LANG Committee Report
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The Honourable Don Boudria, C.P.
Standing Committee on Official Languages
House of Commons
180 Wellington Street
Dear Mr. Boudria:
I am pleased to respond, on behalf of the Government of Canada to the recommendations of the Ninth Report of the Standing Committee on Official Languages entitled « Access to Health Care of the Official Language Minority Communities: Legal Bases, Current Initiatives and Future Prospects », tabled by the Honourable Mauril Bélanger, M.P. in the House of Commons on October 31, 2003.
I would like to take this opportunity to acknowledge the interest shown and the important work undertaken by the Committee in calling for ongoing improvements for better access to health services for official language minority communities.
Enclosed is the Federal Government’s response to the Recommendations of the Ninth Report of the Committee.
The Government of Canada is pleased to have this opportunity to respond to the Ninth Report of the Standing Committee on Official Languages, which was tabled in the House of Commons on October 31, 2003.
The Government is firmly committed to enhancing the vitality of the English- and French-speaking minority communities in Canada, and to supporting and assisting their development.
The Government recognizes the critical importance of access to health services for all Canadians. Over the past few years, it has implemented a series of initiatives to improve access to health services by official language minority communities in their own language. Many measures are well underway and are yielding positive results; others are still under development and should be implemented during the coming months.
In 2000, Health Canada established the Consultative Committees for English- and French-Speaking Minority Communities to advise the Minister of Health on what Health Canada needs to do to contribute to the development and vitality of these communities, pursuant to section 41 of the Official Languages Act.
Health Canada’s commitment is clear and has been demonstrated by funding various projects for these communities solely or in partnership with Canadian Heritage and by funding the “Forum Santé en français” in Moncton in November 2001. Overall, more than $13.6 million has been allocated to official language minority communities over the past three years in response to requests by the communities. Also, Health Canada added two questions to be included in the next round of the Canadian Community Health Survey (CCHS, Cycle 2.1) with the cooperation of Statistics Canada to specifically collect data on French- and English-speaking minority communities.
On March 12, 2003, the Prime Minister announced the Action Plan for Official Languages. The Government of Canada developed the Action Plan following numerous consultations with community members representing various sectors including health. The work accomplished by the Consultative Committees for English- and French-Speaking Minority Communities and the orientations outlined in their respective reports to the Federal Minister of Health greatly influenced the actions being taken in this sector.
With respect to the health sector, the Action Plan for official Languages provides an investment of $119 million, including $89 million over five years, for the implementation of two initiatives at Health Canada within the framework of the Official Languages: $14 million for networking and $75 million for a training and retention of health professionals. This investment also includes the reallocation of $30 million from 2003 to 2006 within the Primary Health Care Transition Fund, to support primary health care renewal initiatives of benefit to official language minority communities.
These funding decisions constitute a major example of the Government’s commitment to enhance the vitality of English- and French-speaking minority communities, and demonstrate the importance that Health Canada attaches to supporting these communities.
The proposed Government Response to the recommendations of the Standing Committee on Official Languages takes into account the fact that under the Constitution, the responsibility for health falls primarily to the provincial and territorial governments. Provinces and territories retain full responsibility for administering their health insurance plans. The Government of Canada supports provincial/territorial governments and communities in their efforts to provide better access to health services for official language minority communities.
The Standing Committee’s recommendations (1 and 2) directed to the Commissioner of Official Languages, and the recommendation (5) to the Consortium national de formation en santé, will be addressed by an individual response from these organizations. A specific response to recommendations targeting the Government of Canada follows.
The Committee recommends the Government of Canada ensure that the funds it allocates to the linguistic minorities for primary care by the Primary Health Care Transition Fund (PHCTF), are guaranteed at least until 2008 and permanently thereafter.
On September 11, 2000, First Ministers agreed that “[ ... ] improvements to primary health care are crucial to the renewal of health services. Governments are committed to ensuring that Canadians receive the most appropriate care, by the most appropriate providers, in the most appropriate settings.” In response to this commitment, the Government of Canada announced the Primary Health Care Transition Fund (PHCTF), which is an investment of $800 million, ending in March 2006. Issues of accessibility and sustainability of health care services for all Canadians were identified as priority areas during the 2003 First Ministers’ Meeting.
The PHCTF is intended to support the transitional costs of implementing sustainable, large?scale, primary health care renewal initiatives. As a result, it is expected that fundamental and sustainable change to the organization funding and delivery of primary health care services will result in improved access, accountability and integration of services. Recognizing the importance of addressing the particular needs of official language minority communities in primary health care reform, a specific funding envelope was created for these communities within the PHCTF, which committed funding up to $30 million (2003-2006). This commitment was included in the Action Plan for Official Languages announced in 2003.
The PHCTF does not currently have approval for continuing any of its funding beyond March 2006. An evaluation of the Fund will be conducted, which will inform decisions related to emerging needs and areas that require further investments, if any.
