LANG Committee Meeting

37th PARLIAMENT, 2nd SESSION

Standing Committee on Official Languages

EVIDENCE

CONTENTS

Tuesday, October 7, 2003

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0910

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

Mr. François Houle (Assistant Vice Rector-Academic, University of Ottawa, Consortium national de formation en santé)

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0915

¿

0920

The Chair

Mr. Benoît Sauvageau (Repentigny, BQ)

Mr. François Houle

Mr. Benoît Sauvageau

The Chair

Mr. Pierre Gaudet (Director General, Consortium national de formation en santé)

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0925

Mr. Benoît Sauvageau

Mr. Pierre Gaudet

Mr. Benoît Sauvageau

Mr. Pierre Gaudet

Mr. Benoît Sauvageau

Mr. François Houle

Mr. Benoît Sauvageau

Mr. Pierre Gaudet

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0930

Mr. Benoît Sauvageau

The Chair

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

Mr. François Houle

Mr. Eugène Bellemare

Mr. François Houle

Mr. Eugène Bellemare

Mr. François Houle

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0935

Mr. Eugène Bellemare

Mr. François Houle

Mr. Eugène Bellemare

Mr. François Houle

Mr. Eugène Bellemare

Mr. François Houle

Mr. Pierre Gaudet

Mr. Eugène Bellemare

Mr. François Houle

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0940

Mr. Eugène Bellemare

Mr. François Houle

The Chair

Mr. Yvon Godin (Acadie—Bathurst)

Mr. François Houle

Mr. Yvon Godin

Mr. François Houle

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0945

Mr. Yvon Godin

Mr. François Houle

Mr. Yvon Godin

Mr. François Houle

Mr. Yvon Godin

Mr. François Houle

Mr. Yvon Godin

Mr. François Houle

Mr. Yvon Godin

Mr. François Houle

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0950

Mr. Yvon Godin

Mr. François Houle

The Chair

Mr. Pierre Gaudet

Ms. Carole-Marie Allard (Laval East, Lib.)

Mr. Pierre Gaudet

Ms. Carole-Marie Allard

Mr. François Houle

Ms. Carole-Marie Allard

Mr. François Houle

Ms. Carole-Marie Allard

Mr. François Houle

Ms. Carole-Marie Allard

Mr. Pierre Gaudet

The Chair

Mr. Raymond Simard (Saint Boniface, Lib.)

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0955

Mr. François Houle

Mr. Raymond Simard

Mr. François Houle

Mr. Pierre Gaudet

Mr. Raymond Simard

Mr. François Houle

Mr. Raymond Simard

Mr. François Houle

Mr. Raymond Simard

Mr. François Houle

Mr. Pierre Gaudet

À

1000

Mr. Raymond Simard

Mr. François Houle

Mr. Raymond Simard

Mr. François Houle

Mr. Raymond Simard

The Chair

Ms. Yolande Thibeault (Saint-Lambert, Lib.)

Mr. François Houle

Ms. Yolande Thibeault

Mr. François Houle

Ms. Yolande Thibeault

Mr. François Houle

Ms. Yolande Thibeault

Mr. François Houle

Ms. Yolande Thibeault

The Chair

À

1005

Mr. Pierre Gaudet

The Chair

Mr. Pierre Gaudet

The Chair

Mr. Pierre Gaudet

The Chair

Mr. Pierre Gaudet

The Chair

Mr. François Houle

Mr. Pierre Gaudet

The Chair

Mr. Pierre Gaudet

The Chair

Mr. Pierre Gaudet

The Chair

Mr. Pierre Gaudet

The Chair

Mr. François Houle

The Chair

Mr. François Houle

The Chair

Mr. François Houle

The Chair

Mr. François Houle

À

1010

The Chair

Mr. François Houle

The Chair

Mr. François Houle

The Chair

Mr. François Houle

The Chair

Mr. François Houle

The Chair

Mr. Pierre Gaudet

The Chair

Mr. François Houle

The Chair

Mr. François Houle

The Chair

À

1015

Mr. François Houle

The Chair

Mr. Pierre Gaudet

The Chair

Mr. Pierre Gaudet

The Chair

Mr. Pierre Gaudet

The Chair

Mr. François Houle

The Chair

Mr. François Houle

The Chair

Mr. François Houle

À

1020

The Chair

Mr. Benoît Sauvageau

Mr. François Houle

Mr. Benoît Sauvageau

The Chair

Mr. Benoît Sauvageau

The Chair

Mr. Benoît Sauvageau

Mr. François Houle

Mr. Benoît Sauvageau

Mr. François Houle

The Chair

Mr. Eugène Bellemare

Mr. François Houle

Mr. Eugène Bellemare

Mr. François Houle

Mr. Eugène Bellemare

À

1025

Mr. François Houle

Mr. Eugène Bellemare

Mr. François Houle

Mr. Eugène Bellemare

Mr. François Houle

The Chair

Mr. François Houle

The Chair

Mr. Raymond Simard

The Chair

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CANADA

Standing Committee on Official Languages

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NUMBER 036

l

2nd SESSION

l

37th PARLIAMENT

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EVIDENCE

Tuesday, October 7, 2003

[Recorded by Electronic Apparatus]

¿  (0910)  

[Translation]

    The Chair (Mr. Mauril Bélanger (Ottawa—Vanier, Lib.)): Good morning, ladies and gentlemen. Since we have quorum, we shall begin this morning's deliberations.

    Mr. Houle and Mr. Gaudet, we are concluding a series of hearings on a bill calling for the addition of a sixth principle to the Canada Health Act, namely the respect of linguistic duality.

    The subject of this bill was referred to us by the House, and the committee decided to double its workload by not only examining the legal aspect of such an approach, but also by studying the possible creation of a federal program to help provinces improve the health care services provided to their linguistic minority.

    We have therefore met with representatives from communities, from various departments and from various agencies, and we will conclude our overview with you today and with another meeting on October 20, before preparing our report, which must be tabled in the House before the end of October.

    That provides the setting for our hearing with you this morning. We want to see where we're at with regard to the provision of health care services in minority language communities. The consortium you are representing this morning is an essential tool for these communities. Gentlemen, you have the floor. We will then move on to questions and answers, as usual.

    Mr. Houle and Mr. Gaudet, you may begin.

    Mr. François Houle (Assistant Vice Rector-Academic, University of Ottawa, Consortium national de formation en santé): Thank you very much, Mr. Chairman.

    Mr. Chairman, members of the committee, I am pleased to be here today to tell you about the role of the Consortium national de formation en santé. I would, however, like to begin by apologizing for Mr. Yvon Fontaine's absence. He would have liked to be here today, but was unfortunately held back and could not appear before the committee. I am François Houle and I am the Assistant Vice-Rector, Academic, at the University of Ottawa.

    As you know, the Consortium national de formation en santé was created to make health care services more accessible to Canadians in their own language. That is our basic mission. The consortium was created to ensure that French health care services are available.

    We are mostly concerned with training; I want this to be very clear. That is our first priority. If you want to provide health care in French, you have to make sure that you have French-speaking health care professionals. As you know, our official language communities are often in a minority situation and do not have access to services in their own language, nor do they have access to francophone or bilingual health care professionals.

    Therefore, our first objective is to increase the number of professionals, to train more professionals. In that regard, we have a very ambitious objective, which is to enrol, over the next five years, about 2 500 students in health studies and to have about 1 200 graduates. To give you an idea of the scope of this project, under phase 1 of the CNFS, which is mostly located at the University of Ottawa, but also at the Montfort Hospital, 200 health care professionals were trained. So, our objective is truly ambitious.

