Latest news with #médecins
CBC
30-05-2025
- Business
- CBC
Quebec doctors say new bill will drive them away, threaten patient access
Doctors at a medical clinic in Kingsey Falls, a town in central Quebec, say they're contemplating closing their clinic and pivoting out of family practice — or Quebec altogether — if a bill allowing the province to regulate how physicians are paid is adopted as it is written. Bill 106, tabled earlier this month, would link up to 25 per cent of physicians' pay to their performance in an effort to get them to take on more patients. But in a statement posted to their social media, doctors at the Kingsey Falls medical clinic said the new rules would impose unattainable performance targets on them and reduce their ability to deliver quality care to patients. "We can't take on more patients if we don't have more resources or a system that's more efficient and productive to be able to take good care of them," said Dr. Isabelle Lemieux, who works at the clinic. As legislative hearings on the bill run their course, the clinic and others in the province are warning their patients that they risk losing their family doctor — despite Article 4 of the bill suggesting otherwise — and are asking them to write to their local MNA. The clinic has since deleted its statement and letter templates from its Facebook page. Quebec's College of Physicians (CMQ) has condemned these types of communications after being confronted about them by Health Minister Christian Dubé during Tuesday's hearing. "They transmit false information," wrote the college's president Mauril Gaudreault in a statement to Facebook. In the halls of the National Assembly Thursday morning, Dubé said the college did the right thing by adding that "what is important are the interests of the patients." But the debate rages on as doctors continue to voice their concerns, some echoed by the CMQ, about the bill's impact. WATCH | Why doctors are upset: Why Quebec doctors are upset with the government's proposed changes to their salaries 2 days ago Duration 2:46 Gaudreault argues the bill and its title — An Act mainly to establish the collective responsibility and the accountability of physicians with respect to improvement of access to medical services — make explicit the government's attempt to place the burden of a well-functioning health-care system squarely on the shoulders of doctors. What the bill changes — and what its blind spots may be The bill proposes a mixed model of remuneration for family doctors: capitation payments (an annual flat rate per patient based on their level of vulnerability), an hourly rate for time spent with patients and a fee-for-service. Part of their pay would also be tied to their collective performance based on targets set at the provincial and local levels. Those targets aren't specified in the bill but could look like reducing waiting times and absenteeism rates as well as increasing quality of care, said Dubé at Tuesday's hearing, adding the targets would need to be discussed. The president of the Fédération des médecins omnipraticiens du Québec (FMOQ), which represents family doctors, called the bill "catastrophic," warning that it will negatively affect accessibility to doctors. "We need to stop evaluating the work of family doctors solely based on their clinical appointments because we're neglecting a whole lesser-known section of their work," said Dr. Marc-André Amyot. He addressed the committee with a pair of family doctors who said the new rules would penalize the doctors whose colleagues chose to take on less work for mental health reasons or whose workload is underrepresented by Quebec's health insurance board's (RAMQ) compensation system. "I work full-time all year, but the RAMQ thinks I work for barely four months," Dr. Benoît Heppell told the committee studying Bill 106, explaining that the hours spent training, doing administrative work or teaching aren't taken into account. Heppell said the government's targets need to be tied to a promise of more resources. Currently, there are 1.5 million Quebecers who don't have a family doctor, according to Dubé. "It's not about working harder, it's about working differently," he told the FMOQ. For Roxane Borgès Da Silva, a professor at Université de Montréal's school of public health, the shift to capitation pay is good news. She says it encourages more collaboration and delegation between doctors and other health-care professionals and takes away the incentive for doctors to reach a high volume of appointments. For example, under the proposed model, a physician wouldn't lose compensation for an appointment if a patient registered to them is treated by a nurse or physiotherapist instead. Setting performance targets could help counter the shift away from productivity, said Da Silva, but they need to be the "right" ones and should be for all health-care personnel and not just doctors as the bill proposes.
