Official Languages Committee on Oct. 26th, 2006

[Le président, Conservative, Guy Lauzon]

Thank you, Mr. Lemieux.

We now turn to Mr. Simard to ask the next question.

[Raymond Simard, Liberal, Saint Boniface, MB]

Thank you Mr. Chairman.

Gentlemen, welcome to the committee. I apologize for having missed your presentation.

We recently welcomed Société Santé en français representatives to speak before the Committee. They discussed the new model they had created in partnership with Health Canada.

I have three questions for you.

It is not easy to create a new relationship with a non-governmental group. Can you begin by discussing the challenges that exist in such a relationship? If the formula proves to be working well, can we apply it to other departments?

All governments, including the former liberal government, demand results. They are ready to invest so long as there are concrete results. The Société Santé en français and Consortium national de formation en santé were evaluated midway through the project. Taking this evaluation into consideration and the progress made since that time, do you think this model is working well? Would you be ready to make a recommendation for renewal and improvements to the program?

Mr. Nouvet, I am sure you have seen many projects in your 20 or 30 years of service with Health Canada. We are hearing extraordinary things about these projects. I know that it is working well in Manitoba. When the people come to see us, their testimony is very positive.

In your opinion, is the program worth renewing?

[Marcel Nouvet]

I will start with your last question, because it is the hardest one to answer.

I told you that we at Health Canada were very proud of what we had accomplished over the last four or five years. I can't tell you what kind of recommendation we will make. We will be providing options when asked to do so. It will be up to government to decide. It is difficult for us to tell you what we are going to recommend to the minister.

Communities wanted to know, before the beginning of the five-year plan, what officials would recommend to the minister. We said that we really could not tell them what our recommendation would be, but that we had heard their request for some $500 million over five years. We told them that we could not tell them what would result from it. Actually, we came up with significant amounts, but they were lower than the communities had hoped for.

As far as I am concerned, the creation of a new model of governance was arduous work. I have done many things over the course of my career within the federal government, and I can assure you that it is one of the three, four or five most challenging initiatives I have ever been involved in. The public service has a culture which is based on cautiousness and, at the end of the day, the status quo. It does not like change. The fact that we were going to be shaking things up, that we would no longer be managing projects, but that they would be managed by the communities themselves so that they could take ownership of them and make their own choices, all of that made people uncomfortable. Some people feared perhaps that by losing that control, they would no longer know what to do nor whether the money was well spent. We experienced a shift in culture because we needed to create a climate of trust.

In general, the public does not appreciate public servants. I am sure some community representatives support the people helping decision-makers make decisions, but at the end of the day, there is a bias against public servants. When they find themselves caught up in the bureaucracy, which exists for good reason because it is after all tax payers money that is being spent, things grind to a halt due to the culture and the checks and balances which must be applied to ensure money is well spent. That reinforces the bias people may have against the bureaucracy.

After two years, a number of bumps in the road and lively meetings with francophone communities, they know now that we are acting in good faith, that we are trying to break down barriers, but that we must exercise some control. We have struck the right balance and the communities trust us. That is my view of the situation. We should ask Hubert Gauthier and Andrée Lortie what they think. I think that we have reached some common ground.

I don't know if I am addressing your second question. I am impressed by what the communities have done. Some may say it was Health Canada's doing but that would not be true. The federal government provided the money, and the communities decided on how to spend it. Incredible things are being done. For one thing, five or six provinces now listen to these communities and get along very well with them.

There are some examples I can give you. Notre-Dame-de-Lourdes is a health services centre which will soon be built. The federal government's investment was $30,000. The total value of the project is $3 million. With just $30,000 in seed money, the communities managed to get funding from the provinces and their own communities in order to build a $3 million centre. That is exactly what happened with the training centre in New Brunswick which I discussed earlier. A small amount was invested in training and all of a sudden, the university and the province decided to work together to build something.

[The Chair, Conservative, Guy Lauzon]

Mr. Petit, you have the floor.

[Daniel Petit, Conservative, Charlesbourg—Haute-Saint-Charles, QC]

Thank you for being here this morning on behalf of Health Canada.

The question I have for you may be general in nature but I would like to begin by saying a few words just to be clear. You said that the federal government supports linguistic minority communities, be they francophone or anglophone, in terms of health care. I come from the province of Quebec, where there are other francophone minority groups. I am referring to Indian reserves. Some Indian tribes—for instance, the Hurons in my area—live close to downtown and have access to services in French. The other Indian nations in northern Quebec which speak French are having some difficulty obtaining services in French. Although we are in the majority, we are still having a hard time accessing services. Can you imagine, there are Indian nations living close to Lake Mistassini!

Of course, it is an issue under provincial jurisdiction, but there is a minority group which speaks my language and is having a hard time obtaining health care service in French. That is not the case when people live in cities, however. Two major reserves can easily access services: the Huron-Wendat, in Quebec City, and the Aboriginal people in Kanesatake, in Montreal, because they are close to two big cities. When you go into northern Quebec or towards New Brunswick—there are a few Indian nations in Quebec near New Brunswick—things are different. We know full well that to be able to obtain services in one's own language—in their case it is French—leads to enhanced vitality in a community.

What is your goal in providing funding. How do you react?

[Marcel Nouvet]

That is an excellent question, and my colleague has just suggested an answer.