    But we think it is feasible, especially because the consortium works out of several institutions. It includes 10 institutions from the east to the west, five universities, four colleges, and also New Brunswick's medical program, which is offered in cooperation with the University of Sherbrooke. Therefore, it is a national consortium which feels it can increase the number of health care professionals being trained in French because it is located in many communities and provinces.

    The first challenge we face is to recruit students, that is, we have to go into the communities and, as soon as they hit high school, get young francophones interested in pursuing their studies in the area of health care. This might not always be an obvious choice for them. Often young people don't think of entering this field because there's nothing available in their region. So, to recruit young francophones, you really have to tell them about career possibilities in the area of health care.

    Providing training in the field of health care is a real challenge. It's no secret that it is a challenge for the consortium to develop training in the area of health care, because this training directly affects the lives of people. When you train a physician, a nurse, or an occupational therapist, these people have to be competent. The training is often very demanding, very complex and often quite specialized. One thing we want to avoid at all costs is that the training be too centralized.

    Therefore, our challenge in that regard is not only to offer demanding, complex and specialized training, but to provide it across the country so that students can study in their areas, rather than in a major urban centre. This is because often the students won't go back home again, as you know; therefore, one of our greatest training challenges is not only to create training programs, but also to build a network so that the training programs are based on partnerships.

    Let me give you two examples with regard to that issue.

    Three years ago, the Collège de Saint-Boniface, in Manitoba, implemented a nursing program. In the first three years, the program was operated by the Collège de Saint-Boniface in cooperation with the University of Ottawa. In the beginning, the university helped develop the curriculum and later on offered some distance training. The institution ultimately provided on-site training to the college's professors.

    The program, which is now almost entirely independent, provides on-site training during the first three years. This means that nurses who have been trained at the Collège de Saint-Boniface will stay in the area. Furthermore, there is a lot of emphasis on training in the community and a lot of attention is given to tutors who supervise the clinical training periods. As much clinical training as possible is provided in the community, and this is a major challenge for us. The goal is not to bring the students here, but to ensure that the member institutions of the consortium work together to provide training in other regions.

    Of course, the entire undertaking has been made possible thanks to a 63-million dollar grant over five years by the Department of Health. This is an important grant and we know that several committee members contributed to it actually happening. The grant will help us achieve many things, but we have to be aware of the fact that five years is a short time. In three years, we will already start asking ourselves how it will go on. Three years is not a long time.

    With regard to education, we have to take a long-term perspective. We have to develop training programs with the Collège de Saint-Boniface and with the Collège de l'Acadie. However, if, in three years, we cannot develop anything concrete, it will be impossible to develop top-quality training programs. That's why we have to take the long-term view.

    That's why we are already thinking about phase three. We know very well that in the field of education, if we want to pursue our activities, within the next two or three years we will have to start thinking about the next phase. That's why we hope that the work of this committee will help ensure the survival of training programs. As it stands, the implementation of these programs requires a great deal of energy; we have to make sure that the programs last a very long time.

    It is important to note that these training programs are based on direct contact with clients. We are not dealing with abstract laboratory research, for instance. These programs are not only based on essential professions in the area of health care, such as medicine, nursing or rehabilitation, but also on prevention, such as home care services, community care or health promotion.

    We will have to meet this challenge and, as I already said, it will not be possible unless we have training programs. Of course, it is a complex situation and we use a lot of long-distance technology, on-site supervision, hospitals and community clinics. Furthermore, we have to make sure that the communities have the necessary resources at their disposal.

    With regard to our present assets, we have ten institutions on board. As well, as I mentioned earlier, we provide training in 15 different areas, and our potential for growth is huge. In our view, the consortium has implemented tools which, over the next five years, will provide better access to health care services in French.

¿  (0915)  

    I mustn't neglect to mention that the consortium has been a very rewarding cooperative experience. It's not always easy, because it involves a number of provinces as well as institutions with different traditions, different levels, i.e., colleges and universities. But there is a general willingness to work together, to integrate our training to ensure that our goals are in fact reached and basically that Canadians are the main beneficiaries.

    This entails joint action on a number of levels. There is a national secretariat, the director general of which is Pierre Gaudet, and this national secretariat sees to it that certain joint action is in fact taken, whether it is in the area of recruiting students, implementing integrated training or research. It's important to remember that when it comes to health, research is inseparable from health services, so that in the clinic, in the community, whenever people are cared for, we study health determinants at the same time.

    It's important to have local research capacity in order to better understand community health determinants. So in health, research is not something abstract. There is, of course, theoretical research, but there's also concrete research that makes it possible to provide more services of higher quality. That is one of our major focuses, and the national secretariat is treating it as a priority.

    Finally, there is, of course, coordination. There is coordination among ourselves, as I said, but the health field is huge. There's also coordination with professional associations, hospitals, and clinics, and this basically means that we have a tremendous amount of liaison and coordination to do. That sums up the major challenges we have and the main tasks we have set ourselves.

    If you have any questions, I'd be very happy to answer them, with the help of the Director General, Pierre Gaudet, who is responsible for the consortium in phases 1 and 2. Thank you very much, Mr. Chairman and members of Parliament.

¿  (0920)  

    The Chair: Did you wish to comment, Mr. Gaudet? No.

    Mr. Sauvageau.

    Mr. Benoît Sauvageau (Repentigny, BQ): Mr. Houle, Mr. Gaudet, first of all, sorry I was late. There are mornings, or days at least, that are relatively busy. So I missed a little bit of your presentation. If you explained this at the beginning, I am sorry, and just say so.

    I'm reading a note prepared for us by our research service:

On 6 January 1999, the Minister of Canadian Heritage announced funding of 10 million dollars over five years (1998-2003) to create the Centre national de formation en santé, administered by the University of Ottawa. Its mandate was to facilitate access to and education in health sciences and medicine for students from minority French-speaking communities.

    They are referring to nurses and doctors, I guess.

In four years, the Centre national de formation en santé has encouraged 112 new francophone students to enrol in health programs at the University of Ottawa [...]

    I must be mistaken, and I hope I'm mistaken, but if I analyze this simplistically, that means that there have been 28 new enrolments on average each year for four years, and the investment to generate those 28 enrolments in phase 1 was 10 million dollars.

    Is there something else we should know about what the Centre national de formation en santé is doing, or is the final result 112 more enrolments?

    Mr. François Houle: I will give part of the answer, and Pierre can complete it, because he has more information on the subject.

    You have to understand that the implementation of phase 1 was starting from scratch and putting in place something that did not exist previously. For example, it involved major investments at the Montfort Hospital to develop its clinical capacity and to make it a teaching hospital. So, at the outset, investment was required at that level.

    When it comes to recruitment in the field of medicine, for example, in order to recruit students, the exercise is rather lengthy because they don't start in first year. The goal was to go from four to eight, and it was achieved, we succeeded in training them. Those students came from francophone communities outside Quebec and Ontario. So they are people that we brought in from the regions. There is also the whole development of distance education and distance training.

    The example I gave earlier was put in place during phase 1, i.e., the nursing program at Saint-Boniface, a complete program that was set up with the development of a curriculum and teacher training. Today, the college offers in partnership, but on site, the three-year bachelor program. Not only was there training, but also all of the infrastructure and development that went into this implementation.

    Mr. Benoît Sauvageau: That is reassuring. I was not really worried, but...

