When the Québec government adopted Bill 2 in late October, it claimed the law would “improve access to medical services and ensure continuity of care” by making physicians collectively responsible for meeting targets.

The concern of the Pediatric Chairs of Canada and the Canadian Paediatric Society is that this approach undermines access to essential, time-sensitive care for newborns, children and youth at a time when paediatric health is in measurable decline.

Longstanding concerns over the unsustainable nature of Canada's paediatric workforce are well documented by our organizations. The immediate threat Bill 2 poses is an exacerbation of this reality — especially for pediatricians, whose exhaustion, burnout, and moral injury have been building for years.

A relatively and objectively small pediatric workforce across Canada can ill-afford to lose further capacity. Fewer pediatric subspecialists, general pediatricians and family physicians translates directly into decreased care-access for children, and poorer health outcomes.

Healthcare systems serving children are already under strain. This law threatens to dismantle them.

Bill 2 fails to recognize the inherent vulnerabilities of children and youth, and by doing so, puts them at further risk and devalues the experts who care for them.

The law classifies healthy newborns — among the most medically vulnerable — at the same level of vulnerability as a healthy 30-year-old, failing to recognize the unique needs of infants and children. For newborns, children and adolescents with time-sensitive and complex health needs, the margin for acceptable delay in access to essential care is minimal.

Every day matters in the life of a child. Long wait lists, delayed access to subspecialty appointments, and fragile families already define and strain healthcare systems from coast to coast, including in Quebec. Bill 2 adds fuel to that fire. As the Canadian Medical Association has warned, the bill “could worsen access to care and increase pressure on health professionals who are already stretched to their limits.”

At the same time, this Bill undermines Quebec’s ability to recruit highly-trained pediatricians and pediatric subspecialists. A recent surge in applications from Québec physicians seeking licenses in other provinces — more than 100 doctors in a matter of days — reveals a flight of talent that is occurring almost immediately.

Perhaps the most significant concern our organizations have is thinking about the long term. The damage wrought by Bill 2 may take years, even decades, to repair. The relationship between Québec's government, its physicians, and the families who rely on pediatric care (and medical care more broadly) has been fractured.

Rebuilding trust is slow and costly; training and recruiting the next generation of pediatric specialists will be harder still. As national associations committed to ensuring the sustainability of the workforce specialized in care for children and youth, we view this as a catastrophe for Québec and for the profession.

The Pediatric Chairs of Canada and the Canadian Paediatric Society call on the Québec government to reverse Bill 2 in its entirety and return to the negotiating table in good faith with physicians, including pediatric subspecialists, general pediatricians and family physicians.

Policy changes must be implemented in ways that are sustainable, and with the support of those who provide patient care. Anything less is a high-stakes gamble with the health of Québec’s children, and indeed the broader population. Every day this legislation remains in effect compounds the damage.

We have long used the word “crisis” in healthcare, but this goes beyond crisis. It is a severe threat, a new level of risk to the health of Québecers — and if allowed to continue — to all Canadians through the precedent it will set.

We cannot accept that children’s lives become collateral damage. We cannot accept that the current and future physician workforce deteriorates from neglect and distrust through legislation that punishes us instead of partnering with us.

When you weaken care providers, you weaken care delivery. When you undermine the workforce, you undermine children and their families. Québec deserves better. Please act before it’s too late.
 

Dr. Patricia Birk is the President of the Pediatric Chairs of Canada. Dr. Laura Sauvé is President of the Canadian Paediatric Society.