GPs reach partial deal as Quebec's ban on extra health fees takes effect

Groups representing health care providers across Quebec spent Thursday in last minute negotiations with the Quebec government as the province's ban on extra health-care fees came into effect.

Effective today, patients won't have to pay auxiliary fees for a range of products and services covered by the Quebec's health insurance board, the Rgie de l'assurance maladie du Qubec (RAMQ).

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Quebec's Federation of General Practitioners (FMOQ) announced what it called a partial deal with the government on extra fees, but warned grey zones in the rules remain andcould affect the provision of services.

Dr. Louis Godin, president of the FMOQ, announced that general practitioners will absorb the fees associated with minor surgeries, such as vasectomies and the removal of cysts.

Godin said an agreement was also reached that will allow general practitioners to continue furnishing medication and vaccinations covered under public or private health plans.

Ban could affect services

But not all vaccinations are covered, and Godin said the ban on supplementary fees means people requiring somevaccines, like the one for shingles,will have to get it themselves at a pharmacy and bring it to a clinic to be administered.

"We have a problem with the handling of the vaccine between the pharmacy and the clinic.Especially if this vaccine has to be conserved ata specific temperature," he said.

"The government tells us it's not a problem, the pharmacists will tell the patient what to do."

Godin also said a wide gap remains between the general practitioners's positionand the government when it comes to blood samples taken by medical clinic staff.

Before the ban on auxiliary fees, clinic staffcould take a blood test and charge of $20 or $30 for the service.

Godin warned the ban on such fees could result in those services, and others, no longer being provided.

"The patient had the choice and made the choice to have the services in the clinics, and now it's impossible. It's prohibited. So it's not a step ahead to improve access, to improve and modernize our health-care system," Godin said.

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'A new era': Barrette

QuebecHealth Minister Gatan Barrette saidresistance from health care providers to the ban on auxiliary feesis understandable, but the ban responds to public demands.

"Some dissatisfaction is likely, and that's normal we're going from a for-profit model to a non-profit, or at least not as substantially profitable. But it's a new era," he said.

"We've listened to the people. They wanted accessory fees abolished."

In November 2015,the Quebec government passed Bill 20, a controversial health reform law which included an amendment to permit and regulate auxiliary fees a move which groups such as Quebec Doctors for Medicaresaid violatedthe Canada Health Act.

'In medicine, we shouldn't be talking about a business model. It should be about a model of patient care," said Dr.IsabelleLeblanc, president of Quebec Doctors for Medicare

Partly in response to Bill 20, last May a coalition of health groupslaunched legal action against the federal governmentto compel it to enforce the Canada Health Act.

Last September,Barrette backed down, announcing that an end to user fees "illustrates our commitment to the accessibility of our health care network."

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