    The Chair: Excuse me, Mr. Gaudet may have something to add.

    Mr. Pierre Gaudet (Director General, Consortium national de formation en santé): Mr. Houle did a good job of explaining the context. Phase 1 is experimental. The Department of Canadian Heritage had decided that the goal was to train 80 students in medicine and other health disciplines.

    At the University of Ottawa, we have tried to reach this goal by recruiting students, as Mr. Houle said, outside Ontario and Quebec, clearly, in more isolated communities with no program, and as much as possible, by providing practical training in those communities.

    The 1990 goal has been largely surpassed thanks to something that was not foreseen at the outset, training in the communities. There was also the nursing program, the first three years of which are offered at Saint-Boniface. Nurses who want to have a bachelor's degree can complete the program in Ottawa and thus obtain a nursing degree.

    We have implemented many promising opportunities. The main thing is to have students, to train health professionals. However, in my opinion, the true results of phase 1 is phase 2, the grouping of 10 institutions working in solidarity and cooperatively in an attempt to seriously develop health training in all French-speaking areas outside Quebec.

    The other main result, in my opinion, is the attempt to work together with all those working in the field of health—I imagine the committee must have met, for example, with representatives of Société Santé en français—so that ultimately, health professionals can work in French.

¿  (0925)  

    Mr. Benoît Sauvageau: Thank you very much for the additional information. I appreciate the fact that there are quantifiable goals to show whether the $10 million was well spent. The goal was 80 students and the result was 112, that is marvellous.

    Could you tell us the goals of the Consortium national de formation en santé for phase 2, from 2003 to 2008?

    Also, could you tell us—I am sure you have already done this study—how much it costs to train an anglophone health professional in an anglophone environment and how much more it costs to train a francophone health professional in a minority environment, roughly?  

    Mr. Pierre Gaudet: I am not sure I can answer your last question; it varies, depending on the profession. I cannot tell you that off the cuff.

    Mr. Benoît Sauvageau: Just roughly, does it cost 10% more to train a health professional in French?

    You referred to nursing earlier. If a young woman or young man studying in Winnipeg wants to complete a bachelor's degree at the University of Ottawa, that entails additional costs.

    Mr. Pierre Gaudet: Obviously, just in terms of travel and extra effort, it costs much more to come to the University of Ottawa and to take part in an exchange than to cross the street to go to the University of Manitoba.

    I am sorry, Mr. Sauvageau, but I cannot put a figure on that.

    Mr. Benoît Sauvageau: That is fine.

    Mr. François Houle: I will give you an example of added costs.

    If you train a doctor in a majority environment, very often you will have a clinician on site, or not very far away, to supervise the clinical placement. In a minority environment, very often, you have to train the person, provide supervision and update that training at a distance. There are costs associated with such a situation, because of the distance involved.

    Mr. Benoît Sauvageau: Have you set a quantifiable goal, as in phase 1? Is the goal to train 250 new professionals?

    Mr. Pierre Gaudet: I can get you those numbers. If I may, I'll just go over them quickly.

    With regard to the students, who constitute the most important factor, of course, we would like to have 2,500 additional enrolments across our institutions, which number ten, and which want to provide health care training in French. If an institution already provides such training, it will grow the program, and if an institution does not provide such training, it will start some kind of program or proceed as did the Collège de Saint-Boniface.

    Why are these figures so much higher? Because the network of colleges joined our organization, and because training at the college level, for programs such as paramedics, for instance, is often much shorter, but just as essential. That has brought up the numbers significantly. So, our objective is to get 2,500 new student enrolments over five years, that is, by 2008, and 1,200 additional graduates.

    This represents an extra 100 or so professors or clinical tutors. It represents about ten partnerships in the field of teacher training. These are just some examples, but we want to achieve much more. It represents about 100 tele-courses which can be exported and used throughout the network. It represents about 100 new places for clinical health training, because clinical training is an integral part of and essential for overall training. This implies about fifteen continuous training activities. As you know, things change quickly in the field of health care, so ongoing training must be integrated to the greatest degree possible. Ongoing training in French, in a minority francophone situation, is extremely important, although there is not enough of it.

    Also, as Mr. Houle mentioned, we want to promote networking among francophone researchers because research is so important. We want to make progress by getting to know our communities better in order to provide them with better services. Finally, there are ongoing activities which have not been costed, namely the liaison and coordination activities which help keep the partnerships intact.

    That gives you an overall view of the various facets of the results we wish to achieve.

¿  (0930)  

    Mr. Benoît Sauvageau: To conclude, because I don't have a lot of time left...

    The Chair: You are right, Mr. Sauvageau, you're out of time. But we'll come back to you.

    Mr. Bellemare, you have the floor.

    Mr. Eugène Bellemare (Ottawa—Orléans, Lib.): Thank you, Mr. Chairman.

    Whom is the consortium accountable to?

    Mr. François Houle: The institutions are first and foremost accountable to each of their funding agencies and to the relevant authorities, but also to the Department of Health. Since we received a grant from the Department of Health to reach our objectives, we must produce a yearly report which measures our progress towards those objectives.

    Second, we work within the community. We work with the Société Santé en français, we work together with local communities to ensure that local services are available. We are not accountable to these communities; it's more of a working relationship. But our major funder is the Department of Health, for which we produce a yearly, detailed report on whether we have reached our objectives.

    Mr. Eugène Bellemare: Is the Department of Health the only institution which has given you money?

    Mr. François Houle: Yes, for now, the consortium is funded by the Department of Health.

    Mr. Eugène Bellemare: With regard to training, you said that you went into each community to recruit students. I'd be interested to know how that is achieved.

    Something else intrigues me even more. I know that each university sets a certain number of spots aside for each program, for instance 30 spots. Students apply to the University of Ottawa, including francophones and anglophones. Competition is fierce to get admitted into a program, it depends on what kind of grades you got in high school. If you don't get either 90 or 95 per cent, it will be tough to get in.

    Have you looked into whether francophones do well, whether they generally get marks in the 90s, or whether it's in the 80s, and as a result don't get into the program? If for instance there are 30 spots, what happens if a francophone is number 31 or 32 on the list of candidates?

    Mr. François Houle: It generally depends on what profession you're looking at. Let's look at the area I am most familiar with, namely the consortium and the Faculty of Medicine of the University of Ottawa.

    The University of Ottawa has been authorized by the Government of Ontario to train 130 physicians, 80 in English and 40 in French. If the university wanted to train 131 doctors, the government would not pay the additional costs. So, we have 130 spots, which represents a significant increase over the last few years. In our case, 40 of those are reserved for francophones.

    As for us, we have added eight spots per year for francophones. These spots are financed by the consortium. That amount will increase every year. Therefore, there are indeed a certain number of openings reserved for each type of clientele.

    As for recruitment in the area of health sciences, particularly within minority communities, the emphasis must lie with increasing the profile of those professions. This means going into each community, visiting schools and colleges, presenting the programs and getting students interested.

    Various activities are organized. I'll tell you what we did in Ontario in minority francophone communities. Each year, representatives from the Faculty of Medicine go into a community—last year, they went to southern Ontario, and this year, it's northern Ontario—bring together groups of students and take them to a hospital. These students get to spend the day in the emergency room to see what it's like and to get to know the various types of jobs which are involved in the field of health care.

¿  (0935)  

    Mr. Eugène Bellemare: Do you find there is a certain degree of resistance on the part of institutions to admit students?

    Mr. François Houle: No, because everyone agrees that we need to increase the number of places.

