Hello ladies and gentlemen.
On behalf of the chair of the board of directors for the Société Santé en français, Dr. Anne Leis, I thank you for the invitation to appear before your committee.
Created in 2002, the Société Santé en français is made up of a secretariat and 16 provincial and territorial networks. The purpose of the organization is to increase access to health care services in French for francophone minority communities across Canada.
The SSF and the networks have built and maintained partnerships and strong ties with policy makers, health care professionals, health services managers, post-secondary training institutions and communities. That way our communities' health care needs are on everyone's radar.
During the consultations on the renewal of the official languages action plan, Canadians across the country indicated that access to health care in their own language was a priority for their communities and themselves. That is understandable. Language is an essential element in providing safe, high quality health care and it is also a determinant of health.
Why is it important? Language barriers can be troublesome and often cause misunderstandings and misdiagnoses. They result in additional costs for health care systems and leave patients feeling powerless, stressed and dissatisfied because they don't feel understood by health professionals.
The SSF's main focus is on individuals, people like you and me, who need services in their own language, particularly when they are sick and vulnerable. Here are a few examples of real-life situations that we have encountered within the course of our work.
A seven-year-old child did not understand English and had to get chemotherapy treatments without being able to communicate directly with his medical team in his own language.
A teenager with mental health problems had to find the right words to explain what was troubling her and how she was feeling in her second language.
Francophone seniors who lived their whole lives in French or lost the use of their second language had to resign themselves to living out their days in a health care system where care providers were unable to speak their language.
An engineer from Quebec who was working somewhere in Nova Scotia took his pregnant wife to the emergency room at the hospital because she was in severe pain. They were both in a state of panic and unable to find the words in English to communicate with the health care professionals.
Often people put off going to the doctor or do not go at all. Language barriers also cause stress for health care professionals who cannot communicate effectively with their patients or offer them quality services. The message here is simple: when people are sick and vulnerable, they are not bilingual.
I will now talk about the modernization of the Official Languages Act. Together with the Consortium national de formation en santé or CNFS and with the support of legal counsel, we prepared arguments regarding the modernization of the OLA and its impact on health. In December, the CNFS and our organization finalized the document, and we sent each of you a copy.
We also helped our colleagues from the Fédération des communautés francophones et acadienne du Canada or FCFA to develop a model bill to modernize the Official Languages Act. Here is how the modernized act could improve access to health care in French.
We support the following recommendation made by the FCFA, which states:
Any agreement between the federal government and a province involving a transfer of funds must contain a binding language clause that advances the equal status and use of French and English in Canadian society and enhances the vitality and development of official language minority communities.
We cannot enhance the vitality and development of our communities without access to French-language health care services. For example, during recent negotiations between the federal, provincial and territorial governments on agreements pertaining to mental health care, home care, and palliative and end-of-life care, the CNFS and the SSF jointly recommended that Health Canada incorporate performance measures into its obligations toward our communities because communication and language issues are particularly critical in these areas.
Under the current legal framework, these services, which are made possible through federal funding, are delivered in both official languages only if the province so desires, and you know as well as I do that that does not happen in most cases.
The modernization of the Official Languages Act should make linguistic duality mandatory and non-negotiable in all transfer agreements, including those related to health.
When it comes to health care, the federal government already has the power to spend in areas of activity of its choice and can place conditions on the subsidies, conditions that would fall under the jurisdiction of the provinces and territories.
In the field of health, there is an instrument called the Canada Health Act, which recognizes the jurisdiction of the provinces and territories in health-related matters. It sets out five criteria that the provinces and territories must meet in order to be eligible for a contribution. They are public administration, comprehensiveness, universality, portability and accessibility.
In order to satisfy the criterion respecting universality, one hundred per cent of the insured persons of the province must be entitled to the insured health services provided on uniform terms and conditions.
In order to satisfy the criterion respecting accessibility, a province or territory's health care insurance plan must provide for insured health services on uniform terms and conditions and on a basis that does not impede or preclude, either directly or indirectly, reasonable access to those services. That includes francophones in minority communities.
In accordance with the bill proposed by the FCFA, we recommend that the modernization of the Official Languages Act include an amendment to the Canada Health Act, namely, the addition of linguistic duality as a sixth criterion. In order to satisfy that criterion, the provinces and territories would have to develop a program of access to health services for official language minority communities, taking into account the human, material and financial resources of each facility and the sociocultural and linguistic characteristics of the population served.
The OLA requires federal institutions to take positive measures to implement the federal government’s commitment to enhancing the vitality of francophone and anglophone minorities in Canada, supporting their development, and fostering the full recognition and use of both French and English in Canadian society.
We believe that the OLA must be modernized to ensure that the federal health obligations are fully respected in the contribution agreements reached with national organizations, including the Canadian Institute of Health Information, the Canadian Patient Safety Institute and the Mental Health Commission of Canada.
