Illegally Inaccessible: Quebec’s Violation of Universal Health Care

quebec healthcare

If you are living in Quebec and have ever needed to see a doctor you know that it’s impossible to speak objectively about health care. Despite the promises of government after government, the Quebec health care system is a mess. Emergency room wait times in Montreal can be up to ten hours or more. In their haste to treat patients, doctors and nurses often jump to dangerous and unfounded conclusions that put patients at risk.

Take the case of Carol*

At forty seven years old, Carol is active, eats well, and is a devoted mother. She also suffers from ovarian cysts and is allergic to morphine. She arrived at the Glen’s emergency room a month ago with excruciating abdominal pain. Despite her screams of agony the doctors refused to consider that her pain was caused by anything serious. They tried to pump her full of morphine and send her home but Carol refused.

One doctor finally listened and ordered emergency surgery. It was only when she was on the operating table that the nature of her illness was revealed. The cyst had ruptured and destroyed her fallopian tube, requiring its immediate removal.

Then there’s the case of Daisy.

At 33, she’s a non-smoker and active. She suffers from depression and was hospitalized almost ten years ago for it. Her mental health diagnosis has tainted every attempt she’s made to receive care for physical health problems from the Jewish General Hospital (JGH) and its affiliates. Four years ago she went to her GP with crippling back pain. He diagnosed a disc problem and prescribed physiotherapy and anti-inflammatories. In spite of this, the pain kept getting worse, and she returned to her GP who ordered the least conclusive testing. When the results were negative, she said:

“I’m still in pain,”

Her GP shrugged his shoulders and told her it was anxiety before shooing her out of his office without any referrals. Since then she’s made multiple visits to the JGH’s ER and walk-in clinics in excruciating pain that numbed her right foot and robbed her of the ability to use the toilet unassisted. Every time, she’s been pumped full of morphine, lectured about morphine addiction, and sent home. It was only through family connections that she found a specialist who discovered nerve damage and operated on her.

Jewish General Hospital (photo: WikiMedia Commons)
Jewish General Hospital (photo: WikiMedia Commons)

The health care system’s refusal to take her seriously caused delays in treatment that ultimately cost her her job. She’s been surviving on a pittance from welfare ever since. Travelling from ER to ER trying to find a doctor who will properly investigate her physical health problems has become her full time job.

Quebec governments have been hiding behind financial concerns to justify their abhorrent treatment of patients.

The problem is that the quality of care in this province isn’t just awful. It’s illegal.

The Quebec health care system is governed by many laws including the Canada Health Act and the Quebec Code of Ethics of Physicians.

The Canada Health Act is the law that creates a mechanism allowing Parliament some control over the health care system in each province.

It’s called Transfer Payments.

Transfer Payments allow the federal government to transfer money to each province for health care provided they meet certain criteria. The criteria are public administration, comprehensiveness, universality, portability, and accessibility.

Government health insurance plans have to be publicly administered and operated. The plans have to insure all insured health services provided by hospitals and medical practitioners. In order to be universal the plans have to insure all insured persons in the province.

In order to be portable, the provinces can’t impose a minimum period of residence for health care higher than three months, and they have to provide some reimbursement for emergency health services obtained out of province. Last but not least, the provincial health plans have to

“provide for insured health services on uniform terms and conditions and on a basis that does not impede or preclude, either directly or indirectly whether by charges made to insured persons or otherwise, reasonable access to those services by insured persons.” (emphasis added)

Violation of these criteria by the provinces can result in a reduction of this money. If necessary, the federal government can even withhold it in its entirety.

Then there’s the Quebec Code of Ethics of Physicians which lists the obligations of Quebec doctors. Physicians in Quebec can’t refuse to examine or treat a patient for reasons related to the nature of their illness or the context in which it appeared. They can’t refuse to treat someone due to sex, race, colour, religion, civil status, age, pregnancy, ethnic or national origin, social condition, sexual orientation, morality, political convictions, or language.

If a doctor’s beliefs interfere with her ability to treat someone, the doctor has to help the patient find someone else. The physical, mental and emotional behavior of doctors toward patients has to be beyond reproach. Willful or negligent violations of these rules can make doctors fully liable at all times and subject to civil suits for professional negligence.

Despite Quebec’s flagrant violations of Canada’s medical accessibility laws and doctors all but flaunting their prejudices in walk-in clinics, private offices, and emergency rooms, people don’t seem to complain enough.

The reason is fear. We’re all afraid that filing complaints and seeking second opinions will somehow jeopardize our chances of getting lifesaving care when we need it.

But it shouldn’t, because that’s illegal too.

You want proper care? You have to fight for it. If a doctor treats you like trash, file a complaint. If a hospital screws up and you or a loved one gets worse, go to the ombudsman, and then to a lawyer if necessary. If you think you’re being dismissed because of your age, gender, or mental health diagnosis, don’t be afraid to go to another hospital and demand a second opinion.

It’s not only your health at risk. It’s your life. And in this healthcare system, you’re the only one you’ve got.

*Names have been changed for security and anonymity reasons

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