Quebec health minister and family doctors reach agreement on GAP medical service

Quebec's Health Ministry and family doctors have reached an agreement to continue a service that helps connects patients without a family doctor to health-care professionals.

The Guichet d'accès à la première ligne (GAP) program, launched in 2022, goes further than the traditional 811 phone service by allowing people to speak with a nurse, get their symptoms assessed and, if necessary, book an appointment with a general practitioner.

Health Minister Christian Dubé and the Quebec general practitioners' federation (FMOQ) had agreed that family medicine groups (GMF) would take care of patients without a family doctor. An annual premium of $120 was paid for each patient registered with a GMF through the GAP.

But that agreement ended on May 31. Under the new agreement, doctors will get $100 per registered patient annually. Dubé said the agreement will allow important aspects of GAP to be maintained, such as collective registration.

Before the agreement was reached, Guillaume Charbonneau, vice-president of the FMOQ, said the fight is not about money.

"We are fighting to get full access to patients," he said. 

The goal, he explained, has been to secure an agreement that ensures doctors are available and accessible to meet patient needs effectively.

The dispute has had consequences for patients, as some clinics stopped offering appointments to patients registered for GAP.

About 18,000 appointments were available per week at the end of May. But since the start of June, that number has been declining fast. As of earlier Thursday, fewer than 1,400 appointments were available during the first week of July.

"I would like to thank the doctors who have decided to continue making appointments," Dubé said Thursday.

Clinics declining GAP patients had been, for some, part of a pressure tactic by Quebec family doctors as they negotiated the funding package.

Marc-André Amyot, president of the FMOQ, said the number of appointments offered via GAP should increase compared to the drop previously observed. But, he added, it will not return to what it once was.

He said the number of available appointments was higher before because family doctors delayed their retirement to meet patient demands, and Ontario doctors came to help in the Outaouais region. Doctors are now retiring, and Ontario doctors are returning to their home province, he said.

The alternative for patients has been going to the emergency room instead, the health minister said. But he recommends people continue to use GAP since they can be referred to other health professionals to suit their needs.