The federal government is threatening to cut Quebec’s transfer payments because of what it calls a “two-tiered” health care system – and Quebec is telling Ottawa to back off.

“It's our jurisdiction. I think that the network is under our responsibility, so I wouldn't like to see the federal government telling us how to manage the healthcare network,” said Quebec Premier Francois Legault on Wednesday.

In August, just before the start of the provincial election campaign, the federal health ministry warned then-Quebec minister Gaetan Barrette that it was unfair for patients in Quebec to bypass lineups for medical tests by paying for them at private clinics.

Quebec's new Health Minister Danielle McCann is now in charge of the file, and will allow the status quo to continue for now.

McCann said Quebec would also tell the federal government to respect provincial jurisdiction.

"We will discuss with [Federal Health Minister Ginette] Petitpas-Taylor, I've talked to her already, generally, and what we will put forward is that Health is a competency of Quebec, of the province. And we want to maintain access to all Quebecers, so we will work to reinforce the public system, but in the meantime, we will not close any doors in terms of access," said McCann.

McCann pointed out that Ottawa has set a deadline of April 1, 2020, to stop the practice, and said she’s confident the two sides will settle before then.

In the meantime, Quebec is paying private clinics to conduct tests that are normally done at hospitals and clinics, effectively bringing them into the public sphere to reduce waiting times for patients with costs paid for by RAMQ.

Ottawa claims the practice is unfair and counter to the Canada Health Act because it gives quicker access to people who pay.

Legault said it’s fine for Quebecers to have the option at the moment, because wait times are long in the public system.

“I think that right now, some people they like to have access rapidly to some services, so I think it's our responsibility to make sure that those services are offered also in the public sector in a reasonable time. It's not the case,” he said.


Not the first federal threat

This is not the first time the federal government has threatened to reduce transfer payments because of medical issues.

In January 2017 the provincial government forced doctors to stop selling vaccines and other medical supplies and ordered them to stop charging patients "accessory fees" to insert Intra Uterine Devices or to give shots.

That was done because Ottawa said it would withhold tens of millions of dollars’ worth of transfer payments.

But as a result, many doctors stopped giving vaccinations altogether, saying they could not afford to absorb the costs associated with storing and providing materials.

Some patients also stopped getting vaccinations because it became awkward to visit a doctor's office multiple times to get a prescription, have it filled, and then to get injected.