can be ignited if we push our political leaders to start accommodating everybody. James Goldberg is a Cornell University student and an advocate for the disabled community in the United States and Canada.
Montreal Gazette
30-07-2025
- Business
- Montreal Gazette
Montreal, surrounding region could see ‘record population decreases' as immigration wanes
By An expected drop in temporary immigration may spell trouble for Montreal, long the preferred destination for newcomers to Quebec. The island of Montreal's population could shrink by 184,000 by 2030, Quebec's statistics institute said Wednesday, pointing to a projected decline in new arrivals as the main culprit. Montreal and its metropolitan area 'stand out as regions with very low, even negative, projected growth,' according to a report from the Institut de la statistique du Québec detailing updated demographic projections. In the short term, by 2030, both the island and the region could see 'record population decreases.' The population of the island — which includes the city of Montreal and demerged suburbs — could drop by 9.2 per cent. Meanwhile, the metropolitan region's decline is projected at 3.3 per cent. The region includes Laval, Longueuil and other nearby cities. The report also took a longer view. By 2051, the island could face a population decline of 4.5 per cent, with the metropolitan area seeing growth of 2.6 per cent. The institute stressed that its projections, updated annually, 'are not forecasts or predictions.' Instead, they provide 'neutral and objective insight into the range of possible demographic trends in Quebec.' In contrast with Montreal, the Quebec City area could experience a surge in growth. The region that includes the provincial capital is projected to experience the province's highest population growth between 2021 and 2051, at 20.8 per cent, the institute said. The population of the island of Montreal is estimated to be 2.2 million, with 4.6 million people living in the broader metropolitan area. The Quebec City region, by comparison, has a population of 812,000. Quebec's overall population is estimated to be 9.1 million. Under the updated projections, the institute expects the province's population to stabilize at around 9.2 million in the coming decades. Over the next five years, Quebec could lose about 80,000 people (about 0.9 per cent), mainly due to a drop in temporary immigration. The institute said it also now anticipates fewer births, contributing to the province's aging population. Despite the projected decrease in Quebec's population, the institute projects a 0.8 per cent increase in housing needs by 2030. That's because the province is expected to face significant growth in housing demand among older Quebecers, particularly for collective housing such as seniors' residences.
Montreal Gazette
19-06-2025
- Business
- Montreal Gazette
Quebec exports, imports dropped in April amid trade war
By Quebec's international exports declined 12.5 per cent from to March to April, the largest percentage decline since the beginning of the COVID-19 pandemic, the province's statistics institute said Thursday. The decline, which came during the first full month during which United States import tariffs were in place on Canadian aluminum and steel, followed a 4.5 per cent decline in exports from February to March, according to the Institut de la statistique du Québec. Exports to the United States dropped 26.9 per cent from March to April, with $6.3 billion in exports heading south of the border that month, the lowest level since February 2022. The U.S. imposed and paused across-the-board tariffs on Canadian goods in February and March, before exempting goods that are compliant with the Canada-United States-Mexico Agreement. U.S. tariffs on all aluminum and steel imports — including from Canada — came into effect in March 12 and were doubled in June. Exports to all other countries dropped by 10.7 per cent from March to April, the ISQ said. Despite the month-to-month decline, overall exports were up 2.9 per cent in April when compared to the year before. The province's imports declined 9.2 per cent from March to April, after declining 5.7 per cent the month before, the ISQ said. However, they were up 1.3 per cent from April 2024. The ISQ says export data from the federal government was delayed due to issues with a new computer system used by the Canada Border Services Agency.
CBC
31-01-2025
- Business
- CBC
Here are the top Quebec exports to the United States
Quebec's economy is inextricably intertwined with that of the United States. Its southern neighbour is by far its largest international trading partner, accounting for more than 70 per cent of all the province's exports. In 2023, the province exported $87.3 billion worth of products to the U.S., according to the Institut de la statistique du Québec. U.S. President Donald Trump has said he will impose 25 per cent tariffs on Canada on Saturday, though his administration hasn't given details on when they would go into effect or what goods would be affected. "Mexico and Canada have never been good to us on trade. They've treated us very unfairly on trade and we will be able to make that up very quickly because we don't need the products that they have. We have all the oil that you need, we have all the trees you need — meaning the lumber. We have more than almost anybody in those two categories," he said Thursday. Premier Francois Legault has said the government will assist any industries and people affected. "I want to send a very clear message to Quebecers: no matter what Trump does, we're going to protect you at all costs and we're going to get through this together," he said last week. Here's a look at the top industries in terms of exports to the United States.
