On November 28, 2014, the Quebec government introduced Bill 20, An Act to Enact the Act to Promote Access to Family Medicine and Specialized Medicine Services and to Amend Various Legislative Provisions relating to Assisted Procreation.
Bill 20 would overhaul significant elements of the province’s health care system. Quite notably, the Bill would impose minimum case loads for doctors, and would also end the public funding of in vitro fertilization. In addition to addressing the funding of IVF treatments, the Bill would impose restrictions on who could have access to such treatments at all, and under what conditions.
More specifically, the Bill would:
- impose an obligation for general practitioners to provide medical care to a minimum caseload of patients;
- require medical specialists to offer medical consultations, elsewhere than in the emergency department of an institution, to a minimum number of patients;
- provide that if a physician fails to fulfil its obligations respecting case load, the physician’s remuneration will be reduced by the Regie de l’assurance maladie du Quebec;
- require that clinical and research activities relating to assisted procreation are approved and monitored by the research ethics committee established by the Minister of Health and Social Services;
- prohibit IVF for women under 18 or over 42 years of age;
- introduce fines for physicians who counsel women to undergo IVF outside of the province;
- require a positive psychosocial assessment for certain people who are undergoing assisted procreation;
- increase the fines established under the existing law for contravening the Act;
- end coverage by the public healthcare system for assisted procreation activities with the exception of artificial insemination services; and
- add fertility preservation services to those that are publicly covered.
So far, there has been significant response to the Bill from physicians as well as the general public with an interest in in vitro fertilization issues. We will report on progress of the Bill as developments unfold.