Montreal clinic for vulnerable population faces closure amid Quebec’s controversial Bill 2

Clinique L’Agora, a vital health care hub for Montreal’s most vulnerable populations, says it will be forced to close on April 1 due to Quebec’s new Bill 2.

Critics warn the law threatens to make it financially impossible for clinics serving patients with complex needs to operate. Under the legislation, doctors could see up to 15 per cent of their pay cut based on criteria yet to be defined, potentially impacting clinics that care for LGBTQ2 patients, sex workers, and people experiencing homelessness or patients who often require longer, more intensive care.

Founded in 2019, Clinique L’Agora serves roughly 6,000 patients, many living with addiction, HIV, hepatitis, or serious mental health challenges. Some patients don’t even have a RAMQ card, yet the clinic’s philosophy has always been to make them feel safe, welcomed, and cared for.

“The philosophy here is really to allow these patients who would normally struggle to find a place in the health care system to feel at home and feel safe,” said Dr. Antoine Cloutier-Blais, once of the clinic’s co-owners.

The clinic provides critical services, including street outreach, sexual health care, and follow-ups for people dealing with the long-term effects of substance use.

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“We have noticed that substance use disorders are not classified as a priority, homelessness isn’t considered a health issue, and gender-affirming care is not recognized as a priority,” Dr. Cloutier-Blais added.

Bill 2 will tie part of doctors’ salaries to the vulnerability of their patients, determined by a government-defined colour system, raising concerns among health care professionals.

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“So, now, once we have failed them, we’ll consider them a priority? This is just plain neglect,” Dr. Cloutier-Blais said.

The law has already forced Clinique L’Agora to stop accepting new referrals from homeless shelters and supervised injection sites, leaving thousands of patients at risk.

“You don’t increase accessibility by shutting down points of care,” he added. “The math doesn’t math.”

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At Montreal’s largest LGBTQ2 health conference, experts and advocates spoke out against Bill 2.

“With Agora, we’re talking about 6,000 patients who need access to health care, to a doctor they can trust, because they can’t rely on the mainstream health system due to its shortcomings,” said Celeste Trainon, one of the conference’s key note speakers, and the founding director of Clinic Juritrans.

Health care providers warn that losing clinics like L’Agora could lead to preventable health crises and even death among people who fall through the cracks.

Many clinics are calling on the government to revise Bill 2 before it takes effect on Jan.  1, saying Montreal’s most vulnerable populations will lose access to essential care otherwise.

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