LANG Committee Meeting

37th PARLIAMENT, 2nd SESSION

Standing Committee on Official Languages

EVIDENCE

CONTENTS

Wednesday, October 1, 2003

¹

1535

The Chair (Mr. Mauril Bélanger (Ottawa—Vanier, Lib.))

Mr. Gilles Beaulieu (Vice-President, Planning and Operations, Régie régionale de Beauséjour, N.B.)

The Chair

Mr. Gilles Beaulieu

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1540

¹

1545

The Chair

Mr. Gérald Savoie (President and CEO, Montfort Hospital)

¹

1550

¹

1555

The Chair

Mr. Benoît Sauvageau (Repentigny, BQ)

Mr. Gilles Beaulieu

º

1600

The Chair

Mr. Gérald Savoie

The Chair

º

1605

Mr. Eugène Bellemare (Ottawa—Orléans, Lib.)

Mr. Gilles Beaulieu

Mr. Eugène Bellemare

Mr. Gilles Beaulieu

Mr. Eugène Bellemare

Mr. Gérald Savoie

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1610

Mr. Gilles Beaulieu

The Chair

Mr. Eugène Bellemare

Mr. Gérald Savoie

The Chair

Mr. Eugène Bellemare

º

1615

The Chair

Mr. Yvon Godin (Acadie—Bathurst, NDP)

Mr. Gilles Beaulieu

º

1620

Mr. Yvon Godin

Mr. Gilles Beaulieu

Mr. Yvon Godin

Mr. Gilles Beaulieu

Mr. Yvon Godin

The Chair

Mr. Raymond Simard (Saint Boniface, Lib.)

The Chair

Mr. Jeannot Castonguay (Madawaska—Restigouche, Lib.)

Mr. Gilles Beaulieu

Mr. Jeannot Castonguay

Mr. Gilles Beaulieu

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1625

Mr. Jeannot Castonguay

Mr. Gilles Beaulieu

Mr. Jeannot Castonguay

Mr. Gilles Beaulieu

Mr. Jeannot Castonguay

Mr. Gilles Beaulieu

Mr. Jeannot Castonguay

Mr. Gilles Beaulieu

Mr. Jeannot Castonguay

Mr. Gilles Beaulieu

Mr. Jeannot Castonguay

Mr. Raymond Simard

Mr. Gilles Beaulieu

Mr. Raymond Simard

º

1630

Mr. Gilles Beaulieu

Mr. Raymond Simard

The Chair

Mr. Gilles Beaulieu

The Chair

Mr. Yvon Godin

Mr. Gérald Savoie

º

1635

º

1640

The Chair

Mr. Raymond Simard

Mr. Gérald Savoie

Mr. Raymond Simard

º

1645

Mr. Gérald Savoie

The Chair

Mr. Gérald Savoie

The Chair

Mr. Jeannot Castonguay

Mr. Gérald Savoie

º

1650

Mr. Raymond Simard

M. Gérald Savoie

The Chair

Mr. Benoît Sauvageau

Mr. Gérald Savoie

Mr. Benoît Sauvageau

Mr. Gérald Savoie

Mr. Benoît Sauvageau

Mr. Gérald Savoie

Mr. Benoît Sauvageau

The Chair

º

1655

Mr. Eugène Bellemare

Mr. Gérald Savoie

Mr. Eugène Bellemare

Mr. Gérald Savoie

Mr. Eugène Bellemare

Mr. Gérald Savoie

Mr. Eugène Bellemare

Mr. Gérald Savoie

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1700

Mr. Eugène Bellemare

Mr. Gérald Savoie

The Chair

Mr. Yvon Godin

»

1705

Mr. Gérald Savoie

Mr. Yvon Godin

The Chair

Mr. Jeannot Castonguay

Mr. Gérald Savoie

Mr. Jeannot Castonguay

Mr. Gérald Savoie

Mr. Jeannot Castonguay

The Chair

Mr. Gérald Savoie

The Chair

Mr. Gérald Savoie

The Chair

Mr. Gérard Finn (Advisor to the Commissionner, Office of the Commissioner of Official Languages)

»

1710

The Chair

Mr. Gérard Finn

The Chair

Mr. Gérard Finn

The Chair

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CANADA

Standing Committee on Official Languages

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NUMBER 035

l

2nd SESSION

l

37th PARLIAMENT

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EVIDENCE

Wednesday, October 1, 2003

[Recorded by Electronic Apparatus]

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[Translation]

    The Chair (Mr. Mauril Bélanger (Ottawa—Vanier, Lib.)): Ladies and gentlemen, we have quorum. Thank you for coming. Today, we are continuing our hearings on Bill C-202, the bill itself having been discharged from the Order Paper and the study of the topic have been referred to us by the House of Commons. At issue is the addition of a sixth principle to the Canada Health Act, the principle of respect for linguistic duality, but taking a broader approach that covers the whole notion of access to health care for official language minority communities.

    We have heard a good number of witnesses, and we still have a few left to hear. Today, we have the representatives of two frontline institutions. The Régie régionale de la santé Beauséjour (Beauséjour Regional Health Authority), in New Brunswick, is represented by Mr. Gilles Beaulieu. Mr. Beaulieu will give us his presentation first, and then he has to leave at 4:30 to catch his flight home this evening. So we will try to accommodate you, Mr. Beaulieu.

    Then we will hear Mr. Savoie, President and CEO of the Montfort Hospital here in eastern Ontario, in the very beautiful riding of Ottawa—Vanier, if you don't mind me putting in that little plug.

    Basically, we're hoping today to explore with you, after your presentations, the kind of problems you encounter in the field, to see what your priorities would be in terms of improving the situation, and most of all, we'd like you to tell us about your experiences and whether or not they would be worth repeating elsewhere in Canada.

    If there are no questions, we are going to listen to Mr. Beaulieu's presentation, which will be followed by a question and answer period. Then, it will be Mr. Savoie's turn, unless you wanted to testify at the same time. We are quite flexible.

    Mr. Gilles Beaulieu (Vice-President, Planning and Operations, Régie régionale de Beauséjour, N.B.):

    If there's enough time, I would like to hear him.

    The Chair: Go ahead, Mr. Beaulieu. Then we will hear from Mr. Savoie. The first questions will be for you, so that you can leave, and then we will turn to Mr. Savoie. You have the floor.

    Mr. Gilles Beaulieu: Thank you very much, Mr. Chairman.

    Ladies and gentlemen, members of Parliament, first of all, I would like to convey the regret of our president and CEO, Mr. Pierre LeBouthillier, who unfortunately couldn't be here today. I would just like to say a word or two about my boss. He has devoted over 30 years of his working and professional life to making a difference in the lives of francophones in minority communities, that is his legacy.

    A moment ago, Mr. Chairman, I gave you a backgrounder on the Dr-Georges-L.-Dumont Regional Hospital, and epic battle every step of the way. It has been over 80 years, and counting.

    The Beauséjour Regional Health Authority, located in Moncton, New Brunswick, is pleased to appear before the Standing Committee on Official Languages, which is examining health care services as it pertains to minority language communities.

    I will give you a brief overview of our organization. The Beauséjour Regional Health Authority is one of the largest francophone health organizations outside Quebec. The Beauséjour Regional Health Authority's workforce includes nearly 2,000 employees and more than 150 physicians, 90 of whom are specialists.

    At the heart of the Beauséjour Regional Health Authority is the Dr-Georges-L.-Dumont Regional Hospital, which provides primary, secondary and tertiary services. Its key features are the following.

    First, it is a provincial referral centre because of specialties such as oncology, dialysis, cardiology, etc.

    The hospital is also a teaching hospital. It implemented a francophone medical education program in affiliation with the Sherbrooke Faculty of Medicine, whose success is well established.

    It is also a francophone teaching facility in several health professions, some of which are unique for francophone communities outside Quebec.

    The hospital has distinguished itself on the national stage and is a leader in telemedicine, with two innovative programs in telenephrology and teleoncology.

    The hospital is also home to the Beauséjour Medical Research Institute, which is already making a name for itself provincially and nationally.

    I'd like to say hello to Mr. Jeannot Castonguay. He may not know that I am from Grand-Sault, and I like to greet people from my part of the country, including our member of Parliament. We are everywhere!

    The Beauséjour Regional Health Authority includes the Stella-Maris-de-Kent Hospital (a rural hospital), a medical centre in the tourist area of Shediac—Cap-Pelé, an extramural program that provides home care to the entire region, a veterans' health centre, and a family medicine unit, to name a few.

