Quebec's political leaders were thrown immediately into confrontation with one another Thursday night in face-to-face battles during the last televised debate before Quebecers head to the polls Oct. 1.

Instead of the usual four-way format and opening statements, the leaders squared off in one-on-one exchanges.

Liberal Leader Philippe Couillard was forced right away to fend off attacks from Coalition Avenir Quebec Leader Francois Legault over doctors' salaries.

Doctor specialists in Quebec make more than $450,000 a year, leaving little money for nurses and other workers in the health-care network, Legault said.

"He just doesn't understand," Legault said about Couillard. "Doctors (in the province) are the best paid in Canada, but nurses are underpaid. It's shameful."

Couillard responded by saying the salaries translate into "more services to citizens."

Following that exchange, Parti Quebecois Leader Jean-Francois Lisee began attacking Quebec solidaire co-spokesperson Manom Masse over her political formation's uncommon leadership style.

Quebec solidaire has no official leaders but has Masse and Gabriel Nadeau-Dubois as co-spokespersons -- and Masse looked somewhat frustrated that Lisee didn't want to speak about health care, the first theme of Thursday's debate.

"Who pulls the strings in Quebec solidaire?" Lisee asked, ignoring pleas from the debate moderator for him to stick to the subject.

Masse answered that in her party, "we learned how to share power."

After that strange exchange, it was Couillard's turn to debate face-to-face with Lisee.

Couillard once again had to defend his government's budget cuts to the health-care sector in the early party of the Liberal mandate.

The Liberal leader said his government had no choice because the PQ minority government of 2012-14 left Quebec with a massive budget shortfall.

"When you left a $7-billion deficit you knew what would happen," Couillard said. "You put public services in a fragile situation and now you have all these promises worth hundreds of millions of dollars based on the healthy public finances you criticized for the last several years."

Leaders were also to debate immigration and the economy later in the evening.

Two previous debates -- one in French and one in English -- didn't have any clear winners, although a Mainstreet poll indicated respondents preferred Lisee's performance in the first French debate by a few percentage points over that of the three other leaders.