Montreal

Withdrawal of dentists' services 'will not happen,' says Health Minister Gaétan Barrette

The association representing most Quebec dentists says at least 2,000 have filled out their 30-day notice indicating they'll no longer provide government-paid dental care to children under 10 and welfare recipients.

Barrette says a decree compelling dentists to remain in RAMQ 'has already been signed'

Health Minister Gaétan Barrette says he's already signed a decree which would order dentists to remain in the public health insurance system, RAMQ, should they carry through with a threat to leave. (Radio-Canada)

Quebec Health Minister Gaétan Barrette said Thursday dentists will not be allowed to withdraw their services as a pressure tactic in contract talks.

Earlier Thursday, Serge Langlois, president of Quebec's association of dental surgeons, presented journalists with a cardboard box he said contained withdrawal notices from nearly 2,000 dentists indicating they'd no longer participate in RAMQ, the public health insurance program.

"It's obvious that we have to put pressure on the government," Langlois said, noting that negotiations have dragged on since the association presented its case 14 months ago for an increase in the fees they're paid by RAMQ.

Serge Langlois, president of the association representing most Quebec dentists, presented journalists Thursday with this box of close to 2,000 withdrawal forms from dentists who say they will no longer participate in the public program. (Verity Stevenson/CBC)

RAMQ covers basic dental care for children under 10 and people on social assistance, but Langlois says it is only paying a fraction of dentists' costs. 

In order to withdraw from RAMQ, the dentists must provide 30 days' notice.

Patients 'will not be taken hostage': Barrette

However, Health Minister Gaétan Barrette reminded the dentists later Thursday, he has the power under Quebec's Health Insurance Act to suspend their withdrawal notices, to ensure Quebec children continue to have their basic dental care needs met.

"What has been announced [by Langlois] will not happen," Barrette said at a separate news conference.

"The decree has already been signed," he told reporters, recalling that earlier this year, he took the same step to prevent optometrists, who offer limited services covered by medicare, from withdrawing their services.

That dispute ended in June with a negotiated agreement.

"It doesn't affect in any way our intention and our will to negotiate with the dentists," Barrette said.

"But patients, and especially children, will not be taken hostage. Period."

Langlois told reporters that he would not go into details about the association's negotiating position, except to say it has filed a 30-point proposal for increased fees.

Barrette has called on the dentists to decide what are their priorities, a stance Langlois described as "odious."

But Langlois did concede that by trimming their demands down to 20, the dispute "could be resolved in a week of negotiations."

"Thirty days is quite enough to reach an agreement," he said.

Langlois said dentists get $80 for a dental exam for a child under 10, but the dentist's costs are $66, counting rent, the salary of a dental assistant and equipment changes he said were necessary to apply the latest dental techniques.

RAMQ pays $46.75 for the child's dental exam, spokesperson Caroline Dupont confirmed, suggesting a $80 dentist's bill could include extra charges paid by the parents for cleaning and other services.

There are about 4,300 non-specialist dentists in Quebec, Langlois said, and about 3,600 of them treat children.

He said Barrette now wants to reduce the amount RAMQ reimburses by 12 per cent.

What RAMQ pays for

RAMQ in Quebec fully covers oral surgery in hospitals, when it is required in cases of trauma or illness.

For children under 10, one annual examination, emergency examinations, X-rays, anesthesia, fillings, crowns, extractions and oral surgery are covered.

RAMQ does not pay for cleaning, scaling, fluoride application, and pit and fissure sealing for children.

Quebecers who have been on social assistance for at least 12 consecutive months have similar coverage, but medicare does pay for their cleaning, scaling and fluoride applications.

People on social assistance for more than 24 months receive coverage for dental prostheses as well.