    We are here, today, to emphasize the importance of language in the health care setting. At the Beauséjour Regional Health Authority, we are especially proud of our past and our accomplishments. The question of language was an integral part of our development and raison d'être, and this will surely continue to be so in the future. Therein lies the importance of distinguishing between language of work and language of service. At the Beauséjour Regional Health Authority, we are very proud to say that patients and their families are served in the language of their choice, and this is true at all levels of our organization. I believe that we are a model for the rest of Canada in this regard.

    What sets us apart from other health authorities is our ability to have French as our language of work. This characteristic is fundamental, since it provides a work environment that promotes the development of French language in health services. This institutional framework has enabled us to develop and implement a francophone and bilingual workforce in the field of health sciences, thus providing our target population with a wide variety of health services ranging from primary care to highly specialized services.

    Thus the importance of recognizing the strategic role played by health care institutions such as ours and the Montfort Hospital; I didn't know who else had been invited when I wrote this presentation. I would also like to stress the importance of the Evangéline Community Health Centre in rural Prince Edward Island. These institutions and others are part of the social fabric and they are proud symbols of the linguistic and cultural vitality of francophone minority communities.

    That is why the Beauséjour Regional Health Authority supported the idea of adding a sixth principle to the Canada Health Act that would address minority rights in the area of health care services. Although we are not lawyers, we are of the opinion that access to health care services in one's official language is as important as the right to be educated in one's own language or to have a trial in the language of the accused. I would say that health is first and foremost a relationship between a person and a professional, not between a person and technology.

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    In the fields of education and justice, the federal government has played and continues to play a pivotal role in ensuring the protection of minority rights. Why should health care be any different? When you raise that question, you are already attempting to answer it.

    We are of the opinion that our laws should promote that. They should ensure that Canadians can be understood and cared for in their official language of choice, and where numbers warrant, they should ensure that minority communities can maintain and develop their health care institutions.

    When we presented our brief to the Commission on the Future of Health Care in Canada, we did raise this important issue pertaining to minority language communities. We also brought forward the idea of establishing a special fund earmarked for the development of health care institutions and health care services in a minority community. Once the right has been recognized, there have to be long-term programs and agreements.

    Your committee is examining the feasibility of establishing a program of official languages in health care that would be articulated in an interprovincial forum. This idea goes in the same direction as our proposal to dedicate a special fund. Better still, your proposal ensures a framework and a commitment of the various levels of government to develop health care services in a minority community.

    For minority language communities, an intergovernmental forum could certainly develop programs in the area of health promotion, disease prevention and training for francophones in the health sciences. It would also allow for increased use of new technologies such as telemedecine and information technologies, and thus facilitate greater access to health care services for the francophone population in a minority setting. Such an agreement would also allow health care institutions to maintain their assets and ensure their development.

    On May 2 of this year, the provincial Ministers of Health reached an agreement for the establishment of a national council on health care that would report to the Canadian population on their efforts to renew our health care system. It is our opinion that this future council should also include the question of official languages in its mandate. In our efforts to modernize our health care system, minority communities also expect modernized access to health services in their communities.

    Too often, issues of language and minority rights are trumped by the more pressing financial needs of our health care system. I do not mean to underestimate those financial needs, but there are underlying principles, hence the importance of a committee such as yours; you can put this issue back on the agenda of our governments, departments, commissions and agencies.

    In closing, it is strategically important at this time to address minority language rights in health care and that these rights be part of our laws. It is also important that the future council on health care include official languages in its mandate and that the new Canada Health Transfer earmark specific amounts for official language minority communities.

    On that note, the Beauséjour Regional Health Authority thanks the standing committee on official languages for the opportunity to make this presentation, and we hope that it will add positively to your deliberations. Thank you.

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    The Chair: Thank you, Mr. Beaulieu.

    Mr. Savoie.

    Mr. Gérald Savoie (President and CEO, Montfort Hospital): Mr. Chairman, ladies and gentlemen, members of Parliament, I would like to thank you for inviting me to speak to you today as the representative of a proud institution of francophone Ontario, the Montfort Hospital. Before continuing with my presentation, I would like to point out that I didn't know who would be here today. So there has been no discussion, but I can tell you that our contributions are quite complementary in terms of message and recommendations.

    I'd like to bring things up to an even higher level; I am mostly going to focus on the issue of institutions and the need for institutions for the francophone minority as well as for the anglophone minority in Canada.

    I'd first like to talk about the Montfort Hospital. We are a primary and secondary community care hospital with a teaching mandate, the only community teaching hospital west of Quebec. We serve the largest francophone minority population outside Quebec. We are talking about over 550 000 Franco-Ontarians. Forty per cent of that population lives within our service area.

    The Montfort Hospital actually has two major missions: service to the francophone population surrounding the hospital in eastern Ontario, but also an academic mission that encompasses the entire province of Ontario. We are here to make Ontario self-sufficient in health. I join with my colleague in telling you that the Beauséjour Hospital in Moncton, formally the Dr.-Georges-L.-Dumont Hospital, has been a model for us. Thanks to the Beauséjour Hospital, Moncton and the Maritimes in general have much more than we had in Ontario until very recently, let me tell you.

    My comments, which are of a general nature, are based on lessons learned in the context of the Franco-Ontarian community's struggle to protect one of the essential institutions—I repeat, essential—to its survival in Ontario. My comments are above all based on the principle that francophones and anglophones, as the founding peoples of this country, are entitled, and to some extend required, to live and have their language and culture respected all across the country.

    In order to meet the needs of a language minority, it is essential not to stop at offering services in the language of its members. It is essential to provide those services in a context that takes into account the cultural dimension and cultural needs specific to that language minority. The only way to ensure that the linguistic and cultural needs of the minority are met in the provision of services is to have those services provided by the minority's own institutions.

    Studies by eminent Canadian sociologist professor Roger Bernard have shown that providing services to members of a minority through a predominantly English-speaking bilingual institution—all bilingual institutions in which the language majority is English-speaking are predominantly English-speaking institutions—has the direct effect of increasing the assimilation of members of the language minority.

    In the Quebec Secession Reference , the Supreme Court of Canada confirmed that under the Constitution, the federal and provincial governments have a duty to respect and protect their language minorities. In Lalonde versus the Health Services Restructuring Commission, i.e. the Montfort case, the Ontario Court of Appeal confirmed that a government cannot directly or indirectly do anything that will send members of the language minority the message that there is no point in doing what needs to be done to continue living as members of a language minority.

    The federal Official Languages Act attempts to ensure that federal government services are provided in both official languages. Although it is important to provide services in both official languages, it is even more important to ensure that language minorities have institutions capable of providing services in their language, but especially in an atmosphere that meets and recognizes their specific cultural needs. I should mention that this issue is not strictly limited to health. It is an issue that is relevant to all areas that directly or indirectly affect the language minority.

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    In the document entitled "Excerpt from the Committee's work plan", which was attached to the letter you sent me dated September 4, 2003, you said that it might be possible to provide for additional resources, for example, a financial bonus for provinces that try to offer health care services in both official languages.

    I was very surprised to read a reference to a bonus for provinces that meet their constitutional obligations towards their linguistic minority communities. I think we should, rather, be talking about a financial penalty for all provinces that do not meet their constitutional obligations to protect and respect their official language minority communities.

    In practical terms, as the Montfort said in its presentation to the Commission on the Future of Health Care in Canada, the Romanow Commission, we think it is essential to add a sixth principle to the Canada Health Act which would ensure access to health care services in French for minority language communities, as is proposed in Bill C-202. However, these services must be offered by institutions that recognize and respect the special cultural requirements of this community.

    I would now like to read you the conclusion to my presentation to the Romanow Commission in May 2002. It remains very pertinent. I said:

In our view, that principle is constitutionally required. But the most important thing is to make our decision-makers understand that the principle of the respect and the protection of minority rights permeates all the current five principles. For history has shown us that we cannot count on the fact that government authorities will always assume their responsibility in this regard, especially when it is associated with money issues.

By sending the message with your actions, to all our people and all our governments, that Canada will succeed only if it remains faithful to its fundamental values, all its fundamental values.

    With respect to the amendment suggested in Bill C-202, which would add clause 12.1, I recommend very strongly that it be amended to ensure that there is a reference to the importance of ensuring that language minority communities get their health care services in institutions that recognize and respect their linguistic and cultural needs. If you wish, I would offer to help draft such an amendment.

    Thank you very much for allowing me to express my views today.

