Quebec 'ready to use' notwithstanding clause to force doctors to practise in province

Quebec Premier François Legault announced that his administration is considering a measure to require doctors trained at Quebec universities to start their careers within Quebec’s public healthcare system. This approach would involve the potential use of the notwithstanding clause if necessary. Speaking at the legislature on Wednesday, Legault mentioned that his government is exploring a requirement for Quebec medical graduates to either practice within the province for a specific period or reimburse the government for the cost of their education.

“We’re short of doctors,” Legault stated, adding, “The doctors we train at taxpayers’ expense must practise in Quebec.” He acknowledged that enforcing this requirement could conflict with the Canadian Charter of Rights and Freedoms and could necessitate invoking the notwithstanding clause to override certain rights, specifically Section 15, which pertains to equality and anti-discrimination rights.

The notwithstanding clause in the Canadian Charter permits governments to pass laws that override certain Charter rights for up to five years, with the option for legislative renewal. Legault’s comments expanded on Health Minister Christian Dubé’s recent announcement about upcoming legislation that would require newly qualified family doctors and specialists to work in Quebec’s public sector.

However, constitutional lawyer Frédéric Bérard, an instructor at Université de Montréal, noted that such a measure would likely conflict with Canadians’ mobility rights under Section 6 of the Charter, which guarantees the right to live and work anywhere in Canada. Since the notwithstanding clause cannot be used to override Section 6, Bérard argued that this proposal may not be feasible. “If Legault is saying that he wants to invoke the notwithstanding clause, it means that he knows a fundamental right is violated,” Bérard remarked, describing Legault’s approach as politically motivated.

Quebec’s government estimates that training a doctor costs between $435,000 and $790,000. Data suggests that a significant number of Quebec-trained doctors relocate to other provinces, with 400 out of 2,536 doctors who graduated between 2015 and 2017 leaving Quebec. Currently, Ontario has approximately 2,355 Quebec-trained doctors, including 1,675 McGill University alumni. Furthermore, about 775 of Quebec’s 22,479 doctors work solely in the private sector, a number that has surged by 70 percent since 2020, with many of these physicians being recent graduates.