Montreal’s health system is arguably in the worst shape it’s ever been. While healthcare in Quebec has been struggling for quite some time, it has been deteriorating acutely since the COVID-19 pandemic, a decline primarily due to a decreasing number of healthcare practitioners. Closer analysis shows that while some policies may mitigate the effects, Canada, particularly Quebec, has paved an alarming path of ever-worsening shortages in medical workers.
Like most Quebec residents, McGill students suffer from poor healthcare access. To book an appointment at the Student Wellness Hub, students have to call at 8:30 AM on the dot to try to book a wellness visit and often go days or weeks without success. The lack of alternatives for many students, particularly international students, leaves many without care. The Student Wellness Hub, like many Quebec healthcare institutions, does not have enough practitioners to meet the McGill community’s needs.
A lack of workers is the most significant cause of the Quebec health system’s failure. Practitioners have left the Quebec health system in droves since the COVID-19 pandemic. Between 2021 and 2023, Quebec lost 21,000 healthcare workers and today healthcare and social assistance have the highest job vacancy rate in Quebec, at 7.4% in 2023 compared to 3.5% in 2019. This is part of a worldwide trend in which doctors and nurses suffering from high stress and burnout have been retiring and quitting at an alarming pace.
Emergency rooms are simultaneously overcrowded and understaffed. Many people resort to going to the ER due to a lack of family doctors, while hospitals desperately need more nurses and physicians. Between 2023-2024, an average of 1140 Quebecers left the emergency room every day without being seen by a physician.
A U2 student shared with the Bull & Bear: “I went to the ER after accidentally double dosing on my meds, and poison control told me to go ASAP. Guess what? They only had two doctors on the night shift, and the waiting time was 9 hours. The nurse told me to go home and call 911 if I felt like I was having a seizure because the doctors were too busy to check on me then.”
Another U2 student, Lexi, told me: “I fell down the stairs and broke my foot, so I went to the ER by myself. I waited there for 9 hours, then I got an X-ray. Afterward, the doctor told me I had broken my foot. She gave me a bandage to wrap my toe and told me to Uber everywhere. They didn’t give me crutches or a boot, so I had to buy them on Amazon.”
Healthcare staff shortages are compounded by the number of doctors leaving the public system. In Quebec, practitioners can easily opt in and out of the medicare regime, with 98% of fully private healthcare practitioners in Canada operating in Quebec. Other provinces have effectively stopped this practice; in Ontario, for example, doctors can withdraw from Medicare but are dissuaded from doing so as they can only bill patients what they would earn under Medicare. In Quebec, practitioners typically choose to join the private sector for better work conditions and higher salaries, but many are worried that this could lead to a gradual abandonment of the public system, a rise in health costs, and a deterioration of coverage.
Is there much hope for future improvements? Last November, the province launched Sante Quebec, a new government agency aiming to centralise the province’s healthcare network. While the agency purports to work towards reducing ER wait times, hiring more workers, and increasing the rate of surgeries, it also includes the removal of $1.5 billion from the province’s health budget to balance the provincial budget. Detractors worry that Sante Quebec is a smokescreen to introduce budget cuts without improving Quebecers’ healthcare access. Critics and doctors have stated that removing such a large sum without worsening care is unfeasible.
Bill 83, proposed by the Quebec government, would obligate newly trained medical doctors to exercise medicine in the province’s public sector for at least five years before being able to work in the private sector. Currently, 7% of doctors trained in Quebec are working in Ontario, whereas only 2.4% of doctors trained in Ontario work in Quebec. This law aims to tackle this discrepancy by forcing new doctors to remain in Quebec. While it could contribute to increasing the number of doctors in Quebec’s public healthcare system, it alone would not be enough to compensate for the severe shortages. Some critics have argued that this law is overly controlling and might dissuade prospective students from pursuing medicine as it would limit their post-graduation career mobility.
Since 2020, as requested by the government, Quebec faculties of medicine have been admitting more students. Unfortunately, however, Quebec and Canada as a whole still train far too few doctors. According to the Canadian Medical Association, the average number of medical graduates per 100,000 people in OECD countries is 14.2. Canada stands at a measly 7.5. Some suggested policies could make more efficient use of the healthcare workers we do have. For example, many have advocated for expanding the use of new technologies such as virtual care and eliminating the burden of administrative tasks for doctors.
Unfortunately, as time goes on and the Canadian population continues to age, the gap between the number of doctors we need and the number we have will likely keep widening. In fact, most of the world seems to be diving headfirst into a severe medical crisis. The World Health Organisation expects a global shortfall of 11 million healthcare workers by 2030. The difficulties McGill students have in obtaining doctor’s appointments could be just a taste of what’s to come.