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    The Chair: Thank you, Mr. Savoie.

    We will now give the floor to Mr. Sauvageau.

    Mr. Benoît Sauvageau (Repentigny, BQ): Thank you very much. I would like to tell you that it is very interesting and relevant to hear from people who work in the field, who can tell us about what is really happening. Rest assured that the objective of this committee is to ensure that services are available in both official languages throughout Canada. Where we may sometimes differ is on the way to achieve this end. However, that is the intent of this committee. We are not here to engage in federal-provincial squabbles. That is not our objective, even though the subject inevitably comes up when we talk about this issue. We want to improve the situation.

    I appreciate the concrete suggestions made by Mr. Beaulieu, I believe, on the establishment of a health council to focus on compliance with the Official Languages Act, and by Mr. Savoie, who spoke about bonuses and penalties. It would be up to us to recommend such initiatives and to follow up on what happens. These are concrete, interesting proposals that we can put forward.

    You raised the idea of a new body, a health council. Do you not think it is rather odd—before a sixth principle is added and whether or not there is a sixth principle and whether or not there is a constitutional squabble— to note that this was left out of their document and they didn't need a House of Commons committee or a court decision to include it. Even if I had nothing against the sixth principle, if we come up with the same diagnosis—since we are talking about health here—but no one wants to administer the treatment... It is clear that there is a disease, but no one wants to administer the treatment. It is all very well to invent other diagnoses or other solutions, but if no one wants to implement them, we are going to have a problem.

    I think the idea of considering the language issue for the health council—which has not yet been established—takes us further away from the sixth principle. However, I will come back to that point later.

    In light of your recent painful court experience, I would like to know how the government helped you. I'm referring just to the federal government. I know that in New Brunswick, there is the Official Languages Act, among others. However, how did Health Canada, Canadian Heritage and the federal government generally, in its area of jurisdiction, help you keep Montfort or expand the Beauséjour Hospital in New Brunswick?

    Before we talk about the future, I would like you to tell us about the past.

    Mr. Gilles Beaulieu: I think we've always felt that the Canadian government was in favour of our cause. Moreover, as regards languages, we've always felt that health came under provincial jurisdiction. More recently, we dealt with the federal government in the context of a telemedicine program, which was a success. To give another example, the Government of Canada invested in our institution through a national pilot project on dialysis. We see this as a vote of confidence. We established a network of dialysis services, in cooperation with the Campbellton and Bathurst regions and with the expertise of the Dr-Georges-L.-Dumont Hospital.

    We are doing great things with our oncology program in francophone regions; the anglophone regions of the province have acknowledged our expertise and want access to it. We find that flattering, because in this case, we are the leaders. We have the only gynecological oncologist in the province. He took the initiative and suggested this project, and, once again, Health Canada said yes.

    As far as provincial funding goes, that is still a battle that has to be fought, but at least, we have been able to highlight our competency publicly, at both the provincial and national levels. This is reflected in the fact that our communities now have direct access to highly specialized services. We focused first on our francophone communities; we had some catching up to do there. We believe very much in the telemedicine programs. They are somewhat like a hospital without borders. A parochial attitude has been replaced by a technology that can go anywhere. Thank you.

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    The Chair: Thank you very much.

    Mr. Savoie.

    Mr. Gérald Savoie: My answer will be in several parts.

    First of all, at the beginning of our struggle, the federal government was very much involved. It was on our side, even though we did not necessarily see it playing a public role. We were trying to deal with a matter between the federal and provincial governments. To my knowledge, the federal government did everything it could to try to find an acceptable solution. As the situation evolved, with the arguments being put forward and the legal developments we were trying to advance, it became apparent that we were probably heading for the courts. At that point, there was a difference of opinion as to whether or not the federal government would be with us. This was all resolved in the end when we were before the courts, particularly the Court of Appeal, and the federal government decided to exercise its right to be an intervener in our case, the Montfort Hospital case.

    I must tell you that this made quite a difference when we were in court. I would say that the federal government did what it could. We certainly appreciated everything that was done. However, we do suffer from the type of problem that was mentioned by my colleague, that is that this is an area of provincial jurisdiction. For example, what conditions are attached to the funding requested for all transfers to minorities, which the federal government is already providing as support to the provinces? This money goes somewhere, and someone makes decisions that are not always tied to concrete results. We talk about accessibility to health care services. Give me a single example in Ontario or elsewhere—I've worked in three different Canadian provinces—where a statement of conditions guaranteed certain results. I would be surprised to hear about that.

    To come back to your question, I would also like to speak about the involvement of the federal government.

    You took very direct action with Health Canada when Mr. Rock was minister. He established an advisory committee for the francophone minority—there was already one in place for the anglophone minority in Canada—to make recommendations to him on the way of making health care services in Canada more accessible. The committee did an excellent study and submitted a comprehensive plan to the minister, who subsequently told his provincial colleagues about it. This committee had never existed previously; it was a first.

    The minority francophone community throughout Canada met in Moncton during the fall before the report was submitted. Absolutely all sectors of the francophone community were on board. I've never seen the francophone minority adopt such a strong stand. Subsequently, the Dion plan was announced which, if I may say, is backed up with some very significant funding.

    We also established the Société Santé en français. This is the type of initiative that has made a real difference and is continuing to do so. It is just a start. Major investments are involved here. We are speaking here about initiatives put forward by the consultative committee that are now being implemented. This will definitely require close cooperation with the provinces, and we are very much in favour of that. There are some tangible results. It remains to be seen whether this will be enough, but at least we have a plan and we know how far we can go. We know what the mechanisms are, but we do need support.

    The Chair: Thank you.

    Mr. Bellemare.

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    Mr. Eugène Bellemare (Ottawa—Orléans, Lib.): Thank you, Mr. Chairman. My question is to Mr. Beaulieu.

    You mentioned in your presentation that people are entitled to certain services. Later, you suggested that this right should be included in the Canada Health Act. Is this wishful thinking or something that could be done?

    Mr. Gilles Beaulieu: I do not think this right is explicitly recognized in the Canada Health Act. We are talking more about a sixth principle for the Canada Health Act. The idea would be to recognize, as a principle, service in the language of the minority community. People would be entitled to services and institutions where numbers warrant. I think this cornerstone of the Canada Health Act is missing at the moment.

    Mr. Eugène Bellemare: You used an expression that set my teeth on edge, namely “where numbers warrant”. Who takes the place of legislation to decide what number would warrant a particular service?

    Mr. Gilles Beaulieu: We went through the same problem in education, and we managed to reach an agreement and draw up some parameters. I mention that, because I know very well that it is impossible to establish hospitals or health institutions in all communities. Nevertheless, we need to agree on what an institution is.

    At the outset, I mentioned the Montfort, which is a major institution for francophones outside Quebec. The Évangéline Community Health Centre, in Prince Edward Island, is an institution geared to the needs of the local community. I wanted to include some realism by saying that there could not be institutions everywhere. The fact remains that these institutions play a key role in the vitality of a community.

    Mr. Eugène Bellemare: Thank you.

    Mr. Savoie, my riding, Ottawa—Orléans, is proud to be part of the area served by the Montfort Hospital. Personally, I am very proud to say that it is my hospital and that I go there from time to time. The service is excellent, and I have noticed that one of my doctors—I have three or four different ones there—who is an anglophone, speaks to me in French all the time. One day, just to see his reaction, I spoke to him in English, and he replied to me in French.

    At a time when there is a shortage of doctors, nurses and specialists, how do you go about attracting bilingual staff who can serve people completely in French?

    There is talk about an amendment to the Canada Health Act to add another principle. When I think of Newfoundland, British Columbia and Alberta, I imagine that these are some of the provinces that might resist this idea. The act must be enforced everywhere, but I do not know whether this will be done to varying degrees.

    Mr. Gérald Savoie: First of all, I would like to thank you for your question, which, believe it or not, touches directly on the point I raised in my presentation. If there were no francophone institution in Ontario, that is the Montfort Hospital, I very much doubt that we could attract such professionals. We are talking about health care professionals who want to work in their own language. One of the things that allows us to attract them is the fact that we have a French-language institution. The administrative language at the Montfort Hospital is French. Of course, we offer patients the choice of service in either official language, French or English, but we are French-dominant. The health care professionals who may be interested in coming to work in the francophone workplace want to do just that.