The Independent
27-05-2025
- General
- The Independent
France latest country to vote on assisted dying measures with ‘lethal medication' bill
France's National Assembly is set to vote on a bill that would permit adults with incurable illnesses to take lethal medication, reflecting increasing calls for legal end-of-life options throughout Europe. The vote, scheduled for Tuesday afternoon, marks a significant point in the debate over the sensitive issue. If a majority of lawmakers approve the bill, it will proceed to the Senate for further consideration. The proposed law defines assisted dying as enabling individuals, under specific conditions, to use a lethal substance themselves. Assistance from a doctor or nurse would only be available to those physically unable to administer the medication themselves. Eligibility for the measure would require patients to be over 18, and either French citizens or residents of France. A team of medical professionals would need to confirm that the patient has a severe and incurable condition in an advanced or terminal stage, is experiencing unbearable and untreatable pain, and is voluntarily seeking lethal medication. Individuals with severe psychiatric conditions or neurodegenerative disorders, such as Alzheimer's disease, would not qualify under the proposed legislation. The person would initiate the request for lethal medication and confirm the request after a period of reflection. If approved, a doctor would then deliver a prescription for the lethal medication, which could be taken at home, at a nursing home or a health care facility. In parallel, another bill on palliative care meant to reinforce measures to relieve pain and preserve patients' dignity will also be put to a vote Tuesday. A 2023 report indicated that most French citizens back legalizing end-of-life options, and opinion polls show growing support over the past 20 years. Initial discussions in parliament last year were abruptly interrupted by President Emmanuel Macron 's decision to dissolve the National Assembly, plunging France into a months-long political crisis. Months-long debate still ahead A definitive vote on the measure could take months to be scheduled amid France's long and complex legislative process. The National Assembly has the final say over the Senate. Earlier this month, Macron suggested he could ask for French voters to approve the measure via referendum if parliament discussions get off track. Activists supporting the change have criticised the complexity and length of the parliamentary process that they say is penalising patients waiting for end-of-life options. Many French people have traveled to neighbouring countries where medically assisted suicide or euthanasia are legal. The Association for the Right to Die with Dignity (ADMD) has called on French lawmakers 'to respect the French who want the same right that our Dutch, Belgian, Luxembourgian, Swiss, Spanish, Portuguese neighbors have.' French religious leaders issued this month a joint statement to denounce the bill, warning about the 'dangers' of an 'anthropological rupture.' The Conference of Religious Leaders in France (CRCF), which represents the Catholic, Orthodox, Protestant, Jewish, Muslim and Buddhist communities, said the proposed measures risk exerting pressure on older people and those with illnesses or disabilities. Similar talks in the UK The debate in France comes as similar talks are ongoing in the UK, where lawmakers are debating a bill to help terminally ill adults end their lives in England and Wales after giving it initial approval in November. Medically assisted suicide involves patients taking, of their own free will, a lethal drink or medication that has been prescribed by a doctor to those who meet certain criteria. Euthanasia involves doctors or other health practitioners giving patients who meet certain criteria a lethal injection at their own request. Assisted suicide is allowed in Switzerland and several US states. Euthanasia is currently legal in the Netherlands, Spain, Portugal, Canada, Australia, Colombia, Belgium and Luxembourg under certain conditions.
