When Primary Care Becomes Policy

For the first time in its history, and because the context demands it, Quebec is establishing a policy dedicated to primary care.

The document, titled Innovating to Better Meet the Needs of Individuals and Communities, spans a 10 to 15 year horizon and will be implemented through successive five-year action plans.

In this vision statement, the accompanying action plan will be presented by the next government. Built on the concept of the quintuple aim, five dimensions structure the policy: population health and well-being, service experience, equity, workforce experience, and public service sustainability.

The Policy

The Return of the CLSC as a Governance Unit

One of the most structurally significant shifts in the policy is the reaffirmation of the CLSC territory as the reference operational unit. After years of regional and national centralization through the CSSS, CISSS/CIUSSS, and Sante Quebec frameworks, the government is seeking a more local approach: bringing decisions back to the community level, on a human scale.

Territorial CLSC governance thus becomes the common anchor point for all stakeholders across the system, whether public institutions, contracted clinics, technology providers, or community partners. In practice, CLSCs will be granted decision-making autonomy, translated into authority over the allocation of human and financial resources within their territory. This proximity governance will be supported by dedicated funding that accounts for the specific needs of each territory’s population.

The policy provides that this funding will give CLSCs the necessary levers to formalize their relationships with affiliated settings and local partners, and to fully assume their planning, coordination, and evaluation responsibilities toward their population. It is, however, too early to address operationalization, as this will need to be specified in future government action plans.

Universal Affiliation as an Obligation of Results

The policy is unambiguous on this point. Access to care can no longer be conditional on registration status. Coverage of 100% of the population is framed as an obligation of results, which the government intends to meet through the deployment of a new affiliation model connecting all residents to a local care and services setting. This requires affiliated settings to actively document mechanisms for identifying unexpressed needs, particularly among vulnerable populations.

Interprofessionalism as System Architecture

The policy gives a central place to interdisciplinary teams and the expansion of scopes of practice. The nurse practitioner specializing in primary care plays a pivotal role in the proposed model, with the authority to directly enroll patients, and the policy formalizes this. This is an institutional reality that shifts collaboration dynamics across all affiliated settings.

Digital Technology as a Condition of Compliance

Axis 4 of the policy is explicit: interoperability is no longer an aspiration, it is an eligibility condition for any new technological development deployed within the network. The 2024-2027 Artificial Intelligence Master Plan and the Act Respecting Health Information form the regulatory reference framework. The policy also identifies the digital divide as a genuine equity risk: any technological deployment must demonstrate that it does not widen disparities in access.

A Strategic Window, Open

The first government action plan has not yet been announced. It is precisely the interval between the policy’s publication and its adoption that represents the most fertile moment to contribute to the drafting of concrete measures. Organizations wishing to position their solutions or arguments with the MSSS and Sante Quebec have a real opening, in a context where the foundational orientations benefit from solid scientific consensus, even if the legislative timeline remains subject to the 2026 electoral context.

That is why our team will maintain ongoing monitoring to support you in any initiative aimed at influencing the implementation of this primary care policy.