Political Crisis unfolding in Québec over the Physicians’ Compensation Bill

Legislation that was intended to improve access to healthcare for Quebecers has resulted in a full-blown political firestorm. Adopted under a gag order by the Québec government, Bill 2 overhauls the way physicians are paid and has sent shockwaves through the National Assembly and within the Coalition Avenir Québec (CAQ) itself. Within days, it resulted in the resignation of the Minister of Social Services, the expulsion of an MNA from caucus, and an overall loss of confidence in Health Minister Christian Dubé.

At the heart of the controversy is how the bill seeks to reform how doctors are compensated by the province. The government wants to reduce dependence on fee-for-service payments, better distribute resources between primary care and hospitals, and link compensation more closely to performance and access to care. Physicians, however, view the move as a direct attack on their professional autonomy and an attempt to make them responsible for the healthcare system’s broader shortcomings.

Lionel Carmant, who was the Minister of Social Services, comes from a family of physicians—he, his wife, and his daughter all practice medicine. He was noticeably absent during the vote on the bill, and meanwhile his daughter publicly denounced the reform in the media. Facing both political and personal pressure, Mr. Carmant chose to resign and sit as an independent MNA. His high-profile departure exposed the internal tensions that have been simmering within the government caucus for weeks.

Meanwhile CAQ MNA Isabelle Poulet was expelled from caucus just as she was preparing to resign, citing her disagreement with Bill 2 – despite having voted in favor of it. Québec Liberal Party leader Pablo Rodriguez later claimed that Ms. Poulet had been seeking to cross the floor to his party since August, a statement that drew the ire of Premier François Legault. This saga reinforced public perception of a government that is losing control of a fractured caucus.

As if the crisis was not bad enough, Ontario Premier Doug Ford inserted himself into the debate by inviting Québec doctors to “come practice in Ontario.” The provocative remark infuriated François Legault. The CAQ leader, who had previously maintained cordial relations with Ford for years, condemned the comment as “unacceptable” and “lacking solidarity between provinces.”

This major crisis of confidence underscores how the reform has revived a long-standing conflict between doctors and the government. Minister Christian Dubé, who had built his reputation on sound management and an ability to bring health network stakeholders together, now finds his image tarnished by what many see as a heavy-handed approach instigated through Bill 2.

François Legault, weakened by two years of political turbulence and poor polling, surely did not expect that Bill 2 – despite being popular with a majority of Quebecers – would expose such deep divisions within his government. What was meant to be a political victory may well turn into a perilous turning point for the CAQ as the province inches closer to the 2026 election.