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
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
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.
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