The final evaluation report will be available in 2006/07. Since the PHCTF was developed and is being managed in close collaboration with provincial and territorial governments, any consideration for a new program would require a similar evaluation process and must also be congruent with overall government priorities.
The Committee recommends to Health Canada that it submit an annual report on funds granted to minority language communities under the Primary Health Care Transition Fund (PHCTF) so that Parliament and the players concerned may know precisely the level of performance and the amounts spent. The report should also provide a breakdown of the funds accorded by Health Canada for other levers of intervention proposed by the Consultative Committee for French-Speaking Minority Communities and the Consultative Committee for English-Speaking Minority Communities.
It is important that the Government of Canada be accountable to Canadians for the results achieved with the use of public funds. As such, in accordance with the 1994 Accountability Framework-Implementation of section 41 of the Official Languages Act, Health Canada reports annually on its results to Canadian Heritage which in turn reports to Parliament. Health Canada will strive to provide the information requested by the Standing Committee on Official Languages on funds granted during the 2003-2004 period in its Status Report, and on an annual basis thereafter. Members of the Standing Committee on Official Languages and the Standing Senate Committee on Official Languages are systematically provided with copies of Health Canada’s status reports.
In addition, the portion of the PHCTF is part of the broader investment made by the Government through the Action Plan for Official Languages. In that context as well, there will be interim and final reports on implementation that will cover aspects of this Fund.
The Committee recommends that the Social Sciences and Humanities Research of Canada (SSHRC) pay particular attention, especially over the next five years, to research projects on health issues specific to the official language minority communities.
The Social Sciences and Humanities Research Council of Canada (SSHRC) is an arm's-length federal agency that promotes and supports university-based research and training in the social sciences and humanities. SSHRC-funded research fuels innovative thinking about real life issues, including economy, education, health care, environment, immigration, globalization, language, ethics, peace, security, human rights, law, poverty, mass communication, politics, literature, addictions, pop culture, sexuality, religion, Aboriginal rights, the past, and the future.
SSHRC has had a long history of funding excellent research on issues of health, health care, and related social, economic and cultural issues in both official languages. Moreover, the leadership on the funding of research on all matters of health is the priority and mandate of its sister agency, the Canadian Institutes of Health Research (CIHR) since its creation in 2000: this is clearly outlined in CIHR’s trategic plan documentation: Investing in Canada's Future: CIHR's Blueprint for Health Research and Innovation. CIHR's plans for addressing health research gaps . for the official language minority communities are outlined in the response to Recommendation 10.
The Committee calls on the SSHRC to conduct renewed promotion of its programs to researchers in the official language minority communities.
SSHRC has always promoted its programs to both official language minority communities and will continue to maintain its high level of bilingual service in all aspects of its program delivery.
Furthermore, as stated in the SSHRC, Multi-Year Action Plan, 2001-2004, for the Implementation of Section 41 of the Official Languages Act, SSHRC invites social sciences and humanities researchers from official language minority communities to participate in all its programs and to submit research proposals. To facilitate this process in smaller institutions, SSHRC launched the Community-University Research Alliances (CURA) program in 1999 and is in the process of launching a program focused on the strategic priority of Citizen, Culture and Identities (which includes Official Languages). Given its mandate and its independent peer-review process for awarding grants and fellowships, SSHRC cannot promote preferential treatment to minority groups such as official language minority communities. However, as outlined in the above mentioned document, the Council has offered services in both offical languages and adheres to an extensive set of policies, practices and procedures to ensure fair treatment of applications submitted to them.
The Committee calls on the Canadian Institutes of Health Research (CIHR) to appoint a new official languages champion as soon as possible and to inform the Appointments Committee.
Since its formation in 2000, CIHR has supported the implementation of the Government’s official languages programs.
In January 2004, CIHR appointed a new official languages champion, Ms. Christine Fitzgerald, Vice President, Corporate Affairs.
Moreover, at that time, CIHR also appointed a lead Scientific Director for the health research agenda with regard to issues facing official language minority communities Dr. Morris Barer, Scientific Director, CIHR Institute of Health Services and Policy Research.
CIHR has advised the Appointments Committee of these nominations.
The Committee recommends that the Government of Canada add the Canadian Institutes of Health Research (CIHR) to the list of federal institutions designated within the accountability framework adopted in August 1994 to ensure the implementation of sections 41 and 42 of Part VII of the Official Languages Act.
The objective of CIHR is “to excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system”(CIHR Act, April 13, 2000). As a federal agency, CIHR is committed to discharging its responsibilities with respect to the Official Languages Act and is bound by the accountability and coordination framework of the Action Plan for Official Languages.
With respect to the OLA, CIHR will include a summary of its research activities related to official language minority communities, as part of its regular accountability reporting to Parliament (Part III Estimates)--the Report on Plans and Priorities, tabled in the spring of each year, and the Departmental Performance Report, tabled in the fall of each year._ Through this approach CIHR will inform Parliamentarians of its plans and its progress to date in this very important area.