    In bilingual workplaces where English is dominant, there are many francophone health care professionals. Before we could train them to some extent in Ontario, they came mainly from Quebec, but there were also some Acadians as well. They had started practicing in other so-called bilingual workplaces where English was dominant, and shortly thereafter, they came back to our institution, because they really wanted to work in French.

    Let me give you the example of Franco-Ontarians. Ultimately, if Franco-Ontarians manage to get their education and obtain a degree in a French program—and there are several of them available now—where will they head? If there are no institutions in which they can work, what are their choices? Does that mean they will give up? We have already seen that happen. We have to ask why they would do something that is more difficult, that requires a daily effort, when they could opt for assimilation, which would be much easier. They go to work in an institution and things would be much less difficult.

    So we need institutions for health care professionals who want to keep their language and their culture. We are having very little difficulty attracting them now that we have clarified things with the province. We are now considered a partner that offers a full range of services. People want to come to work at the Montfort, because it is a welcoming environment, one in which they can live, survive and even develop as members of the minority community. That is the difference.

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    Mr. Gilles Beaulieu: I would like to add that we are experiencing the same success to some extent. Ninety per cent of our medical students come back to us. We do not have any problems recruiting medical staff, but we do have a problem obtaining practice numbers from the provincial government because of the seeds that we have sown. The seeds have taken root, the doctors are there, the specialists are there and they want to work together as a team in a hospital. So access to these specialists and doctors is very good. The problem lies in the area of practice numbers.

    The Chair: Mr. Bellemare, do you have a final question?

    Mr. Eugène Bellemare: Mr. Savoie, you have expressed some concerns about the decision-makers. The work you do in the hospitals is wonderful, but, at times, what happens outside is not. Perhaps the key lies with the decision-makers, perhaps it is a matter of whether or not there is appropriate culture and attitudes towards the medical francophonie.

    Could you elaborate?

    Mr. Gérald Savoie: Yes. My comments with respect to the decision-makers reflect my great interest in the new principle that we want to establish, which should be directed towards the decision-makers. When I say this, I am taking it for granted that we already have an unwritten principle with regard to the protection of the minority. We have come a long way and it is on this basis that we will assess all of our laws, whether it be the Official Languages Act or some other act. But what I was trying to get at is that this is very important. Even though we have laws, we know that we already have an unwritten principle. I hope that we are going to move this further ahead.

    As an aside, I would like to say that when my colleagues and I appeared before the Romanow Commission, the only issues raised by the various parties in the country were not those put forward by Commissioner Romanow, but those raised by the researchers. They simply asked the following question: When you talk about accessibility to services in French, doesn't this come under the Official Languages Act? It took a lot of expertise from across Canada to finally reach the conclusion that everything was relegated to the act. It is obvious that we need a principle.

    Going back to the matter of the decision-makers, when you deal with decision-makers you are also dealing with planners. This applies to all government bodies, whether at the federal, provincial, municipal or regional level. Regardless of who these people may be, we need a principle enabling us to assess all of the decision-makers and planners, the people who put forward orientations, plans, designs, visions, etc. We need a principle by which we can assess what we have brought to the table, to ensure that it really complies with everything. It's not at the end of the study, when you're starting to make decisions, that you begin to think about the possibility of a francophone aspect. In other words, you write a little chapter that includes a few little points. The plan has to take the minority, whether it be francophone or anglophone, into account from the very outset, in the initial strategy and vision. To do this, we need a principle that is imbued with the responsibility that is visible on a daily basis, so that every action is assessed on the basis of this principle.

    The Chair: Thank you.

    Mr. Eugène Bellemare: I would like to make a comment for you, Mr. Chairman. Mr. Savoie has raised a very important aspect that we could use as a quote in our report, when he mentioned that the Romanow Commission researchers asked or suggested that this was a matter for the Official Languages Act. We could use this quote and the names of these researchers or mention the researchers and when this occurred in order to support our report.

º  (1615)  

    The Chair: Duly noted. Thank you, Mr. Bellemare.

    Mr. Godin.

    Mr. Yvon Godin (Acadie—Bathurst, NDP): Thank you, Mr. Chairman. I apologize for being late, but sometimes my commitments detain me.

    I am pleased to welcome you here to the committee. Mr. Beaulieu, I would like you to elaborate on the practice number. I think that this is important. There are two matters, the first one being that you said that you could not obtain practice numbers.

    I said that there were two matters, but in fact, there are three. I will try to be as brief as possible. There is the matter of the practice number, but, in addition, the Romanow report talked about setting aside a certain amount of money. Once again last week, the provincial premiers of Canada all said that there was not enough money being put into health.

    How can that help the francophonie in the hospitals? When the money does come, people will spend it where they think it should be spent primarily. Perhaps they will think that services and not the francophonie constitutes the first priority.

    Moreover, I believe that people think that the Dr-Georges-L.-Dumont Hospital is able to serve people in both official languages. We know that there are two hospitals in Moncton. There is the English hospital and the Dr-Georges-L.-Dumont Hospital. That is how everybody in New Brunswick identifies the Moncton hospitals.

    Does the Moncton hospital, which is the English hospital, offer a choice of language when serving the client? What is the difference in services provided between the two? I know that a lot of francophones from northeastern New Brunswick go to Moncton but are unable to go to the Dr-Georges-L.-Dumont Hospital because it does not provide the same services as those provided by the Moncton hospital. So the francophones find themselves in a hospital where the service is given in English. But when it comes to treatment, at one point, this issue will not even concern you because you want to ensure that you have proper health treatment.

    I know that my questions are somewhat imprecise, they are a little vague, but I think that they will give you an opportunity to explain these three matters.

    Mr. Gilles Beaulieu: You may be right in your assertion that the people of Moncton have identified a French hospital and an English hospital and this has not yet been acknowledged in our policies. But as far as your average citizen is concerned, this is common knowledge. So, at one point, our legislation is going to have to acknowledge what the citizens have been saying loud and clear.

    As for the Dr-Georges-L.-Dumont Hospital, it has been evolving constantly. Since the 1990s in particular, the hospital has been developing quickly. We realize that as we recruited new specialists and doctors, the clientele followed. We began with gynecology and obstetrics. Families gradually began coming to the hospital and, from generation to generation, the process was set in motion.

    We have made some significant breakthroughs in the field of oncology. Where dialysis is concerned, we have a special relationship with the people in the region. Some specialties are unique to certain regions. In St. John, for example, cardiology is the specialty. There are three institutions in New Brunswick that treat major burn victims: the Moncton Hospital, Fredericton, and St. John. In Nova Scotia, there is one institute that treats major burn victims.

    I think that we have to come up with a comprehensive plan. In New Brunswick, we now have a study underway on manpower planning.

    Earlier I alluded to these infamous numbers. This battle is just as ferocious as the battle for funding. At every monthly board meeting, we talk about the shortfall and the doctors for whom we have no number. This is a hot topic at the New Brunswick government. Increased funding in health care seems to be headed towards the reform of primary care, very expensive drugs, and, as well, new technology. During this brainstorming process, we are hoping to showcase the role that our hospital plays in the population. This also applies to the hospital for the Edmundston region, the Campbellton region and the northeastern region. I would even go so far as to say that we should, amongst us, amongst the francophone regions—we have responsibilities— be creating a network as well, so that we can refer patients from one facility to the other.

º  (1620)  

    Mr. Yvon Godin: Mr. Chairman, I remember when we had the problem in Bathurst. I often say that Moncton is spoiled: it has two hospitals, but the city is relatively big. But when you go to a place like Bathurst, that has both a francophone and an anglophone population, if you were to form an exclusively francophone network, then the anglophone minority would not be served. So you have to make adjustments in accordance with the regions. You just can't do what we did with the community colleges, where it was decided that all of the francophones would go to Bathurst and the anglophones would go to Miramichi. You can't treat people like that.

    Is this issue taken into account in your discussions with the province?

    I was watching a program on Radio-Canada about, for example, students studying medicine at university and who would meet somebody of the opposite sex, or even of the same sex, and decide to live together in the same region. But once the courses were over, the doctor was not able to obtain his licence and the couple had to leave because they could not remain in the region.

    Isn't there a problem in the region of Moncton right now as well?

    Mr. Gilles Beaulieu: I do not want to say too much about that because that is not my area of expertise, but as far as medical resources are concerned, the vice-president, Dr. Simard, could talk to you about this issue at great length. There is the Figutsu report, which we are waiting for on the provincial scene. This is the medical manpower plan. That is an important issue, but it has not yet been resolved.

    Mr. Yvon Godin: What are you suggesting for the regions where it is not possible to have two hospitals but where there is both a francophone and an anglophone community?