    Mr. Eugène Bellemare: Something has been bothering me for a while. A former neighbour of mine, a young man, had applied to study medicine at the University of Ottawa. He was rejected. But the next day, he was admitted into the University of Toronto's program. Today, he works as an orthopedic pediatrician. He finished studying in California, where he got a job. But because he wanted to come back to Ottawa, he took a position at CHEO, which did not have a francophone orthopedic pediatrician. However, he was given only a single operating day per week, whereas in Los Angeles, he could operate five, if not six, days a week. He was offered a very important position in California and went back.

    Of course, that is a very specific sort of example, but how would you try to address that type of problem?

    Mr. François Houle: Well, we would have to consult with...

    Mr. Eugène Bellemare: It is a huge and deplorable loss for Ottawa.

    Mr. François Houle: As you know, in Ontario as elsewhere in Canada, there have been cutbacks in the area of health in the last ten years. There were several periods of budget cutbacks. There was even an attempt to cut back on the number of services provided by CHEO. I think that lies at the heart of the problem.

    The only part of your question I can address, at least in part, is the issue of training. In that regard, we guarantee a minimum number of places for francophones at the university. As it now stands, the consortium finances 40 spots. We normally fill them all because, of course, there are a lot of applications. We could train more doctors, but that is unfortunately the number of spots authorized by the government.

    Mr. Pierre Gaudet: Mr. Bellemare, this discussion allows me to answer your initial question, namely whether Health Canada, through its $63 million subsidy, is the only one to contribute.

    Mr. Houle clearly indicated that in medicine, we have been successful in adding eight places per year for francophones from outside Ontario, that is the minority communities in all the provinces, be they in the west or the east.

    I want to point out the fact that these eight spaces are available because considerable amounts have been invested in a medicine infrastructure at the University of Ottawa. These eight additional spaces are available specifically because the University of Ottawa has a faculty of medicine that was built over 30 years and that now allows us to add eight spaces to the 130 existing slots. In that sense, through existing resources, every institution contributes to the objectives of the consortium in some major way.

    Mr. Eugène Bellemare: You used the word “challenge” at least 700 times during your presentation. What about the challenge you did not mention, that of francophones who study at anglophone institutions such as McGill, the University of Toronto or UBC? Are you going to go and get them so that they can work in francophone environments?

    Mr. François Houle: The objective of all the institutions was to recruit as many francophones as possible to have them study in French. I think that that is one of the objectives that all the institutions are pursuing.

    Right now, there have been some success stories. For instance, in institutions such as the Cité collégiale, the University of Ottawa or Laurentian University, there is a considerable increase in the number of enrolments in French language programs. Therefore, there has been success when it comes to bringing francophones into post-secondary education in francophone institutions.

    Every year, I think that our percentage has increased in most institutions, precisely because francophones are coming in greater numbers. But of course there will always be francophones who prefer to study elsewhere. That is an individual choice.

¿  (0940)  

    Mr. Eugène Bellemare: There are economic and geographic reasons for that. It is not necessarily their preference, but it may be a choice they are forced to make.

    Mr. François Houle: The institutions will often provide scholarships, for example, meaning that most francophone institutions will provide scholarships to francophone students who want to study in French. At the University of Ottawa, there is a series of scholarships earmarked solely for francophone students who come from any region and who want to study in French, precisely to help them overcome this problem.

    The Chair: Thank you.

    Mr. Godin.

    Mr. Yvon Godin (Acadie—Bathurst): I would like to welcome Mr. Houle and Mr. Gaudet.

    Earlier you talked about wanting to... I think this is what it is all about, bringing them back to the regions once they finish their studies. I see that the University of Moncton plays an important role in this. The Collège de l'Acadie is a college that trains nurses. The Bathurst campus has classes...

    But when you talk about trying to encourage young Acadian francophones to study but then go back to the region, what do you think can be done to achieve that?

    Secondly, how can we guarantee them a job? It is all very nice to train them... Last week, someone told me that doctors in Moncton could not get a number—that is what it was called, I think—in order to be able to practice. On a Radio-Canada news broadcast, they also mentioned problems that some couples face when they are both doctors and one can get a job in a hospital but not the other and they decide to leave because they cannot stay here. One of them does not want to work in Ontario while the other one is in New Brunswick or elsewhere.

    Given all these efforts to train francophones for minority communities outside Quebec or Ontario, what would be your recommendation to help bring these people back? Or what could we recommend to get these people back in the regions, in your opinion?

    Mr. François Houle: Let us say that what we do first of all is to try to leave them in the regions as much as possible, that is to ensure that more training is done in the regions in local colleges or institutions. For example, the Collège de Saint-Boniface or the Collège de l'Acadie offer the paramedic program of the Cité collégiale. This program which was developed by the Cité collégiale was transferred to these other colleges and is offered at the Collège de l'Acadie.

    So you have to leave people in their home environment and see to it that the internship and clinical training is done locally as much as possible, and that supervision is provided locally. We strongly believe in training done in the communities as much as possible. That is the first thing we do because the more we leave people in their communities, the more training they receive in their communities, the more they practice in their communities and the greater the chances they will stay there.

    With regard to the other part of your question, that has more to do with the ministries of Health and with training. If provincial governments or regional authorities decide that only a certain number of people can practice in a given region, that is a serious problem. With regard to minority communities, we have to make sure that the required number of health care professionals is in place.

    Mr. Yvon Godin: You talked about teaching in the regions. There are colleges and universities that provide training for nurses, but I do not think they provide medical training for doctors, unless I am mistaken.

    Mr. François Houle: No.

¿  (0945)  

    Mr. Yvon Godin: Does your plan provide for strategies to offer that type of training in more places?

    Mr. François Houle: No. Medicine is quite a specific case. Right now, there are two places that train doctors under the auspices of this project. The University of Sherbrooke, where doctors are trained for francophone New Brunswick, and the University of Ottawa.

    At some point in the future—and we will work with them then—there will be a faculty of medicine in northern Ontario. The government of Ontario is working toward its implementation right now.

    What we do in medicine is more at the level of clinical experience and internships. We provide training and supervision in the communities. You are absolutely right with regard to training.

    Mr. Yvon Godin: Could you tell us more about that?

    Mr. François Houle: In health care, a significant part of the training is done through internships and in clinical settings. In order to have these internships, you have to have recognized institutions that have the ability to provide university or college level training. This cannot be done in just any hospital.

    Therefore, in communities where there are hospitals, we must make sure that there are people in these hospitals or clinics who are capable of supervising internships, to provide training and to ensure that this training be ongoing. Moreover, you have to allow people in nursing to do an internship in a hospital in the north or in the south.

    Mr. Yvon Godin: Does your plan provide for some way of ensuring that after having studied at the University of Ottawa or the University of Sherbrooke, a student goes back to Moncton, for example, to do his or her internship? That is part of the whole process. In concrete terms, what is done to bring these people back home, for example?

    Mr. François Houle: Let us take the example of New Brunswick. All the students who receive their training at the University of Sherbrooke return to New Brunswick for their internship. All the costs related to this are assumed by the Consortium national de formation en santé. We thus ensure that practical training is provided locally.

    In the case of the other provinces, that kind of system is not yet in place. We have been working on it for the past few years and we continue to do so.

    Mr. Yvon Godin: A little earlier, you said that $10 million was good in a way. But five years go by very quickly and three years go by even more quickly.

    What recommendations would you make so that we can transmit them to the government in order to support you and help you continue and improve all this?