As you are no doubt aware, scientific data is needed to make real changes. We need that data to be able to measure results and progress. We cannot change what we cannot measure. Data collection falls under the responsibility of a number of organizations. The act should require federal institutions to collect data on official languages and ensure that they are analyzed in way that is useful to the communities. I am thinking, for example, of Statistics Canada, Health Canada, the Canadian Institute for Health Information and the Public Health Agency of Canada.
What is more, the federal government could encourage the provinces and territories to collect language statistics and offer them financial incentives if they include language preference on their health cards.
Given the nature of our work, we know that institutions often do not fully understand or have misunderstood the act and their responsibilities under it. Individual responsibility and the enforcement of the act in isolation makes it very difficult to implement cross-cutting measures that would make it possible to meet the objectives of the act.
The modernization of the Official Languages Act must therefore give the federal government a clear role. In other words, the government needs to take all of the measures necessary and promote official languages within its own administration.
In closing, Health Canada depends on organizations such as the SSF and the CNFS to meet its obligations under the act. The SSF and its networks want to continue to work with our partners to help them acquire the knowledge, skills, tools and support they need to make decisions and take real action to meet the needs of our communities.
We want to continue our mission to give communities better access to health care in French and thus contribute to their vitality. We need leadership from the federal government and a robust Official Languages Act.
Francophones living in minority communities have not had access to services of equivalent quality to those provided to the majority community for far too long, and they have stopped asking for them. However, there is still a pressing need for such services. There is still a lot of work to be done and a lot of catching up to do.
Thank you for giving me an opportunity to share our perspective and recommendations as part of the study on the modernization of the Official Languages Act.
We would be pleased to answer any questions you may have.
Hello Mr. Paradis, Mr. Clarke, Mr. Choquette and committee members.
The Quebec English-Speaking Communities Research Network, QUESCREN, was founded in 2008 as a joint initiative of Concordia University, the Canadian Institute for Research on Linguistic Minorities and Canadian Heritage. Today, the Quebec government’s secretariat for relations with English-speaking Quebecers also provides support.
QUESCREN is a collaborative network of institutions, researchers and stakeholders. It promotes understanding and vitality of Quebec’s English-language minority communities through research, training, knowledge mobilization, networking and outreach.
Thank you for inviting me to represent QUESCREN here today. I understand that your committee is studying the modernization of the Official Languages Act with a focus on part VII, as well as compliance and the impacts of the act on Canadians. My comments are on the first and third of these topics.
Part VII commits the Canadian government to enhancing the vitality of the English and French linguistic minority communities in Canada and supporting and assisting their development.
Regarding community vitality, Dr. Richard Bourhis, a QUESCREN researcher and member, helped develop the concept. He writes that “the more vitality a group is assessed to have, the more likely it is expected to survive collectively as a distinctive linguistic community.”
Using a vitality framework, researchers look at factors such as demography and institutional support. Studies show that Quebec’s English-speaking communities lack vitality in these areas and have issues of high outmigration, underemployment and poverty. In my view, vitality is a useful concept and should be maintained in the renewed act. However, I suggest a few changes.
First, the act does not define “vitality” or detail how the government would enhance it. It would be beneficial for the modernized act to clarify these.
Second, the act does not refer to concepts used in other research that provide additional insights into official language minority communities. For instance, critical sociolinguistics and ethnology researchers such as Dr. Diane Gérin-Lajoie, another QUESCREN researcher-member, show that minority language community identity evolves and relates to other identities such as bilingual or multilingual identities.
Other researchers use intersectional and multiple minorities concepts to clarify that one can be a member of a linguistic minority and also of racial or immigrant groups, and that minority language communities have their own hierarchies of race and immigrant status. For instance, University of Alberta’s Yasmeen Abu-Laban and Claude Couture argue that referring to what they call “French/English” is binary thinking, and that it is helpful for analysis but minimizes the “complexity and nuance” needed to fully understand linguistic minorities.
It would be beneficial for the modernized act to acknowledge that official language communities are complex and diverse. Their populations have multiple identities and may belong to multiple minorities. In my view, the act’s policies and programs need to take such factors into account.
Still with regard to part VII, while Quebec’s official language community shares characteristics with francophone ones, it is also different. Its population is composed of unique and diverse regional and ethnocultural groups.
A modernized act should, in my view, continue to support official language minority community development while also explicitly acknowledging the distinctiveness and equal importance of both official language minority communities, and addressing the distinct needs and profiles of both. For the English-speaking communities, this may mean addressing vitality issues and challenges faced by vulnerable multiple minorities while also supporting the communities' unique strengths, such as their heritage of welcoming immigrant initiatives.
I do not want to leave the impression that English-speaking Quebec is unique in its heterogeneity, or that the act should be worded in any way that treats linguistic minority communities differently. Each of Canada’s official language minority communities faces unique challenges, which is why consultation is so critical to designing positive measures that enhance their individual vitality.
