Quebec issues ministerial order to prevent optometrists from leaving public system
The Quebec government has issued a ministerial order to prevent optometrists from leaving the public health system.
Optometrists have been threatening to go private since October as a pressure tactic during stalled negotiations with the province.
The order, which comes into effect Thursday, will last six months and can be renewed. However, it cannot exceed a total of two years unless the health minister deems it necessary, in which case it can be extended for up to two additional years at a time.
"We want to give ourselves time to complete the negotiations," explained Quebec Health Minister Christian Dubé during a press briefing on Wednesday.
The agreement between Quebec's optometrists' association (AOQ) and the Health Ministry, which set fees and conditions for services provided to children, seniors aged 65 and older and social assistance recipients, expired four-and-a-half years ago.
Under Quebec's Health Insurance Act, the minister can suspend the ability of health-care professionals to leave the public system when the quality or quantity of medical services is at risk due to an increase in non-participating professionals.
Optometrists plan to challenge order
Dr. Guillaume Fortin, president of the AOQ, criticized the government's decision in an interview with Radio-Canada, expressing disappointment that optometrists are being stripped of their right to opt out of Régie de l'assurance maladie du Québec (RAMQ) participation.
"We're convinced this is our right," said Fortin, adding that the AOQ plans to challenge the order in court. Fortin argues the move deprives optometrists of their only leverage in the negotiations.
"It's clear we will go to court to defend our rights."
The order is "unacceptable" to optometrists, especially given that negotiations have stalled for over four years, he said.
"This seems to be an increasingly common tactic when negotiations aren't going the government's way — imposing working conditions by decree," he said.
Fortin also pointed out that optometrists cannot strike or refuse to see patients, further limiting their options.
Financial strain for optometrists
At the core of the dispute is compensation.
The AOQ has stated that operating costs have risen three times faster than the government-set, per-visit fees, leaving optometrists earning just $3.50 per RAMQ-covered patient visit.
According to the association's statement, the fees for optometry services paid by the RAMQ represent 0.16 per cent of the province's health-care budget, which every year amounts to about $11 per Quebecer.
The AOQ, which represents 1,500 members, said in a statement on Oct. 23 that 85 per cent of its members had decided to withdraw from RAMQ.
"We are asking for reasonable and fair treatment, so that we can continue to play our role throughout Quebec and help to relieve congestion in the system, not least by treating some 180,000 eye emergencies every year," Fortin said last month.
The association said it regrets that the public would bear the brunt of this decision, but insisted it was necessary to address the financial imbalance.
According to the AOQ, patients covered by the public system account for 55 per cent of their clientele, and that percentage continues to grow.