    Mr. François Houle: I think that by the time three years have gone by, we will have seen how much progress we've made. We've already surpassed the objectives of phase 1 and if the past is anything to go by, we will achieve our objectives. We are a group of 10 organizations that work in many communities. If we attain these objectives, the next goal will be to make this something permanent. We will have to ensure that the training of health care professionals in minority communities is offered on a permanent basis and we must continue to insist more and more that training facilities be located in these communities.

    Mr. Yvon Godin: I'd like to ask you one last question. What do you recommend? As I was saying, we want to go into the regions. We want to encourage people to have careers in medicine or nursing. Unfortunately, it's a well-known fact that when you undertake a career in medicine, or when you have a diploma in nursing, for example, you're initially a part-time employee. You work 70 hours a week, but you're not considered a full-time employee. Pardon the expression, but it's a disgusting job. There's no future, because it's an ongoing battle every minute of the day.

    Since you work in the field of education, what kind of pressures can you bring to bear? I don't mean that you should do the work of unions, but what do you do as stakeholders in education? Why don't you suggest to the government that it implement a system in which people can feel good about what they do? These jobs would become stable and promising. On the one hand, everybody says that, but on the other, no one wants to accept what this implies. No one wants to pay them properly. They claim there are no full-time jobs in this field.

    Let me give you an example. One of my sisters-in-law worked part-time in a hospital for five years. She worked 70 hours a week, and sometimes she was already at the hospital and she got phone calls at home to call her into work. There was a need there, but there weren't able to—

    If I was young, I wouldn't want a job like that. I would want a job where I know where I'm going. You have a schedule and you know where you are headed. The need is there, so why isn't something done?

    My question is as follows: what could you perhaps do? I'm not placing the entire burden on your shoulders, but I think this is an issue that concerns everyone. What can we do to have the government -- or governments -- take action, because this doesn't make sense? They are not serious when it comes to health care. They want what we call cheap labour. They say there are shortages and no one is committed in this field, but they don't encourage people to become committed.

    Mr. François Houle: Quite obviously, some professions such as nursing are in difficulty right now when it comes to employment. As far as we're concerned, when we're called upon to intervene, we emphasize full-time employment in this field. Nevertheless, I think that right now, changes are being made to health care policy. All the provinces have understood the importance of health care and the magnitude of the problems the field faces. They're trying to make improvements and we can only hope that they will succeed. The federal government also has a role to play; it has to ask to provinces to provide good quality services.

¿  (0950)  

    Mr. Yvon Godin: I know, but you have 10 million dollars at your disposal for this. Will that be included in your recommendations to the government?

    Mr. François Houle: I don't know what our recommendations will be in the final analysis, but first and foremost, they will certainly be focused on training, mainly in the communities. We have to see what we can do to ensure that our communities take charge of their own affairs.

    The Chair: Thank you.

    Mr. Gaudet, would you like to comment? Go ahead.

    Mr. Pierre Gaudet: I would like to transmit some factual information to Mr. Godin, who referred to the medicine program in New Brunswick on several occasions. Dr Aurel Schofield is the coordinator of francophone medical training in New Brunswick and he is the one who ensures that medical students who receive their theoretical training at the University of Sherbrooke come back to New Brunswick for their clinical training. He could provide you with ample information on his formula, which I might add works very well.

    Ms. Carole-Marie Allard (Laval East, Lib.): Mr. Gaudet, I want to congratulate you because you have before you a very interesting project. I apologize for having had to go out for a phone call but nevertheless I want to tell you how much I believe your cause is important.

    I was personally faced with a situation similar to the one we are discussing. My mother became ill in Florida and I was able to observe to what extent someone who does not speak the local language is lost in a health care system where they are not understood. Unfortunately, she died there. I simply want to say how important it is to make sure that when people are in a very vulnerable situation there is someone who can help them in their own language. In my opinion, your goal is a very laudable one.

    I would like to ask you one question. Earlier you talked about four graduates. I would like to know if these people remained in large cities or if they went back to their minority communities. You referred to these four people in response to a question by Mr. Sauvageau.

    Mr. Pierre Gaudet: I was referring to four years of training, not four individuals.

    Ms. Carole-Marie Allard: Can you tell us whether the people you train go back to their home communities or do they choose to remain in larger cities, including Ottawa?

    Mr. François Houle: I do not have any data about that, but I can tell you that in medicine, there are external internships, and training lasts five years. The first graduates are currently in residence.

    Ms. Carole-Marie Allard: Perhaps you already referred to the agreement between Quebec and New Brunswick that we have here in the plan, but this intrigues me and I would like you explain briefly what it consists of.

    Mr. François Houle: There is no faculty of medicine in New Brunswick; francophone doctors in that province are therefore trained at the University of Sherbrooke under an agreement which, within the framework of the CNFS, provides for an increase in the number of francophone doctors to be trained. These doctors receive their training under the same agreement, except that the additional fees are assumed by the consortium.

    Ms. Carole-Marie Allard: So there are a certain number of additional candidates that are accepted at Sherbrooke to make up for that deficiency.

    Mr. François Houle: Be it in Ottawa or all the other programs, there is an increase in the number of students.

    Ms. Carole-Marie Allard: And this money is paid to the universities as compensation.

    Mr. Pierre Gaudet: The point you raise illustrates an important principle of the consortium, namely that we use what already exists in order to try to go further. However, we must never deny what already exists; it enables us not to have to start from scratch.

    Up until now, we have used the example of medicine repeatedly. Over a period of five years, we will allow about 100 people to get training in this field, but our overall objective is 2,500. There is not just medicine, even though that is the program that impresses the most because it is the most complex.

    The Chair: Thank you, Ms. Allard.

    Mr. Simard.

    Mr. Raymond Simard (Saint Boniface, Lib.): Thank you, Mr. Chairman. Gentlemen, welcome.

    I also missed the beginning of your presentation and I apologize for that. In principle, there is a lot of catching up to do. You are talking about 2 500 admissions over five years and 1 200 graduates. I would like to know if these figures are related to openings in these educational institutions or if they are an attempt to fill the current shortage.

¿  (0955)  

    Mr. François Houle: That won't solve the current shortage because it apparently would probably take three or even four times more health professionals. It will definitely provide for higher quality service in French, but it won't completely solve the shortage.

    Mr. Raymond Simard: How many years will it take to solve the shortage?

    Mr. François Houle: You would also have to take a look at the rate of retirement. I don't know whether that has been studied.

    Mr. Pierre Gaudet: We don't have any simple numbers on that because these are very complex things. As you know, even when it comes to forecasting shortages, many people with greater expertise than us have been mistaken in the past and are still making mistakes.

    All I am trying to say is that our figures are based on studies and that studies of minority communities are often not completely accurate because those communities are often not captured in the statistics. So our figures are approximations. But the finding is that minority communities received services in 50% of cases and less, according to studies done under the auspices of the advisory committee of Société Santé en français. So it was apparent that professionals were 50% and fewer in number. That is why it is necessary, in our view, to at least triple the number to have a full complement.

    That said, when we have the full complement, will it be in the right place, in the isolated communities, for example? It's never a single-factor equation; it's a multi-factor equation.

    Mr. Raymond Simard: Is there any cooperation between your consortium and Quebec? Obviously, that is an incredible resource in terms of professionals. They are probably dealing with the same challenges in Quebec. To my knowledge, there are also shortages there. But have you established any contacts to see whether doctors and nurses would be willing to go and work, for example, in the regions?

