The Health Minister’s ban on hospital accessory fees eight months ago has proved to be problematic for Quebecers seeking some basic health services.

Earlier this year, Gaetan Barrette did away with the conventional option that previously allowed patients access to IUD’s and vaccinations in doctor’s offices.

“Every week, several patients come in and say ‘this really frustrates me, why can’t you do this?’” explained Dr. Mitchell Shiller, a pediatrician.
Patients used to be able to purchase vaccines at their doctors’ offices and have the doctor administer the shot on-site.

“They didn’t have to make a second appointment to go to the CLSC if they were willing to pay a nominal charge. Parents chose accordingly, whatever their wishes were, and it was respected,” Shiller explained. “The biggest issue for many parents now, they have to take a second day off work—getting appointments is not very easy.”

Shiller says he’s also noticed a public health consequence: some parents are less likely to vaccinate their child at all—especially those skeptical about vaccines.

Last week, Barrette told CTV that he’s heard the grumbling, and that it may impact a future move to reverse the accessory fees.

“The public is sending, or asking, or criticizing that measure—they want to go back to where it was before, and I’m contemplating exactly that,” Barrette said, adding that he plans to update the regulation on the table in the fall.

IUD’s—intra-uterine contraceptive devices now have to be bought at a pharmacy, and as with vaccines, now necessitates several doctors’ visits instead of one.

“We know that with accessory fees, the amount of money that patients have to pay at the pharmacy is much higher than what physicians would sell the device like the IUD at the office before,” explained Dr. Diane Francoeur, head of Quebec’s Federation of Medical Specialists.

Francoeur said she’s happy Barrette is considering amending the regulation, but this is the first she’s heard of its possible reversal.

“Of course we wish we had better relations and we would be able to discuss this at the negociation table. That’s where it should be,” Francoeur said.

Doctors would want the government to either absorb what they say are the basic costs associated with providing vaccines and IUD’s at their offices, or allow them to charge patients a nominal fee for the service.

A spokesperson for the Health Minister said they are still considering the issue, and that no definitive decision has been made.