The Quebec government appears to be backing away from a polarizing language directive that has sparked fears it could restrict access to health care in English and potentially violate the Canada Health Act.

The 31-page directive, which came into effect July 18, has triggered anger and confusion in the province, a rebuke from at least two Liberal MPs from Montreal and a response from the federal health minister.

“The reaction has been shock and disbelief and a sense of true betrayal,” McGill law professor Pearl Eliadis said in an interview with Global News Friday.

Facing a growing backlash, three Quebec ministers wrote an open letter, saying they’re ready to make changes to the directive, which sets out specific examples for when English can be used in hospitals, clinics and health-care facilities.

One of its most controversial sections states a patient needs to present an eligibility certificate proving they have a right to receive health care in English because of their anglophone roots.

“It would be absurd and maybe amusing if it weren’t for the fact that people’s health and people’s lives and vulnerable people’s access to social services are put into question,” Eliadis said.

In the open letter published Friday, the Quebec ministers insist the province is not limiting the availability of health services in English, adding there will be no language requirements in Quebec to treat patients.

Quebec’s French Language Minister Jean-François Roberge told Global News that “no questions” will be asked of English speakers in health-care facilities and they will not be required to present documents like an eligibility certificate.

“It won’t impact in any way the way you discuss with medical professionals. Let’s be clear. It was never our intention,” Roberge said.

It’s not clear how Quebec might change the directive and whether the federal government will intervene if the guidelines are not rewritten.

Health Minister Mark Holland’s office says there are “broad principles” under the Canada Health Act that provincial governments must respect.

“We expect provinces and territories not to make decisions that would impede Canadians’ access to health care in their official language of choice,” Holland’s press secretary Matthew Kronberg said in a statement Friday.

The comments come as Liberal MP Anna Gainey, who represents the largely anglophone Montreal riding of Notre Dame de Grâce-Westmount, said this week that she had voiced “serious concerns” to Holland.

Anthony Housefather – another Montreal MP – also criticized the guidelines, posting on the social media site X Thursday that “when it comes to health care the language preferred by the patient is paramount.”

On Friday, Housefather said he was “pleased to see the letter” from the provincial ministers that “health care in English will be available to all” but added that the directive should be scrapped altogether.

“The next step would be to withdraw the directive which does not say this at all and come up with something as clear as their letter,” Housefather posted.

Eliadis also called the provincial government’s actions “contradictory.”

“I think the government has brought itself into disrepute.”

Eliadis says the Quebec government was likely “counting on the fact that the federal government” would “do nothing,” which has been the case with other controversial rules stemming from Bill 96.

Quebec Premier Francois Legault introduced the bill as an overhaul of the French language charter, which places new language requirements on businesses, education institutions and health-care organizations in the province.

“The question is going to be what are the consequences for Quebec? Is there going to be a withholding of transfer funds?” Eliadis said.

Under the Canada Health Act, Ottawa can withhold funding transfers to provinces found to be violating the terms of access to care laid out under its standards.

Last December, Angus Reid ranked Legault Canada’s least popular premier based on responses from people polled by the institute.

Since last fall, his party – Coalition Avenir Quebec (CAQ) – has waned in popularity, with the sovereigntist Parti Québécois (PQ) leading in the polls.

“I think the CAQ is trying to ‘out PQ’ the PQ,” Eliadis said.

“I think they are trying to establish their credentials in this area to divert votes from the PQ.”