    Mr. François Houle: There is cooperation with the Faculty of Medicine, for training.

    Mr. Raymond Simard: Is that all? It's only at that level?

    Mr. François Houle: It's at that level.

    There may be complementarity when it comes to recruiting francophone trainers... Another challenge that I didn't focus on is that it's not always easy to find francophone teachers to train health professionals. In that regard, we have often had the assistance of professionals from Quebec for individual supervision or to give courses. You have to take francophones where you can get them. It's already hard enough to recruit at the university and college level, because there's a shortage. It's even harder in the health field. And once you recruit them, you have to keep them. But the majority community can often offer better conditions, better salaries, among other things, and that is one danger. If we don't offer comparable working conditions, we risk losing them too. So not only do you have to recruit them, you have to be in a position to provide them with working conditions that are at least satisfactory to them, though they may not be fully comparable with what they would get in majority institutions.

    Mr. Raymond Simard: I wanted to ask a question about training.

    You mentioned, for example, the University of Ottawa and the University of Sherbrooke, which could train young people. Back in Manitoba, there's a clinic in Sainte-Anne with 11 doctors, the eldest of whom is probably 45. They were all trained in English at the University of Manitoba, but they all provide bilingual service. That avenue should also be explored.

    A typical example is my nephew, who is in second year university and would like to go into medicine. But there is a lot of pressure from other faculties because he is quite a good student. So the Manitoba Faculty of Engineering would like to have him. But for us in the consortium, it might be a good idea to follow up with those young people, to examine the possibilities and move forward in that area, because we risk losing them.

    I don't know if that kind of effort is being made. I don't know whether you encourage young francophones to continue their studies, for example, by attending universities like the University of Manitoba.

    Is that part of your mandate too?

    Mr. François Houle: Our mandate is primarily to provide training in French and ensure that professionals are trained in French, as much as possible, and that they go back to their communities. He would be the ideal candidate, if he wants to go into medicine, to take the national training program and do his placements in Manitoba clinics and hospitals. That is the kind of thing we are trying to do, I think.

    Mr. Pierre Gaudet: I would add that in Manitoba, however, there are two added dimensions. First of all, there are people who have come from Manitoba to the University of Ottawa to become doctors, and the Ottawa team has gone to Manitoba to try to set up clinical placements precisely so that those students can do their clinical placements in Manitoba. In addition, at the Collège universitaire de Saint-Boniface, an effort is being made to coordinate training with the health care community. Those who studied at the University of Manitoba are trying to see whether it is possible to do clinical placements in French, for example, at the Centre de santé Saint-Boniface, at the Saint-Boniface General Hospital, even if they were taught in English at the University of Manitoba.

À  (1000)  

    Mr. Raymond Simard: That would make sense. A few years ago, I remember there was some tension because one province had a shortage of nurses... We, for example, went to Acadia to try to find people. Is that part of your role, to try to coordinate things, to ensure that the resources are indeed shared? That may not be easy, either.

    Mr. François Houle: No, it isn't easy. Our role, as I said and will say again, is training. But that means that there are networks. If you take the Collège universitaire de Saint-Boniface for example, it is going to increase its health training, and ensure coordination with hospitals and clinics. So we can play a role in helping to provide for the desired services, but we cannot regulate the way hospitals recruit, given that they are independent.

    Mr. Raymond Simard: That's right.

    Mr. François Houle: But if we train more people, there will be less need to recruit elsewhere.

    Mr. Raymond Simard: Right. Thank you.

    The Chair: Ms. Thibeault.

    Ms. Yolande Thibeault (Saint-Lambert, Lib.): Thank you, Mr. Chairman. Good morning, gentlemen. Two things: in your document here, you say your main goal is to increase the number of professionals, to have 2,500 admissions in five years and 1,200 graduates. That's less than half of the people who enrol.

    Am I right? That means that along the way, you will lose all those people? Has it been too long since I was in school?

    Mr. François Houle: No. If you take 2,500 admissions over five years, in medicine, for example, in five years, there is a cohort that will graduate, while 80 per cent will still be in school.

    However, for paramedics, it's two years. So two cohorts will graduate in five years.

    Ms. Yolande Thibeault: I understand. That answers my question.

    Mr. François Houle: In general, retention rates for health sciences are very low. Medicine, for example, has one of the best rates because, basically, the training is so expensive that first of all, it is highly selective, and then there is intensive supervision. So, in medicine, nearly everyone finishes. In nursing, about 80% or 85% of those who enrol will graduate.

    Ms. Yolande Thibeault: That is what I would have thought. That is reassuring. Thank you very much.

    Secondly, our researchers referred us to a 1961 royal commission—a long time ago—under the chairmanship of Justice Emmett Hall, which recommended that the University of Moncton have a medical school. Forty years later, do you think such a project would be feasible? Would the costs be prohibitive? Do you have an opinion on that?

    Mr. François Houle: We have no opinion on that, but I will tell you that currently, there are groups in New Brunswick working on the development of a medical school in New Brunswick. There are communities, groups and individuals that are very active right now, and there are negotiations with a view to developing a medical school in New Brunswick.

    Will there be one? That remains to be seen. It is up to the government to decide whether it will invest at that level. Let us just say that it has once again become a major issue in the community.

    Ms. Yolande Thibeault: Forty years later!

    Mr. François Houle: Yes, indeed.

    Ms. Yolande Thibeault: Thank you very much, gentlemen.

    The Chair: Thank you, Ms. Thibeault. I am sorry, I had not noticed that you had asked for the floor.

    I had a few questions. A number of them have already been raised. So I am going to run through them quite quickly, if you do not mind.

    Mr. Houle or Mr. Gaudet, you were saying earlier that for phase 1, the goal was 30 medical students and 60 students in other related professions, and that you had reached 200. Can you give us a breakdown of those 200 people? How many in medicine and how many in the other professions?

À  (1005)  

    Mr. Pierre Gaudet: Just off the cuff—I do not have the tables in front of me—I think there are 27 in medical training for the first four years, because phase 1, although it was supposed to be over five years, was in fact over four years. You will recall, Mr. Bélanger, that the funding was announced later. But still, it is encouraging, and it allowed us to get to phase 2.

    So I think there are about 27 in medical training. Some are doctors... We do not have the results yet—Ms. Allard made that request—because they have not finished their training yet. They are just starting their residencies.

    In the other health sciences, I do not remember the breakdown, but there are a lot of them in rehabilitation, whether it is occupational therapy, physiotherapy or speech therapy.

    The Chair: You must have statistics.

    Mr. Pierre Gaudet: We could give you a detailed table.

    The Chair: That would be great if you could send us that.

    Mr. Pierre Gaudet: There are some in physical activity and also in nursing.

    The Chair: Okay. I would also like...

    Mr. Pierre Gaudet: To give you numbers, the big success was having unexpected training, like the nursing program with around 60 students at the Collège universitaire de Saint-Boniface.

    The Chair: It would be helpful if you also had statistics or a somewhat detailed analysis of the situation for graduates who are in the labour market, if you could tell us what percentage of those people have gone back to work in their communities. I understand that there are doctors who are still in training. That cannot be determined in advance, but I would like to know. It can wait, it is not urgent.

    I also had a question about the agreement between New Brunswick and Quebec, but that has been asked. However, I would like to make sure I understood. The $10.8 million to be taken from the $63 million under the agreement is for new positions, not existing positions. How many are there currently, and how many new ones will there be?