My brief comments will now turn from part VII to impacts the act has on Canadians. Quebec, as you know, has a second language law, the Charter of the French Language. To my knowledge, in English-speaking Quebec, it is much better known than the Official Languages Act. QUESCREN researcher-member Dr. Paul Zanazanian has studied our community’s common historical memory about Quebec. He identifies the charter’s passage, but not the act’s, as a key event in this shared memory. Moreover, research on English-speaking Quebec has paid much more attention to the charter. A keyword search of online bibliography calls up over 450 publications on the charter and only around five on the federal act.
I wonder how well known the act is among other Quebeckers as well. In modernizing the act, it may be useful for the government to determine how well known the act is among English-speaking Quebeckers, and indeed all Quebeckers, and if, as I think, it is not very well known, to consider how this might affect promotion and policy implementation.
Another aspect of the act’s impact on Canadians is perceptions of inclusion and exclusion. Prominent Canadians have addressed this issue. For instance, Drs. Abu-Laban and Couture, whom I already quoted, write that “[f]rom the stand-point of Aboriginal peoples (and postcolonial theory) there is much to question about the discourse of 'two founding peoples'.” Likewise, a political commentator has recently identified indigenous and immigrant Canadians as groups “whose linguistic experiences occur outside” what he calls “these dated frames” of the act. He calls for the government to protect these groups’ languages, not just official languages.
My colleagues at the QUESCREN secretariat and I definitely believe that the act and its identification of official language minority communities continue to be relevant. However, we believe that it is important to be aware of critiques. Could the process of modernizing the act also somehow acknowledge or address concerns of these other populations? For instance, I wonder how the renewed act will relate to the newly tabled indigenous languages act and, in particular, outcomes for Quebec’s many English-speaking indigenous people.
In conclusion, ideally modernizing the act will help keep social cohesion in Canada at a time of social change. Drawing from QUESCREN's own experiences, I believe that the modernization process should involve and promote the following general principles: recognition of diversity, inclusiveness and rapprochement between different linguistic and cultural communities; respectful dialogue; evidence-based decision-making; and the use of research based on different methods to capture nuance and complexity.
I will close my remarks by inviting all committee members to attend a conference that we are co-organizing. It is called “50 Years of the Official Languages Act” and it will take place in Gatineau on May 29 and 30.
Thank you for inviting me here today. Merci.
Thank you very much, Mr. Chair.
Thank you very much for your presentations, Mr. Tremblay and Ms. O'Donnell.
Very quickly, I would like to first ask Ms. O'Donnell a question, and then I have a different question for Mr. Tremblay.
You shared general comments around the unique challenges of various communities—francophones outside of Quebec, anglophones in Quebec, and all of the questions of consultation. I found your comment—and maybe you can expand on it—quite interesting because it seems to fit with some of the comments that have been made in the last three or four months about duality and Canadians' understanding of that duality.
You seem to draw a fine line, which is that Quebeckers, even English Quebeckers, understand law 101 in Quebec. That doesn't mean they agree with it, but they understand what it stands for and what it's about. The same goes for the Charter of Rights to some extent, but not the Official Languages Act. That's quite interesting because the same can be said of francophones, or even anglophones, across Canada. I don't believe they have a full understanding of the richness and strength of the official languages.
That's a very good point, and I think we can learn something from it.
Thank you, Ms. O'Donnell.
Mr. Tremblay, I would first like to tell you what I think.
There is not enough funding for research. Research is my theme for the day. I think that official language minority communities really need research to justify the situation on the ground and to show just how disadvantaged they are and how they are still suffering. That is just a general comment.
With regard to the field of health, Mr. Vachet, a journalist who is not far from us right now, wrote an article entitled “La recherche en santé en français menacée”. In it, he clearly indicated that, last August, the announced an investment of $378 million for 405 projects and that only one French project was approved. That is very serious.
Here's the situation. A program was put in place by the Liberals in 2004 for official language minority communities. As you are well aware, the Harper government eliminated that program in 2012, which is really unfortunate because we are now seeing the impact of those cuts.
In spite of all that, nothing has changed, and the Liberals also take responsibility for that for now.
Tell me a little bit about that program. How was it helping to advance French-language health care in Canada?
Thank you very much for the question, Mrs. Fortier. You are my MP.
I would like to add that a new committee was created two years ago. I am referring to Health Canada's Federal Health Portfolio Consultative Committee for Official Language Minority Communities in Canada, or OLMC. This committee existed in the past. It was abolished in 2007, but then re-established two years ago.
This committee brings together people from the CNFS, the SSF and, on the Quebec side, the Community Health and Social Services Network, or CHSSN, McGill University, the Public Health Agency of Canada, the Canadian Institutes of Health Research and Health Canada. It meets twice a year. We have established a work plan and linguistic data is one of the topics. It is the subject of our next meeting in May.
At present, representatives of the SSF, CNFS, Health Canada and CIHI, are working on this file together. The only thing we need to add is the research component, which is really important. We also need to know what kind of data is required. Statistics Canada also has a consultative committee looking into this.