The Independent
27-05-2025
- Health
- The Independent
France's National Assembly to vote on long-debated bill legalizing end-of-life options
France's lower house of parliament, the National Assembly, is voting Tuesday on a bill to allow adults with incurable illness to take lethal medication, as public demands grow across Europe for legal end-of-life options. Tuesday's vote, expected in the late afternoon, is a key legislative step on the contentious and long-debated issue. If approved by a majority of lawmakers, the bill will be sent to the Senate for further debate. The proposed measure defines assisted dying as allowing people to use a lethal substance under certain conditions so that they may take it themselves. Only those whose physical condition doesn't allow them to do it alone would be able to get help from a doctor or a nurse. The bill provides for strict conditions To benefit from the newly proposed measure, patients would need to be over 18 and be French citizens or live in France. A team of medical professionals would need to confirm that the patient has a grave and incurable illness 'at an advanced or terminal stage,' is suffering from intolerable and untreatable pain, and is seeking lethal medication of their own free will. Patients with severe psychiatric conditions and neurodegenerative disorders such as Alzheimer's disease won't be eligible. The person would initiate the request for lethal medication and confirm the request after a period of reflection. If approved, a doctor would then deliver a prescription for the lethal medication, which could be taken at home, at a nursing home or a health care facility. In parallel, another bill on palliative care meant to reinforce measures to relieve pain and preserve patients' dignity will also be put to a vote Tuesday. A 2023 report indicated that most French citizens back legalizing end-of-life options, and opinion polls show growing support over the past 20 years. Initial discussions in parliament last year were abruptly interrupted by President Emmanuel Macron's decision to dissolve the National Assembly, plunging France into a months-long political crisis. Months-long debate still ahead A definitive vote on the measure could take months to be scheduled amid France's long and complex legislative process. The National Assembly has the final say over the Senate. Earlier this month, Macron suggested he could ask for French voters to approve the measure via referendum if parliament discussions get off track. Activists supporting the change have criticized the complexity and length of the parliamentary process that they say is penalizing patients waiting for end-of-life options. Many French people have traveled to neighboring countries where medically assisted suicide or euthanasia are legal. The Association for the Right to Die with Dignity (ADMD) has called on French lawmakers 'to respect the French who want the same right that our Dutch, Belgian, Luxembourgian, Swiss, Spanish, Portuguese neighbors have.' French religious leaders issued this month a joint statement to denounce the bill, warning about the 'dangers' of an 'anthropological rupture.' The Conference of Religious Leaders in France (CRCF), which represents the Catholic, Orthodox, Protestant, Jewish, Muslim and Buddhist communities, said the proposed measures risk exerting pressure on older people and those with illnesses or disabilities. Similar talks in the U.K. The debate in France comes as similar talks are ongoing in the U.K., where lawmakers are debating a bill to help terminally ill adults end their lives in England and Wales after giving it initial approval in November. Medically assisted suicide involves patients taking, of their own free will, a lethal drink or medication that has been prescribed by a doctor to those who meet certain criteria. Euthanasia involves doctors or other health practitioners giving patients who meet certain criteria a lethal injection at their own request. Assisted suicide is allowed in Switzerland and several U.S. states. Euthanasia is currently legal in the Netherlands, Spain, Portugal, Canada, Australia, Colombia, Belgium and Luxembourg under certain conditions.
CBC
08-05-2025
- Health
- CBC
Quebec government aims to hold more family doctors accountable with upcoming bill
The Quebec government is expected to table a bill today aimed at bringing doctors into line. It would introduce "collective responsibility and accountability" to improve access to health care in the province, according to a media invitation from the office of Health Minister Christian Dubé. He is scheduled to present the bill in further detail and take questions from journalists at a news conference at 11:30 a.m. ET. The proposed law comes in the middle of negotiations to renew the framework agreement for doctors. On Saturday, the Fédération des médecins omnipraticiens du Québec (FMOQ) rejected Quebec's offer to change their compensation model. The Legault government wants 25 per cent of family doctors' compensation to be tied to their performance. It also wants to introduce colour codes for patients. During a media availability on Wednesday, Premier François Legault said tabling the bill would be "non-negotiable." "We will never have an effective health-care network until all Quebecers are taken care of by family medicine groups, starting with family doctors," he told reporters. Legault added that he believes "two-thirds of doctors take care of Quebecers, but there is one-third who need to do more." Dubé said in a social media post published on Wednesday that he is working to ensure "100 per cent of Quebecers" are cared for by the summer of 2026. He added that government negotiations with Quebec medical federations are ongoing. WATCH | Concern about patient colour code: Why Quebec doctors say proposed colour system for patient priority is concerning 14 days ago Duration 2:24 The federation representing the province's general practitioners is sounding the alarm again as negotiations with the Legault government over a new agreement defining their working conditions get underway. They're not alone in sharing concerns over a proposed colour-coded system that would identify patients by priority and redistribute family doctors to the most vulnerable ones.
