CBC News

Over the course of two years, the number of inspections Quebec’s health insurance board (RAMQ) has done at medical clinics dropped by half, according to documents obtained by Radio-Canada.

The check-ups help uncover whether private clinics are charging illegal fees to patients, among other things.

In 2015, the RAMQ did 298 inspections and found that 35 clinics were charging patients for services that are covered by the public health insurance plan. In 2017, only 150 inspections were done; 12 clinics were found to be charging illegal fees.

A law passed in 2016 gave teeth to the RAMQ’s inspectors — before, inspections were more preventive in nature. Inspectors weren’t able to invoke laws and dole out fines.

In an email, a spokesperson for the RAMQ explained that the new powers bestowed upon the board’s 25 inspectors makes the inspection process more complicated, notably because they increased the standard of proof needed to write up lawbreakers.

The spokesperson also said the inspectors’ work was delayed last year due to the passing of a new law that forbids doctors from charging certain fees to patients. Staff had to undergo training in order to be able to apply it properly.

Worrisome drop, says watchdog

Dr. Isabelle Leblanc heads a group of Quebec doctors and medical students who work to preserve the universal nature of Quebec’s health care system.

She says the drop in inspections is cause for concern because it’s up to the RAMQ to make sure that doctors are following the rules.

“Inspections that aren’t based on complaints, just going to check out what’s going on in the clinics, are important because we know that due to the power imbalance, there are many patients who don’t want to file a complaint against their doctors,” she said.
Leblanc questioned whether the government made sure the RAMQ had the necessary resources to carry out inspections and investigations when it decided to increase their powers.
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