The Coalition Avenir Québec (CAQ) has proposed a dramatic policy shift that would allow Quebec doctors to practice simultaneously in both the public healthcare system and private clinics. The controversial Quebec CAQ mixed practice proposal has divided medical professionals and unions, with the Fédération des médecins spécialistes du Québec (FMSQ) welcoming the change while the Confédération des syndicats nationaux (CSN) calls it “appalling.”
The announcement represents a 180-degree turn from legislation the CAQ government passed just last year. That law, championed by then-Health Minister Christian Dubé, aimed to curb the exodus of physicians from the public system and limit their movement between sectors. Now, CAQ leader Christine Fréchette is reversing course ahead of the October 5 election.
What the CAQ Healthcare Proposal Includes
Under the proposed system, medical specialists would first gain access to mixed practice privileges, with general practitioners following at a later stage. The plan eliminates the current requirement for doctors to obtain authorization from Santé Québec each time they want to work outside the public network.
A CAQ government would establish a minimum floor of hours that physicians must dedicate to the public healthcare system. This measure aims to maintain adequate staffing while giving doctors flexibility to supplement their practice in private clinics.
According to official data, Santé Québec granted 121 temporary disaffiliation authorizations to 71 different medical specialists in July 2026. The new policy would streamline this process significantly, removing bureaucratic barriers that currently slow physicians’ movement between sectors.
Medical Specialists Federation Backs the Plan
The FMSQ expressed strong support for the CAQ proposal, arguing it addresses critical workforce challenges in Quebec’s healthcare system.
“This prevents permanent departures and promotes optimal use of specialized personnel, while several doctors are still unable to work to the full extent of their skills and availability in the public network.”
The federation has called on other political parties to make the same commitment. Additionally, the FMSQ urges whichever government takes power after the election to “reserve public investments for strengthening the public network.”
Union Leader Calls Proposal ‘Appalling’
The CSN president Caroline Senneville offered a scathing critique of the mixed practice proposal, warning it would accelerate the deterioration of public healthcare.
“If you take a glass, fill it with water — the water being the doctors — and pour half the water into another glass, you don’t have more water.”
Quebec already leads all Canadian provinces in the number of physicians who have opted out of the public healthcare system. According to the Régie de l’assurance maladie du Québec, as of July 14, 2026, a total of 821 doctors were non-participants in the public regime, including 271 specialists.
Senneville argues the back-and-forth movement between sectors only disperses resources and creates a two-tier healthcare system. She emphasized that the proposal primarily benefits “people who have access, either through insurance or their own means, to the private sector.”
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Public Health Advocates Sound Alarm
The group Médecins québécois pour le régime public (MQRP) expressed “particular concern” about the CAQ’s openness to mixed medical practice. Their analysis challenges the fundamental premise behind the policy proposal.
“Allowing doctors to share their time between the public network and a lucrative private market creates incentives to shift medical time toward the most profitable and less complex activities, while the public must continue to handle emergencies, heavy cases, and continuity of care.”
Dr. Élise Girouard-Chantal, vice-president of MQRP, directly challenged the CAQ’s claim that the world’s best-performing health systems allow mixed medical practice.
“Studies clearly demonstrate that the introduction of private practice into public systems deteriorates the quality of care and globally reduces access for the entire population.”
What This Means for Quebec Voters
The mixed practice debate highlights fundamental tensions in Quebec healthcare policy that voters will weigh when they head to the polls on October 5. The issue cuts to the heart of how the province balances physician autonomy, public system sustainability, and equitable access to medical services.
For the Latin community in Canada, understanding these healthcare debates is crucial. Many immigrants rely heavily on the public healthcare system, and changes to how physicians divide their time could directly impact wait times, specialist availability, and overall access to medical care.
The CAQ’s policy reversal also raises questions about political consistency. Just one year after implementing restrictions on physician movement between sectors, the party now advocates for the opposite approach. This shift comes as Christine Fréchette leads the party into her first provincial election as leader.
Other Quebec political parties have yet to fully articulate their positions on mixed practice. The FMSQ’s call for all parties to commit to similar policies suggests this issue will remain central to healthcare debates throughout the campaign.
Voters concerned about healthcare access should closely monitor how candidates address the tension between physician retention and public system equity. The outcome of this debate could reshape Quebec’s healthcare landscape for years to come.
What is mixed medical practice in Quebec?
Mixed medical practice allows doctors to work simultaneously in both the public healthcare system and private clinics. The CAQ proposal would eliminate the current requirement for physicians to obtain authorization each time they want to work outside the public network.
How many Quebec doctors currently work outside the public system?
According to the Régie de l’assurance maladie du Québec, as of July 14, 2026, there were 821 non-participating doctors in the public regime, including 271 specialists. Quebec has the highest number of disaffiliated physicians of any Canadian province.
When is the Quebec provincial election?
The Quebec provincial election is scheduled for October 5, 2026. CAQ leader Christine Fréchette has stated she would implement the mixed practice policy if elected to lead the government.
Why do some groups oppose mixed medical practice?
Critics like the CSN and MQRP argue that mixed practice creates a two-tier healthcare system, benefits only those who can afford private care, and incentivizes doctors to focus on profitable procedures rather than complex public cases.
What is the current law on physician practice in Quebec?
The CAQ government passed legislation last year to limit physician movement between public and private sectors. Currently, specialists must obtain authorization from Santé Québec to temporarily leave the public network. In July 2026, 121 such authorizations were granted to 71 specialists.
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