The Committee recommends that a fourteenth institute be created at the Canadian Institutes of Health Research (CIHR) to explore all issues of health care related to official language minority communities.
CIHR is committed to exploring health research topics related to issues facing official language minority communities.
Because this topic is relevant to many CIHR Institutes, CIHR plans to address this through the designation of a scientific research champion, who will lead and coordinate activities across CIHR Institutes. To this end, it has appointed Dr. Morris Barer, the lead Scientific Director for the health research agenda. (See response to Recommendation 8.)
Through this coordinated approach CIHR will build on work to date related to official languages. This includes a research grant recently awarded to study les Déterminants de la santé dans les minorités francophones; discussions with Health Canada’s Consultative Committee for French-Speaking Minority Communities and with the Consortium national de formation en santé on barriers to access to health services and the strategies to address these barriers, such as improving strategic information on official language minorities and their health needs/status, providing support to postsecondary institutions that provide services to official language minority communities.
In March 2004 CIHR will hold an invitational workshop with relevant researchers to discuss pertinent issues and to define a health research agenda. The title of this workshop is “Needs, Gaps & Opportunities: Improving Access to Health Services for French and English Speaking Minorities.” Next steps will be identified following this workshop.
The Committee calls on the Government of Canada to have one of the future federal-provincial-territorial conferences of health ministers focus primarily on the question of health care for linguistic minorities.
Health Canada’s mandate is to help all Canadians maintain and improve their health. Improving access to official language minority communities is an integral part of that mandate as is the need to respect provincial jurisdiction. Any initiative in this area will need to be thoroughly discussed with our partners, the provinces and territories.
Federal/provincial/territorial (F/P/T) relations in the Health sector are both complex and extensive. F/PT collaboration takes place through many F/P/T committees working on a large spectrum of health issues. The Conference of F/P/T Ministers of Health is the most senior such committee. As is recommended by the Standing Committee, Health Canada will work on developing options to improve access to health care services for official language minority communities with its provincial and territorial partners and identify collaboratively the appropriate opportunity to bring forward these issues to the agenda of F/P/T Ministers of Health.
The Committee recommends that the Government of Canada create an intergovernmental cooperation program in the health field, a program to be managed by Health Canada which will provide financial support to the provincial and territorial governments in providing health care for the linguistic minorities. That program should be based on the following principles: respect for the provinces’ areas of jurisdiction, equal partnership, participation of the community health networks and accountability.
The PHCTF was created in response to the 2000 First Ministers’ Meeting agreement and depends on federal/provincial/territorial cooperation. The program is managed by Health Canada and provides financial support to provincial and territorial governments for primary health care reform. Recognizing the importance of addressing the particular needs of official language minority communities in primary health care reform, a specific funding envelope was created under the PHCTF to support renewal of benefit to official language minority communities.
Evaluation data related to the PHCTF’s performance, as well as federal/provincial/territorial government priorities will prompt decisions on whether or not to renew the Fund or to create a new program beyond March 2006.
In the light of the prime ministers’ 2003 Health Care Renewal Accord, in which a fund of $16 billion was set up to support reform to health care and in which front-line health care, home care and the skyrocketing costs of prescription drugs were targeted specifically, the Committee recommends that the Government of Canada target as well health care in minority language communities in the current agreement and in future ones.
Many Canadians are part of official language minority communities. It is important to ensure that health care providers in these communities are able to serve clients in their own language. It should also be noted that provincial and territorial governments are primarily responsible for the administration and delivery of health care services. Accordingly, they are responsible for managing their own resources, according to their respective priorities for health care.
In the 2003 First Ministers’ Accord on Health Care Renewal, First Ministers agreed to shared commitments on primary health care, home care and catastrophic drug coverage and to secure a long-term, sustainable publicly-funded health care system for all Canadians. To support these priorities, the Government of Canada created a five-year Health Reform Transfer of $16 billion to provinces and territories. First Ministers also agreed to place a priority on the implementation of electronic health records and the further development of telehealth applications. To support this Accord initiative, the Government of Canada provided $600 million over three years to Canada Health Infoway, which includes up to $150 million for expanding telehealth implementation in rural and remote regions across the country, including in Aboriginal and official language minority communities.
The 2003 Accord built on the First Ministers’ agreement of 2000, which resulted in the creation of the Primary Health Care Transition Fund, itself including now $30 million to support transitional activities that improve access to primary health care services for official language minority communities across Canada.
In addition to the $30 million mentioned above, the Action Plan for Official Languages provided an investment of $89 million over five years to implement a training and retention initiative for health professionals and a community networking initiative to improve access to services for official language minority communities.
These initiatives highlight the Government of Canada’s continued commitment to health care in official language minority communities.
The Committee recommends the Government of Canada ensure the official language minority communities are represented on the Health Council.
Councillors serve in their own capacity, not as representatives of any group. It should be noted that three francophones – Jean?Guy Finn (NB), J. Camille Gallant (PEI), and Simone Comeau Geddry (NS) – are on the Council.