    Mr. Gilles Beaulieu: I believe that the language of service, regardless of where you are, has been taken care of. Our hospital is known as the francophone hospital, but I would say that 60 per cent of our nephrology clients speak English. In oncology, it is 50-50. So we provide service to our clients in the language of their choice. It is incumbent on us to implement recruiting policies that enable us to recruit individuals who are capable of serving in either language. That doesn't prevent an institution from having a language of work, though.

    Mr. Yvon Godin: Let's talk about the Montfort Hospital now.

    First of all, I would like to congratulate you on the battle you waged. Now that the battle is over, how are things working out? Is it simply a matter of saying that the institution does exist in principle but that, in actual fact, obstacles are being put in your way, or are things really progressing?

    The Chair: Mr. Godin, may I interrupt? I will go back to you.

    I wanted to ask colleagues whether or not they had questions for Mr. Beaulieu specifically, because he has to leave.

    Mr. Simard, do you have any questions for Mr. Beaulieu?

    Mr. Raymond Simard (Saint Boniface, Lib.): I would like to give my time to Mr. Castonguay.

    The Chair: Mr. Castonguay, go ahead. I will however respect the time limits for everyone.

    Mr. Jeannot Castonguay (Madawaska—Restigouche, Lib.): Thank you, Mr. Chairman.

    You raised a good issue, Mr. Beaulieu, when you talked about the language of service and the language of work. I appreciated what you had to say a great deal because I think that that is part of the solution to the problem raised by Mr. Godin in his question.

    I also worked in a hospital where we had adopted the same approach: we had our language of service and our language of work and the institution made this commitment to its employees.

    Is that currently a requirement of the Government of New Brunswick?

    Mr. Gilles Beaulieu: No.

    Mr. Jeannot Castonguay: Do you think that that should be the case?

    Mr. Gilles Beaulieu: Last year, we waged an epic battle because there was a new act establishing regional health boards, and we wanted to include the language issue in this new piece of legislation. To some extent, we won. The act recognizes that the citizen is entitled to have service in the official language of his or her choice and it also recognizes that institutions may, should they so choose, declare themselves as being francophone, bilingual or anglophone. Barely three weeks after this legislation was adopted, we were the first to proclaim officially that our language of work was French. So our patch of earth was very well... Then, the northeastern region declared that French was the language of work in the Acadian Peninsula. In Bathurst, both languages are spoken.

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    Mr. Jeannot Castonguay: Should we be putting more effort into the whole matter of language of service? Is it not part of the solution? I can understand talking about a sixth principle; there are pros and cons to this. Clearly, if we have a sixth principle but there are exceptions, loopholes that a provincial government can use to say that the numbers do not warrant... Would it not be preferable to work on the issue of language of service? Regardless of whether the language of work is French or English, the minorities would be respected when they consulted the medical staff.

    Mr. Gilles Beaulieu: I would go back to what my colleague said, a matter I have already dealt with in the file, namely, the role of institutions. We have to emphasize language of service and accessibility to services in French or English for citizens. In the case where an institution's language of work is not French, this institution may constitute a centre for assimilation. In the long run, we may very well forget our Latin. It is important to have an institution where the language of work is French. We must make a distinction between the language of work and the fact that we provide services in the patient's language. If French is not a language of work, we will have difficulties providing services in French, in the long run.

    Mr. Jeannot Castonguay: I agree with you, but if I have understood correctly, the choice of language of work is made by the institution and is not something which is imposed by the government.

    Mr. Gilles Beaulieu: Absolutely.

    Mr. Jeannot Castonguay: Do you think that the sixth principle would ensure that clients would have access to services in their language of choice, or do you think, that, once again, there would be a difference between what is written down and what is reality? Do you really think that this would change anything in your area?

    Mr. Gilles Beaulieu: I think so. That's what happened in the area of education. It also happened within the legal system. We won our rights one step at a time. In the area of health care, if there is a clear legal framework, I think it will be possible to create programs and make progress. Of course, a simple principle cannot change the world, but communities will have a tool to solidify their differences.

    Mr. Jeannot Castonguay: I also think that the attitude of employees is extremely important if you are to provide services in the language of the patient. In light of my experience in my region, I can say with certainty that it is important to change the attitude of employees and physicians.

    Was that a challenge or did it all work out fairly easily?

    Mr. Gilles Beaulieu: In terms of the culture of the institution, I think people are proud that they can meet the needs of patients. We are very proud of the fact that we can meet the needs of patients in the official language of their choice. We are not petty about this. Our patients have this right and it is reflected in an attitude of compassion and communication.

    Sometimes when people are told that the idea of “duality” is a principle, they are afraid. This does not necessarily mean that there will be two hospitals. Linguistic duality is the foundation of our country. It's the recognition that we have two founding peoples. I do not want to indulge in semantics, but I think it's a matter of being open to the other culture.

    Mr. Jeannot Castonguay: Even though their names have changed, there used to be eight health care regions in New Brunswick. I appreciate the approach you have taken. Can you tell us whether, in the other regions, the same approach has been taken to provide services in both languages irrespective of the language of work? You mentioned the New Brunswick Heart Centre in St. John. I've heard that people are making an effort to serve the patients in both languages.

    Have other institutions adopted a similar approach?

    Mr. Gilles Beaulieu: I don't want to judge the other health boards, but I would just say that no one looks after your interests as well as yourself. The day you get your own institutions, you make sure that they will provide quality services in your language.

    Mr. Jeannot Castonguay: Thank you.

    Mr. Raymond Simard: I have a final question for Mr. Beaulieu.

    Thank you very much, Mr. Beaulieu, for your patience. I am intrigued by your health authority. I would like to know, for instance, whether the 2,000 employees and the 150 physicians are all bilingual.

    Mr. Gilles Beaulieu: Yes, it is one of New Brunswick's crown jewels.

    Mr. Raymond Simard: Let's speak to the importance of taking advantage of the presence of a champion or a leader, be it at the hospital level or the health authority level. In our area, Saint-Boniface Hospital employs between 4,000 and 5,000 people. Very few services were provided in French. But that all changed when we got a new chief executive officer. You said that you fought a long time to get to where you are today. I'd like to know how important it is to have good people at the top to fight these battles.

º  (1630)  

    Mr. Gilles Beaulieu: It is strategically important. The institutions are not alone in waging these battles. They fight with their communities on side. There are also champions within the community, who can simply be ordinary Joes. Historically, in our area, these battles have been fought by the religious communities. Later on, lay people took up the fight and other leaders came on board. They hired chief executives of substance. I think that was the strategy.

    Mr. Raymond Simard: Thank you very much.

    The Chair: Mr. Beaulieu, I, too, would like to thank you for having come here, and in particular for raising several issues in your presentation, especially the one regarding the mandate of the national council. I don't think anyone thought of it and I think we will take the time to review the mandate. If there are any recommendations to be made, we will certainly make them.

    You may leave now, but I will ask the question of Mr. Savoie. If you can think of anything else you would like to send, please feel free to do so. One of the conclusions of the report by the Consultative Committee for French-Speaking Minority Communities was that 50 per cent of communities do not receive services. But that is not the case for New Brunswick and eastern Ontario; we are served by the institutions represented here. If you have any advice on how to build capacity in places where there are no services... I would have been interested to hear something on this subject, because we want to make recommendations.

    I would also like to thank you for your clear thinking with regard to the principle. It was clear. We know what you want.

    Mr. Gilles Beaulieu: I will venture a very brief answer. Throughout the country, we have turned community centres and schools into cultural centres within minority communities. Why not turn health care institutions into cultural centres as well, whether they be in Saskatoon or elsewhere?

    I think it would be a good place to start for francophone communities in those regions. It's just one of many ideas, but I think that, in the area of education, schools were not the only institutions which were built, but also churches and cultural centres. Therefore, why should health care also not be included in this group of services within minority communities?

    The Chair: Thank you so very much and have a safe trip back home.

    Mr. Godin, you have the floor if you wish to continue.

    Mr. Yvon Godin: Do you remember the question I asked, Mr. Savoie?

    Mr. Gérald Savoie: Yes. First of all, things are much better at the Montfort now that the Government of Ontario has accepted the entire judgment of the Court of Appeal. A mutual respect has developed. We met with the minister and all the officials so that we could turn the page. We have negotiated a new budget base that gives full recognition to the role played by Montfort, including its academic role. We were getting absolutely no provincial funding for our academic role. We are in the process of dealing with the future, that is determining whether we are a full-fledged partner in the system. If we had been on board in 1997, where would we be by 2010? That is what we are working on at the moment. So things are going much better.

