Premier François Legault made two specific claims about Quebec's healthcare system just before the adoption of a controversial law regulating physicians' pay, and a fact-check by the Montreal Gazette has found them to be accurate.
The Premier's Claims Verified
In October, Premier Legault stated that Quebec has more doctors per capita than Ontario, yet access to family doctors is slightly worse within its borders. This assertion came amidst heated debate surrounding what is now known as Law 2, which governs doctor remuneration.
This is a notable shift from the pandemic period and beyond, where the Premier's boasts about his government's handling of healthcare were often found to be misleading upon closer examination. This time, however, the data supports his position.
A Tale of Two Provinces: The Numbers
Delving into the statistics reveals a complex picture. According to figures from the non-partisan Canadian Institute for Health Information (CIHI), Quebec reported 129 family physicians per 100,000 population last year. This is significantly higher than Ontario's rate of 107.
The disparity is even more pronounced for medical specialists. Quebec boasted 131 specialists per 100,000 people, compared to 114 in Ontario.
Despite this numerical advantage, access to primary care tells a different story. In July 2024, the Ontario College of Family Physicians estimated that 2.5 million Ontarians were without a family doctor. When adjusted for population, this means approximately 84.38% of Ontarians had access to a general practitioner.
In Quebec, with a population of 9 million, the government's own ad campaign noted that 1.5 million residents lack a family physician. This translates to an access rate of 83.33%, confirming that access is indeed marginally worse in Quebec.
Wider Implications and Interprovincial Tensions
The verification of these facts did not occur in a vacuum. The CAQ government spent $250,000 in taxpayer funds on an ad campaign to build support for the then-Bill 106, highlighting the very issue of 1.5 million unassigned patients.
Ontario Premier Doug Ford, despite his province's relatively better access rate, quickly seized on the political opportunity. He publicly invited Quebec doctors frustrated with the new remuneration law to relocate to Ontario.
This sales pitch from Ontario may stem from its own challenges. Data from CIHI shows that from 2020 to 2024, Ontario suffered a net loss of 207 physicians to interprovincial migration, the highest in the country. In contrast, Quebec saw a net gain of 95 doctors during the same period.
Remuneration and Systemic Challenges
The new law aims to boost access and ease emergency room congestion, but the path is fraught. The issue of pay is a mixed bag for Quebec physicians. Family doctors in Quebec earn considerably less than their Ontario counterparts, with average gross payments of $297,461 compared to $346,607.
However, Quebec's medical specialists, on average, earned slightly more ($392,970) than those in Ontario ($389,358). For the highest earners, one must look to Alberta or Nova Scotia, where ophthalmologists averaged nearly $1.6 million in gross clinical payments.
Beyond clinic doors, Quebec's emergency rooms are in a far more critical state than Ontario's. A September study from the Montreal Economic Institute found that 11.55% of Quebec ER patients left without being seen by a doctor in 2024, a rate more than double Ontario's 4.92%.
While the government's goal of improving healthcare access is clear, many doctors argue that Law 2 imposes performance targets over which they have little control, setting them up to fail and bear the blame for systemic issues a government trailing in the polls is struggling to solve.