    Mr. François Houle: In terms of numbers—

    Mr. Pierre Gaudet: Wait, I think that to date, they have been training 27 per year, and that they are adding another ten or so per year. Once again, I can give you the exact figures, because that is in the detailed tables.

    Perhaps I should point out, Mr. Bélanger, that medicine is not part of the agreement between Quebec and New Brunswick. There is all kinds of other training, like speech therapy, physiotherapy and so on. There is also dentistry, I think. So they are training a lot of other health professionals, in addition to those who are in medicine.

    The Chair: Is all of that training offered at the University of Sherbrooke?

    Mr. Pierre Gaudet: No.

    The Chair: Is it new or was it there already?

    Mr. Pierre Gaudet: It was there.

    The Chair: What I would like to know is whether it's a matter of replacement, or something brand new.

    Mr. Pierre Gaudet: It's always additional.

    The Chair: Fine, thank you. At the University of Ottawa, you mentioned that there were now 130 spots. Could you give us some background? You said that this was recent, that there have been recent increases. Could you take us back a few years and walk us through that?

    I remember that in the 1990s, medical schools in Canada decided together to reduce the number of available spots, at a time when the size and age of the population were increasing. I had trouble understanding that decision at the time. It is my understanding that that decision has now been reversed.

    Mr. François Houle: Absolutely. I don't remember the exact numbers, but we used to have about one hundred, we went down to 80 and now we're heading back up toward 130. We are currently at 120 and change. So in the last few years there has been a significant increase in the number of admissions allowed.

    The Chair: What is the split between English and French?

    Mr. François Houle: It's about two thirds to one third.

    The Chair: I have a bit of a dumb question, Mr. Houle. I'm sorry, but I'm going to ask it anyway. The University of Ottawa is giving itself a new personality: it is calling itself a “Canadian university”. I am a graduate of the University of Ottawa, and I agree with that.

    Why, then, wouldn't the 130 spots become bilingual, instead of having an 80-40 split? By the way, 80 plus 40 equals only 120.

    Mr. François Houle: Yes, I have to check the numbers.

    The Chair: Why not require all graduates of the University of Ottawa, national university, Canadian university that it is, to have a command of both official languages of Canada?

    Mr. François Houle: Many medical students, be they anglophones or francophones, are bilingual. I don't think there is a solution.

    Don't forget that, historically, the University of Ottawa's Faculty of Medicine was an anglophone faculty. Medical training in French at the University of Ottawa came later. It is much more recent than training in English at the university.

    The university's policy has always been to maximize its students' bilingualism.

À  (1010)  

    The Chair: What would the maximum be? That every student be bilingual?

    Mr. François Houle: Yes, but for now, students are encouraged to get a certificate of bilingualism, for instance. Some fields of study require these skills.

    The Chair: Has this objective been discussed within the Faculty of Medicine, within the board of governors or the senate of the University of Ottawa, that is, to make sure that all medical graduates are bilingual, and I would go even further, that all graduates of the University of Ottawa are bilingual?

    Mr. François Houle: I would agree with you.

    The Chair: Is that something which is being discussed?

    Mr. François Houle: What is being discussed is how to get as many of our students as possible to become bilingual. For instance, one of the things the university brought in this year is a certificate of second language competency. This means that every student can have their second language fluency assessed, can improve their language skills, and if a student wants to work in a bilingual environment, they will know that they need to have a certain level of fluency. We have created this new certificate and are encouraging students to get it. It's being offered for the first time this fall; 90 people enrolled in September—this course has only been available since September—and we hope to increase the number of enrolments to 300 per year.

    Therefore, we're encouraging students to develop their second language abilities. In our case, it is mostly anglophones who need to improve their second language skills.

    The Chair: Thank you.

    If I understand correctly, minority francophone communities are catching up, because there needs to be more French language training to make up the difference. This morning, you yourself or someone else said that we may need to perhaps triple or even quadruple the number of professionals working in French. Is that correct? In your opinion, how much time will it take to finally catch up, reach a certain level and maintain it?

    Mr. François Houle: I don't think there is a specific time frame to catch up and reach a certain level. At this point, we could only guess. One thousand two hundred graduates will not make up the difference, that's clear. How much time will it then take to make up the gap? It's hard to say. We would also have to see how many people go into retirement and so on, but we don't have the means to undertake that type of assessment.

    The Chair: I see that money has been set aside for research. I will come back to the issue of reaching a certain level, but I want to briefly talk about research. Last week, we heard from representatives from the Canadian Institutes of Health Research, who recognized that there was still a lot of work to be done with regard to minority official language communities.

    Is there any contact between the Consortium national de formation en santé and the institutes?

    Mr. Pierre Gaudet: That's something which still has to be done. We are just starting to get in touch with each other. You said that there was some catching up to do, but there is also development to be done. Some things simply don't exist yet and we have to try to develop them. As regards research, we are working on creating a joint commission on research with the Société Santé en français. Once the commission is up and running, and with the help of participants from the institutes, we will try to help each other out, since we now don't always have the figures you have ask for, because our statistics do not yield basic data.

    The Chair: In your view, does...?

    Mr. François Houle: If I may add a few words with regard to research, I would say that we have to address any basic potential problems. In the field of rehabilitation, for instance, it is very important to do on-site research to make sure that the rehabilitation meets community needs. As it now stands, in most fields of research there are no recognized evaluation tools for minority francophone communities, that is, often the English evaluation tools are simply translated. Therefore, these tools must be developed.

    The Chair: Of course, there are more than enough needs. In your opinion, is there enough capacity to provide input for and maintain a 14th institute, which would be added to the 13 existing ones, and whose mission would specifically be to study the current health care situation of minority language communities?

    Mr. François Houle: There isn't any, so I imagine that it would be...

    The Chair: There is not any for now, but do you think that there are enough resources to create another such institute? There is a crying need, which no one can deny.

À  (1015)  

    Mr. François Houle: There is one thing we will certainly do, and that is develop capacity, and help develop community capacity with...

    The Chair: I am referring to the Canadian Institutes of Health Research. In your view, does Canada have the capacity to sustain and maintain a 14th research institute?

    Mr. Pierre Gaudet: If you are asking us to dream, well, that is a great one.

    The Chair: I understand that you may not have expected that question, but if anything comes to mind later on, please tell us what you think.

    Mr. Pierre Gaudet: Certainly.

    To come back to your starting point, Mr. Bélanger, you were asking how long it would take to reach a certain level. We do not have any specific figures, because we often do not have basic statistics. However, that being said, why do we not look at the past for guidance?

    It took 30 years to develop the medical program that exists at the University of Sherbrooke to train people for New Brunswick, and we will be able to grow the program to make it even more useful to minority communities. It took 30 years to get to where we are today. Take the University of Ottawa's faculty of medicine. I think it took 40 years to create it. It took 10 years—actually, nearly 15—to develop a near total French medical program at the university. This gives you an idea of how much is involved. When Mr. Houle said that continuity and education were long term undertakings, I feel that a 25-year period, in the area of training, is a reasonable timeline.

    The Chair: That gives me a good idea. Once we have reached a certain level, if we ever get there, what kind of level of training do you think will be necessary to maintain the situation? I do not expect an answer today, but if ever there is research into that, I think it would be interesting to know, collectively, what it would take and how much time it would take to get there.

    I have a brief last question, since I am already over my time, and I apologize to my colleagues.

    What is the proportion of foreign students in the consortium?