    I think the questions raised by the chair and other members have to do with some very important issues.

    How can the francophone community go about finding appropriate solutions geared to the needs of the different communities and regions, which vary considerably? How can we build that capacity?

    First of all, the report tabled by Mr. Rock's advisory committee, through the report that came out with the FCFA, set out the five or six main solutions. They included the establishment of networks, for example. This involves giving communities enough vitality that they can state, explain and recommend what they need. The idea is to start developing solutions geared to particular needs. What will be done in one part of New Brunswick, compared to another?

    As you know, I am of Acadian background, so I am very familiar with the situation. You have developed some extraordinary models, that should be copied in other parts of the country.

    I am going to come back to the issue of capacity. First of all—and I'm not saying that networks will become regional or other authorities—I'm talking about mechanisms. We need to establish mechanisms, because the dollars are already there. We are already spending on health care services for the francophone community. We spend much more than we should be because when these communities are unable to explain what they need in their mother tongue, whole series of tests are repeated. There's a lack of understanding, and the health care plan is not necessarily followed. What is the cost of all that to the system?

    I think we could demonstrate through studies that it would not be more expensive, that it might even be less expensive. And the least expensive solution may perhaps offset the cost of setting up the structures or infrastructure to serve the community. If we take the right approach, there may be a considerable amount of money available. If you establish structures in places where funding is available for the anglophone or francophone minority community, and if the community can purchase these services, if I may put it that way—there may be other approaches as well which would ensure that they control the health care funding—I can guarantee you that there will be more services in French. This is true of both French-dominant institutions in francophone minority communities or bilingual English-dominant institutions. This is a model used in some parts of New Brunswick that are English-dominant, and where it may not be possible to establish a whole parallel set of institutions.

    I would like to come to another principle. If we have new funding available, will the service be developed as a priority? I am speaking for the francophone community of Ontario, for example. Will the service in French be developed before a bilingual program? We are drowned out in bilingual programs, and we are in the process of losing our community in this way. We say that French comes first and that bilingualism is a bonus. Other approaches may be possible in communities that do not have the capacity required.

    If I may, I would now like to go out on a bit of a limb. I spoke about establishing health care networks to study all these issues. We must establish mechanisms that come complete with funding and to which, with the assistance and support of the provinces, the funding can be directed so as to offer better accessibility to francophones. These are things we can try to achieve.

    We hear about the labour shortage and all the rest of it. Think about the possibilities offered by the new communications technology, the information highway, information technology, and so on. Roads are a thing of the past. We have francophone global villages. There are many villages throughout the country, in all the provinces. With the new technology, we can bring them together.

º  (1635)  

    As far as the information highway goes, that is, telehealth, which my colleague mentioned, there is a telehealth centre that works with the dialysis service in Moncton and serves all the communities in northeastern New Brunswick. We do not even have that capacity in Ontario, even though we have as many francophones as New Brunswick.

    These new technologies enable us to expand services to communities where they would not be available otherwise. We have talked about remote training. We now have video conference centres, the first of which is located in the Montfort. My colleague has already had this type of facility for 10 years. The objective is to bring the clinic, residents and students to the francophone minority communities in the country, where there are so few professionals who say they can teach. We have some clinicians who are not professors, who took some pedagogical training and are now teaching. We now have the ability to find clinicians in remote areas who can complete their pedagogical training and subsequently teach students who will stay with them afterwards.

    Our students have understood that they had to make a significant effort, and this effort paid off. In other words, we can expand. That is the point I want to emphasize. We have mechanisms that will allow us to expand today. I'm thinking of the information highway, telehealth, information technologies and remote training. We can offer direct services and train and keep young people from the minority community in their own area, because as soon as we uproot them and place them too high in our huge system, they remain in the large part of the system, and the rest of the system loses out.

    When we apply for grants from the federal government or the provincial government, we are shown no extra consideration. I am an insignificant part of the furniture and I'm asking for something that could benefit 600,000 people. The big players are already well ensconced, they already have a wonderful telehealth system for whatever—I will not go into it—and they come in and say who they are and what their next project is. We, however, are at the bottom of the totem pole, and we have absolutely nothing. The trifling amount that will be used to establish a computerized system for all of Ontario, for example, might have cost us $4 million or $5 million for the entire health care network. I'm talking about community health centres, hospitals—everything. We were told that we were not in the know, that we had no experience. But where will we get that experience?

    We have all the resources, we have the thinking, we have the professionals, but we have to find tangible support in this regard to establish additional criteria that are strong enough to cover cases where more money is available. I'm thinking of the Dion plan, the information highway, or the federal Innovation Fund, which provides millions of dollars.

    For example, at the moment, we are trying to establish a health care research institute for francophone minority communities, and we are being asked where our infrastructure is and where all our researchers are. They are also asking us to demonstrate that we have carried out 50 or 100 different research projects. I can tell you that we are starting very far back. However, we do have these researchers right across Canada. We have ways of bringing them together. We can do research by means of an information technology system, and so on. These are all concrete examples of what can be done.

º  (1640)  

    The Chair: Are there any more questions? Mr. Simard, it is your turn. We will nevertheless let you conclude, Mr. Savoie.

    Mr. Simard.

    Mr. Raymond Simard: Thank you.

    I have a few questions for Mr. Savoie. You said earlier that the money was already there. I would imagine that one of Health Canada's concerns pertain to the additional costs that may arise if services were provided in both official languages. You already do this, and I am sure that there are already systems in effect to measure hospital costs. I would like to know if you have already compared Montfort hospital with those hospitals that provide services in only one language. It would be interesting to find out what the statistic is, whether it be on a per bed or per room basis.

    Mr. Gérald Savoie: I can tell you that Montfort hospital is the most efficient hospital in Ontario. We are being compared with the other 138 hospitals. We provide services in both languages, namely, in the language chosen by the client. We have by far a much bigger challenge, necessitating more money to find the required personnel and to develop all the tools required for providing service in the client's language of choice.

    However, we were able to demonstrate that we are capable of providing all of that at a very affordable price. I'm not saying that we have all the money we need on the table, but a large portion of the money is there. Will we need more? Weshall see.

    I would like to go back to the question you raised earlier, Dr. Castonguay, about whether or not this principle was really necessary. The provinces may be able to find an escape hatch or some type of exception. But I can guarantee you that such a principle will make things a lot more demanding. Without this principle, we have absolutely nothing, we have zero. So in our opinion, this principle, in practical terms, is extremely important when we deal with our regional boards, our networks. As soon as we start thinking about these things, as soon as we start wanting to earmark money for this, we will have to take this principle into account. That is what's going to make the difference.

    As for solutions, we now have plans to resolve the problems, something we did not have beforehand. The investments you made in Health Canada, Heritage Canada and other departments have helped to develop the initial networks, to set up the advisory board and to bring together the players from the minority francophone—I'm talking about these experiences—so that we could prepare an action plan that makes sense. These are very tangible examples. This money went a long way, and I think that you would agree with me on that.

    Mr. Raymond Simard: I would like to spend a bit of time talking about the Dion plan, which includes quite a significant envelope for health. I would like to know whether or not you view this plan favourably, whether you see it as a solution, as a good start, or whether or not you think it is really not the solution.

    Are we heading in the right direction with this Dion plan?

º  (1645)  

    Mr. Gérald Savoie: I will give you my personal opinion as a professional, and I have been working in the field for 27 years. In my opinion, it is definitely moving in the right direction. It is breathing wind into our sails and providing us with a tremendous helping hand. We now see that this can be a reality. This project to set up the Société Santé en français was created on the basis of the plan that was tabled. This has never happened before.

    Now we have the capacity to decide amongst us how we're going to earmark money for very significant projects, which are going to enable us to move ahead and develop. Networking was one of the critical aspects in implementing the plan. As far as decision-making on funding is concerned, we have already put money on the table to develop other networks in Ontario and elsewhere in Canada. We are already seeing the results and I can tell you that the people in the field who are watching this occur are saying that, finally, something is happening.

    As far as training is concerned, you have established the CNFS, the Consortium national de formation en santé.

    The Chair: Representatives from this group will be appearing before us next Tuesday, moreover.

    Mr. Gérald Savoie: Another excellent example is the fact that we are now serving as a driving force for the other training institutions. Saint-Boniface has benefited from this and Montfort did at another time, when it was called the Centre national de formation en santé. I can tell you that if this had not been in place, we would not be in the process of developing our ability to be self-sufficient in health care.