    Mr. Pierre Gaudet: I will be very frank. We still have not looked directly into that issue; it falls more under the purview of the institutions. But in the minority francophone community, in most provinces, there simply was no real basis for health care training in French. So, we have started at the beginning by creating programs and attracting francophones. However, these francophones obviously come from many different places and, up to a certain point, reflect the diversity of their communities.

    The Chair: For now.

    Mr. François Houle: For now.

    We still have not looked at that aspect per se. However, in the institutions...

    The Chair: I wonder whether there is a trend with regard to the participation of various francophone ethnic communities within the group of 2,500 students who will be recruited and the 1,200 who will graduate within five years.

    Mr. François Houle: Absolutely, people from other ethnic communities have enrolled in these programs. They are francophones, but they do not come from abroad. The question was about foreigners. These are people who were not born in Canada, but who live here and come from those communities.

    The Chair: Do you know whether the institutions—not necessarily the consortium—are trying to recruit students abroad?

    Mr. François Houle: Not for the CNFS openings.

À  (1020)  

    The Chair: Fine. There are so many other questions I would like to ask, but I see that Mr. Sauvageau has raised his arm so I will give the floor over to him and to other colleagues, if they wish to engage in a second round. Otherwise, we will end the meeting.

    Mr. Sauvageau.

    Mr. Benoît Sauvageau: We are studying the object of Bill C-202 and the possible addition of a sixth principle to be added to the five national principles. You work in the area of education, which is probably the basic tool needed to provide services in both official languages. So, do you think, in light of the recommendation contained in the Romanow report and in the Kirby report, and in light of promises made under the Dion plan or by other governmental organizations working in the area of health care within official language minority communities, that it is important, in the short term, to have a sixth principle, which would help us keep the many commitments which were made? Or do you think that adding a sixth principle means we are getting ahead of ourselves, and that the focus will be on the sixth principle, rather than focusing on previous commitments and projects which are already underway? This goes to the heart of today's meeting.

    Mr. François Houle: In my view, the introduction of a sixth principle will not draw attention to other issues. It will reinforce what we are already doing. The sixth principle will provide significant support for minority communities, for those working in the area of health care training in minority communities, and it will induce governments and various stakeholders to make sure that progress is made. I think it represents significant support for communities. I don't think we are getting ahead of ourselves; I think that the sixth principle will move the process forward.

    Mr. Benoît Sauvageau: According to the Association des juristes d'expression française, the sixth principle could be challenged under the Constitution. We know that francophone communities—

    Am I wrong to assert that? That's about—

    The Chair: I don't think that's what they said.

    Mr. Benoît Sauvageau: They didn't? I seem to have understood that from what they said, but sometimes interpretations differ.

    The Chair: They said the opposite.

    Mr. Benoît Sauvageau: They said the opposite?

    Mr. François Houle: They said that it would be constitutional?

    Mr. Benoît Sauvageau: I'm not sure that they said the opposite, but I'll ask you the question anyhow, since I'm not shy about it.

    Given the fact that health care is a shared jurisdiction, don't you think that the sixth principle will raise objections, bring about constitutional infighting and lead to legal action? Don't you think that it is a waste of time in an area in which we should rather be taking concrete measures?

    Second, do you think that other recommendations contained in other committee reports on the same subject, namely health services in minority areas, should be given priority? For instance, there is an interesting proposal before the committee. A few moments ago, I was set straight with regard to comments made by the Association des juristes d'expression française, but other committees have also studied this area. I named them a few moments ago. In your view, if we were to give priority to a recommendation with regard to helping francophone minorities, which one should it be?

    Mr. François Houle: On the face of it, it is fairly difficult to answer that question. The way the Consortium national de formation en santé was created and the way it works, I find, demonstrates very well that communities can benefit from the recognition of those principles. I think concrete action would be better, as is called for under phase 2 of the CNFS, which has received the support of the Department of Health. These concrete measures will directly benefit francophone communities. Without these measures, it would be very difficult, at least in the short and medium term, to improve services to francophone communities. Therefore, we feel that this type of intervention could only be positive for our minority communities.

    The Chair: Thank you, Mr. Sauvageau.

    Mr. Bellemarre, you have the floor.

    Mr. Eugène Bellemare: Mr. Chairman, it is obvious that our committee, in its report, must recommend that the Department of Finance increase its funding for the Consortium national de formation en santé.

    Are you going to change your objectives? I presume that when you went to the Department of Health, you had objectives. But since you have been in existence for two years...

    Mr. François Houle: We are getting started this year. As it now stands, we are in the process of signing agreements with the Department of Health. We are still operating thanks to a six-month extension financed by the Department of Heritage. They granted us an extension until we get funding from the Department of Health. So we started six months ago.

    Mr. Eugène Bellemare: Does your funding come from Heritage Canada or Health Canada?

    Mr. François Houle: We got our funding from Health Canada for a period of five years beginning last March. It sometimes takes a long time before agreements are signed and authorizations given in the public service. The agreements have been signed, but the Department of Health is still studying the budgets and authorizations. In the meantime, Heritage Canada has funded phase 1 until we get the money from Health Canada.

    Mr. Eugène Bellemare: So you still haven't got the money from Health Canada.

À  (1025)  

    Mr. François Houle: No.

    Mr. Eugène Bellemare: Is it guaranteed?

    Mr. François Houle: Yes, it's guaranteed, but we still need budget authorization and the signature...

    Mr. Eugène Bellemare: The amount has not yet been...

    Mr. François Houle: The amount is guaranteed. It's the authorization for each establishment's budget and...

    The Chair: In the Dion plan, which provides for an injection of 751 million dollars over five years, 119 million dollars were earmarked for health care. That is included in the budget and the budget was approved. That's just a housekeeping matter; we have to ensure that all the accounting audits are done and all necessary authorizations obtained, but there is no question that the funding is available. It's guaranteed.

    Mr. François Houle: I hope that you will continue to support the development of health care services for minority communities.

    The Chair: We thank you for having taken the time to come and meet with us this morning.

    I'd like to confirm two or three things. Tomorrow, we meet with the Commissioner of Official Languages, as scheduled. Our annual report was tabled yesterday. The report speaks very highly about our work and our achievements.

    In addition, on October 21, we are scheduled to hear Mr. Edmond Labossière, who is the senior official connected with the Council of Intergovernmental Francophone Affairs Ministers as well as representatives from the Committee for Anglophone Social Action, a group from the Gaspé Peninsula, I believe, which is especially interested in health care for minority anglophones in that region.

    Tomorrow, I also hope that we can distribute a confidential draft work plan to produce our report. We can possibly consider and adopt the report on October 21, 22 and 28, since according to the Order of Reference from the House, we are to table it in the House before the end of October.

    We have confirmed the November 5 appearance of Minister DeVillers to talk about the Vancouver Winter Olympics in 2010. We're looking at this far in advance to ensure that linguistic duality is properly respected and well reflected. That's all I have for the time being. We will get some work done during the other meeting in November and I will give you some flexibility with regard to the report.

    Mr. Raymond Simard: Mr. Chairman, are the Olympic Games the only topic we can discuss with Minister DeVillers?

    The Chair: We agreed with the minister that the topic under discussion would be the Olympic Games; there will also be witnesses from Vancouver. Right now we are looking at the francophone community and representatives of the organizing committee. Perhaps we should stick to that for the time being. Nevertheless, we remain quite flexible. However, I will warn the minister so he can be prepared to answer other questions. Is there anything else? So, I'll see you tomorrow. Thank you and have a good day.

    The meeting is adjourned.