    We need health professionals. I would like to make a brief comment on another matter. If young people from the minority groups, whether they be anglophone or francophone—I will use the example of Ontario's francophonie—, don't have examples, mentors, people from the field who have chosen certain professions, if they do not have any opportunity to develop, namely to register in certain programs, obtain their diploma and work in their language, what can they do? What kind of models do they have if the example is quite simply to assimilate? We can see that there weren't really any examples. This was the situation in Ontario before we established the Montfort hospital teaching program.

    So we have encouraged these young people to see that there are opportunities at the end of the road, that they can work in their mother tongue. That has made all the difference. We do not have a problem of shortages in a very broad sense because these young people are arriving on the scene. We have equipped them. We see many of them applying. Ten years ago, there were not enough applications and we were wondering whether or not we would have to lower the criteria in order to accept francophones. We are no longing talking about that.

    The Chair: Mr. Castonguay, the floor is yours.

    Mr. Jeannot Castonguay: Thank you, Mr. Chairman.

    That is very interesting and your position with respect to the sixth principle is very clear. At any rate, there are many positive things in the Dion plan, from what I can see. Do you think that this would be an avenue to exploit and that we should continue along this line? Some people will say that adding a sixth principle to the Canadian act is dangerous. How will the provinces react? Are we not running the risk of being told once again by the provincial jurisdictions that the federal government is intervening in matters that are not under their purview? Is this not a danger? Would it not be preferable to continue as we are now, while we have individuals who want to move things further ahead instead of a group of individuals who want to buck the system?

    Mr. Gérald Savoie: After a certain period of time, we would encounter the same wall, the same closed door. What I mean by that is that even with the Dion plan, the Société Santé en français, and so on, sooner or later, we will have to have close cooperation with the provinces. We need to take steps to increase this cooperation.

    I think we must definitely promote the sixth principle and get back to our fundamental values. It is a question of respect and rights, among other things. This principle would simply confirm and make visible something that should already exist. I am familiar with all the tensions around this issue. I have experienced them in every possible way. It comes down to a matter of respect and fundamental values and principles. This is what made our country what it is today.

    Cooperation with the provinces is absolutely essential in the area of health care. Unless the respective jurisdictions are amended, I do not think the situation will change very quickly. We must have this support. I think the provinces will understand, otherwise, there will be other cases like Montfort. The name will be different, but the unwritten principle does exist. Rights exist. They do not disappear just because someone says they do not exist. The provinces are there, and we have to find ways of integrating them into the whole process.

    The recommendation made by my colleague from the National Health Council is absolutely necessary and, to reply to Mr. Sauvageau's point, this may be the best example possible. We are in the process of establishing this council and we do not know how to include the minorities in this country.

º  (1650)  

    Mr. Raymond Simard: I  thought about that.

    M. Gérald Savoie: So have I.

    The Chair: This may be included. We will check into that.

    You have the floor, Mr. Sauvageau.

    Mr. Benoît Sauvageau: You are ardently defending the idea of adding a sixth principle. I would like to hear your views on another matter. Is it more important to show political will or to adopt a sixth principle in order to enforce the recommendations made by Mr. Rock's committee, the Romanow commission and the Kirby Committee?

    Mr. Gérald Savoie: We need both. The sixth principle...

    Mr. Benoît Sauvageau: I want to make sure I understand you correctly. Do you mean that we cannot implement the recommendations made in Mr. Rock's report or those made in Mr. Romanow's report if we do not have the sixth principle? Is there a cause-effect relationship there?

    Mr. Gérald Savoie: I think that without the sixth principle, progress and the speed of progress will be very restricted. I think it is absolutely essential that we get this sixth principle. The political will may follow once the principle is in place, but we definitely need some political will.

    Mr. Benoît Sauvageau: And what if the opposite results were produced? What would happen if, after adopting the sixth principle, some provinces went to the courts to say that this was unconstitutional? Could a sixth principle, which was designed to help us, actually be harmful? I am afraid that we are off-loading our problems and solutions. We have spent $182 million and held 18 years of consultations. There are 500,000 pages of text and recommendations, but we cannot do anything because this sixth principle is not in place? Do you understand what I am getting at?

    I think that sometimes in the area of official languages, we tend to apologize or to accept excuses, and say that we are missing some little detail or other that would allow us to move forward. When Romanow and Kirby made their recommendations, they were not talking about a sixth principle. Why should we say it is essential now and run the risk of providing an excuse for doing nothing for another 30 years?

    Mr. Gérald Savoie: The leaders of the francophone minority communities—and this goes for the anglophone minority as well—will see that this is done. We will never give up; the question of health care is too crucial. Things will continue to progress. Having the sixth principle will make our job easier and will hasten the process.

    We talk about accessibility. If you look at the trends, you will see that in four or five years, around 2008 or 2010, there will be a phenomenal increase in the number of older people. It will be a shock to the system. We are not ready to deal with that, hence there will be a crisis.

    I would just like to add a point on a different matter. Sometimes people make fun of me, but when they finally listen to me, they take me seriously. The number of francophones in my community is continuing to grow. All the statistics show that this percentage is increasing in the current context of assimilation. Francophone immigrant groups are coming to live in Canada. Some 1 million people who speak French and who want to continue to speak French are arriving in my province, Ontario.

    To come back to the minority francophone community in Canada, I would like to say that at some point in the aging process, for health reasons among others, people go back to using their mother tongue. That means that all those who were assimilated and who were quite content to get service in a different language, namely English, ultimately come back to us. The only possible choice at that point is to speak to them in their mother tongue. That is a scientific and technical fact.

    My community is growing phenomenally. If we factor in the aging process as well, the demand will be so great that we will have to find solutions very quickly. Community leaders, decision-makers and health care professionals could certainly benefit from your assistance. They need a great deal of support and courage to continue their struggle.

    Mr. Benoît Sauvageau: I have no other question.

    The Chair: Thank you.

    Mr. Bellemare.

º  (1655)  

    Mr. Eugène Bellemare: I have two questions.

    National Defence is coming to the Montfort. Are we just talking about another building or will it be an active partner in the services provided by the Montfort? What is going on exactly?

    Mr. Gérald Savoie: First of all, National Defence has decided to close down its military hospital on Alta Vista drive here in Ottawa. It has decided to establish a partnership with a community hospital, with the Montfort Hospital. In no way will it be involved in our management. Construction will begin on a new building soon, and two floors of it will house facilities reserved for military personnel. They will be using some of the space they have to run a family medicine clinic for military personnel.

    All the extra services required by the forces will be purchased through the Montfort Hospital and offered exclusively by it. I am thinking, for example, of surgery, all the diagnostic services, diagnostic imaging, laboratory services, beds and so forth. To this extent, members of the military will be clients of the Montfort Hospital.

    Mr. Eugène Bellemare: At that stage?

    Mr. Gérald Savoie: Yes.

    Mr. Eugène Bellemare: Is this a positive or negative thing for the Montfort Hospital and the francophone community—and I am not talking about financial considerations?

    Mr. Gérald Savoie: It is a positive thing, because initially, this issue was part of the broad dialogue about values and value-added. We structured our agreement on the basis of that.

    Theoretically, we will be integrating francophone professional health care workers from the military into the Montfort Hospital community. That is part of the agreement. There are provisions in the agreement that protect our institution from any diminution and its role. Nothing could minimize or abolish our role as an institution. Under no circumstances will we adopt such an approach.

    Mr. Eugène Bellemare: As an institution, or as a francophone institution?

    Mr. Gérald Savoie: As a francophone institution. These health care professionals, mainly doctors, nurses and physiotherapists, because those are the three largest groups in the Canadian Forces, are either francophone or perfectly bilingual. They will offer their services to military personnel in our facility. This will be a bonus for us, because these professionals will also be involved in providing health care training. We do not have enough professors or lecturers. This will be an interesting feature for them and we will help the Canadian Forces to retain more professionals, because we will be offering them a much more interesting place to work.

    At the moment, the forces are experiencing some difficulties. Let me give you a few examples. Their health care professionals often want to leave the forces, because they do not have access to a complete range of the various pathologies. Their client group is generally composed of very young people who do not have any major health problems, unless they are on missions abroad.

    Montfort offers a complete range of pathologies, which will enable these professionals to prove their skills. So their health care professionals will be able to maintain their skills. Moreover, they will now have the option of branching out, and helping us with training. So this starts to be incredibly attractive. I should also emphasize that the Research Institute on Population Health is an interesting feature of our facility. This is a much richer, more interesting community. The objective of the plan is to keep doctors and nurses in the Canadian armed forces and to promote improved recruitment, as a result of this community that will enable them to maintain their skills and give them much more fulfilling jobs. That is clear to us. We have structured the whole arrangement to ensure that the health care professionals who come to the Montfort from the Canadian Forces are francophones.

»  (1700)  

    Mr. Eugène Bellemare: Earlier, you reminded us of something we already knew—namely, that medicine and hospitals come under provincial jurisdiction. However, I think the federal government can be involved in many areas. Could this be useful to the Montfort Hospital? You can answer that in a moment.

    While health care may not come under federal jurisdiction, the Government of Canada is responsible for the information highway, offers scholarships, has innovation programs and research chairs in Canada. In addition, postsecondary education is of great interest to the federal government. It can provide a great deal of money.

    I imagine that someone at your hospital will be responsible for getting this funding. You could get equipment for dialysis care, for example. Perhaps you already have such equipment. There are now two groups working together, so it is even more likely that you will get the dialysis services you require if the province is unwilling to provide them. Do you have the legal right to speak to the representatives from National Defence and tell them that you need such services? You will be using them because you need them, and having such equipment on-site will help your institution to develop.

    Mr. Gérald Savoie: Not directly, no. What we do with National Defence is to describe the needs together. They identify their own needs. For our part, we determine what services we can offer with respect to a service delivery plan. That is as far as it goes. We could not necessarily develop services for non-military Franco-Ontarians, and so on.

    However, we do provide another solution for them, for the families of military personnel, who are not members of the armed forces, who are covered by the Canada Health Act and who are scattered everywhere. Now, we have a single site where all family members, including members of the military, can get health care services.

    The other part of your question was about how the federal government can be helpful in this regard. The answer is exactly what you mentioned, through grants, and other new funding that we will invest to promote development. As I have demonstrated in my earlier answers, we can establish something that goes much beyond what would normally be available in a majority anglophone community. So there is no doubt that we must continue our efforts in this regard.

    As regards the provincial government, I'm thinking of the Innovation Fund. As we know, 50 per cent of the money that we would normally get for these infrastructures come from the Innovation Fund. The fact is there is an equivalent provincial fund. I think the possibility of having the two levels of government work together to create something is extremely appealing.

    I hope that my colleagues, other leaders and myself will be able to provide concrete proof to show provincial organizations and governments that we are worthwhile, and that we are a solution, not a problem.

    The CNFS, which began with a special fund from Heritage Canada—and this was part of the assistance we received in a battle to keep Montfort—became a reality as a national consortium involving all the stakeholders in the country. Our training centre is a success, and no one at the provincial level see it as a problem today. The fact that we are delivering services incredibly efficiently at a much lower cost is no longer seen as a problem. It is a solution.

    The Chair: I will stop you there, Mr. Savoie, because we must move now to Mr. Godin.

    Mr. Yvon Godin: If I understood you correctly, you were saying that we need both. You give examples to support your point. If Nova Brunswick Bill 88 had not been enshrined in the Constitution, would we have won the case on municipal by-laws? It is all very well to be polite, but if we had been polite, the Montfort Hospital would be closed down. So we also need legislation to make people move. They become frustrated, but later on, that goes away.

    I live in an apartment in Hull. When I listened to the radio in the morning, some people wondered what was happening and why francophones wanted to have a hospital. Many people did not understand why the supporters of Montfort were crying to have their own hospital every day, but finally you took the matter to court. Because this tool was available, you won your case and people are living with this decision. So sometimes it takes tools to force people to live with a situation. Subsequently, they learn to live with it.

    Do I understand you to say that we need the whole tool box?

»  (1705)  

    Mr. Gérald Savoie: Definitely. That is exactly that.

    Mr. Yvon Godin: We need the tool and we need the box as well. Thank you.

    The Chair: Mr. Castonguay.

    Mr. Jeannot Castonguay: Earlier, your colleague, Mr. Beaulieu was talking about the community centres in New Brunswick, particularly for the anglophone community. They involve schools, churches and cultural centres. My understanding was that they could probably include medical clinics as well.

    Do you see that as a model that could be used Canada-wide within your networking system. Could it...?

    Mr. Gérald Savoie: Absolutely. This model was put forward by our Acadian colleagues. These examples were mentioned in appendices to the detailed reports of the advisory committee. These are minority communities where the population may not be large enough to have a francophone institution, but they can have a combined institution, one that is both cultural and educational, for example. Anything can be added to a health care centre. It is a meeting place and a rallying point, and a symbol of success, if you will, that shows that it is worthwhile to continue to live in French in our community, where we can get the services we need.

    Mr. Jeannot Castonguay: It goes without saying that this could be a positive momentum for the provinces, by showing them that this makes sense, that it is a good investment, not an expense.

    Mr. Gérald Savoie: We have a made-to-measure plan that takes into account each part of our communities in each province. Some perfect models have been established here and there. We can determine how the plan could be applied in the community and implement it gradually, where numbers warrant, even though I do not particularly like to use this expression. Of course, there are various models available. That is not what I was referring to when I spoke about a large enough population; there are other parameters to determine this.

    Even in communities where the francophone minority is small, we can provide remote training or establish a centre. If that is not possible, there can at least be a group representing francophones that can make recommendations about how the moneys should be allocated. I can guarantee you that if we maintain the funding and state the services we want, even in a majority anglophone community, with very few... Do not worry. There will be a significant shift as regards the delivery and accessibility of health care services.

    Mr. Jeannot Castonguay: Thank you.

    The Chair: I would like to ask a question, but I am going to refrain from doing that, because it might be rather long. I would just like to draw a conclusion.

    Do you agree, Mr. Savoie, that since about 1997, since the beginning of the Montfort crisis, there has been a sort of wake-up call? Yesterday, we heard from a representative from the Research Institutes on Population Health and we noticed that there is a sort of awareness that is reflected in various ways. For example, Health Canada finally established an advisory committee, there is now a corporation and a training centre, which is now the Consortium national de formation en santé.

    However, do you not think that without legal pressure, not as much progress would have been made?

    Mr. Gérald Savoie: That is absolutely correct. As your colleague was saying a few minutes ago, these court decisions make the difference. We need only think of the major developments in the area of education. Unfortunately, the minority community had to go to the courts.

    The Chair: There are now rights under the Constitution.

    Mr. Gérald Savoie: That is correct and that is something new.

    The Chair: If my colleagues do not mind, I have a question for the representative of the Office of the Commissioner of Official Languages, Mr. Finn.

    Having a representative of the office attend the meetings of this committee is part of our way of doing things. You may make comments if you wish.

    Mr. Finn, I would like to know whether the office has considered the issue of the mandate for the national health council.

    Mr. Gérard Finn (Advisor to the Commissionner, Office of the Commissioner of Official Languages): After the federal-provincial conference in February, we analyzed all of the documents, at least those that were known to us, and the commissioner publicly criticized the fact that no reference was made to health services for minorities.

»  (1710)  

    The Chair: Has there been any formal communication with the government?

    Mr. Gérard Finn: We did approach health officials for more information, but apart from that which was already publicly available, there was not much of any use.

    The Chair: Thank you.

    Mr. Finn, would you like to make any other comments about what you have heard today?

    Mr. Gérard Finn: No.

    The Chair: Thank you very much.

    Thank you for coming. Our meeting is drawing to a close, but Mr. Sauvageau wishes to discuss an issue in camera.

    I would like to tell you that next Tuesday—this has been confirmed—we will have a witness from the Consortium national de formation en santé and the following day, October 8, we will have the Commissioner of Official Languages, who will have released her report on October 6, if I remember correctly.

    Over the break, our researcher is going to do up a first draft of our report, but it will not be complete because on the Tuesday following our return, i.e. October 20, we are scheduled to hear from, as was mentioned briefly yesterday, Mr. Edmond Labossière, who is part of the ministerial conference on francophone affairs. It is also possible that we may hear from groups like the Montfort and Beauséjour, but from the anglophone Quebec side.

    After that, we will not have much time left to adopt a report. Let us hope we can manage it and that it can be tabled by the end of October, as was requested of us.

    Thank you very much.

    I am going to ask those who should not be here for the in camera meeting to leave the room and the rest to stay. It will not take very long.

    [Proceedings continue in camera]