My understanding of the matter is that the Official Languages Act requires the federal government to undertake special measures to help official language minority communities. These communities comprise English speakers in Quebec and French speakers and Acadians living in a province other than Quebec. This has been our focus. If I were a member of the Quebec National Assembly, it would be my responsibility to ensure that Quebeckers had access to health care services, which fall under provincial jurisdiction, in the language spoken by the majority. I do not believe that to be a matter of federal responsibility. Perhaps I am mistaken, but I understand the federal government's responsibility to be towards those in a minority situation, like English speakers in Quebec.

[Daniel Petit, Conservative, Charlesbourg—Haute-Saint-Charles, QC]

Mr. Nouvet, health care services are said to constitute a key element in the development of official language minority communities. Could you tell us what has been accomplished thus far on this front? Could you define some of the challenges for us? I am of course referring to the English language and French language minority communities that you just described.

What are the current and future challenges for Health Canada?

[Marcel Nouvet]

If your question is what challenges do these communities face, I would say, as they have already said, that it is twice as difficult for them to get services in their mother tongue as it is for the majority. It is difficult for people to seek treatment when they do not have a command of the official language that is being used by the health care provider.

In addition, it should be remembered that the primary focus of the Official Languages Act is not actually health care, it is how to ensure the development of official language minority communities. I am talking about French speakers, perhaps because I myself am a French speaker. The bottom line is that if there are less and less services available in French, and if people cannot study in French, they will end up working in English either for the English language community or for French speakers who have been assimilated. It is something of a vicious circle and one which will quickly undermine French language communities.

The communities have been using their funding to try to increase the number of professionals who receive their training in French. It has been shown that those who study in French are more likely to work in French. They have also developed vibrant community networks in an attempt to facilitate working relations with the province.

Four years on, it is, in my opinion, difficult to get an exact measure of the results. At a recent advisory committee meeting, we heard that the French language communities were more satisfied with the services than they had been previously. That being said, we all acknowledged that it is very difficult to prove this assertion as it is primarily based on anecdotal evidence.

[The Chair, Conservative, Guy Lauzon]

You have five minutes, Ms. Brunelle.

[Paule Brunelle, Bloc, Trois-Rivières, QC]

Good morning, gentlemen.

I have been told, rightly or wrongly, that although Health Canada has 10,000 public servants in its employ, it does not actually run a single hospital. Yet it is in hospitals that the real problems are to be found. Furthermore, I noticed that the results that you shared with us actually only concern primary care. Like my colleague from the NDP, I am concerned by the difference between the number of projects in Quebec compared to the rest of Canada.

You told us that the Société Santé en français is responsible for choosing the projects. I would like you to elucidate further. Do the communities themselves launch the projects? Why is it that, proportionately, there are so few projects in French language minority communities outside of Quebec? How is the funding allocated?

Furthermore, the official languages interim report informs us of a three-million dollar loss attributed to funding delays. I would like you to explain how this can be justified.

[Marcel Nouvet]

I would be delighted to address this question. When I listened to the debate during the last election campaign I was at a loss as to why a clear answer could not be given to this question.

Health Canada runs hospitals that serve the first nations communities. We therefore do have staff working in hospitals. We also employ nurses who work on reserve and who should, as a rule, be able to provide services in both official languages. A good half of Health Canada's budget is spent on providing these services. In addition, another significant chunk of the budget is spent on regulating and testing new drugs, and so forth. That explains why we have such a large staff.

Allow me now to address project selection. The Société santé en français, which has a very small team and modest offices here in Ottawa, depends on 17 networks. All of the networks are represented on the steering committee. The committee started by defining its project selection criteria. They then asked the networks to develop and submit project proposals. Bearing the criteria mind, the networks went to work in the communities to try to develop sound proposals for the Société santé en français. The selection was made based on the criteria developed by all stakeholders. Some projects were rejected and others were approved.

[Paule Brunelle, Bloc, Trois-Rivières, QC]

Given that this is an area of provincial jurisdiction, you have to negotiate with the provincial governments. How does that work?

[Marcel Nouvet]

No request is reviewed by the Société santé en français and no investment is made in a project unless formal approval has been obtained from the province. Nothing can be done without first having the support of the province.

That is why working together within the networks is so important.

[Paule Brunelle, Bloc, Trois-Rivières, QC]

You enjoy a good relationship with the provinces. However, you mentioned earlier that some provinces are concerned that the government will provide limited funding and then turn on its heels and walk away. Is that a problem?

[Marcel Nouvet]

It is a problem in some areas, but in others it is working very well. I am certain that the success stories will pave the way for the others to follow suit.

[Paule Brunelle, Bloc, Trois-Rivières, QC]

What are your views on the three million dollars in program funding that have not yet been spent?

[Roger Farley]

There are a number of administrative problems related to this three million dollars. There was $30 million for all of the projects. Ten million dollars were earmarked for the English language community and $20 million for the French language community. As of September 30, the entire amount had been spent.

[Paule Brunelle, Bloc, Trois-Rivières, QC]

I still have a little bit of time left. You said that you manage the on-reserve hospitals. How many hospitals are there?

[Marcel Nouvet]

We will have to send you this information.

[Paule Brunelle, Bloc, Trois-Rivières, QC]

Are there any in Quebec? I am thinking of the problem Mr. Petit raised.

[Marcel Nouvet]

No, I do not think that there are any in Quebec. Did you know that we are responsible for providing nursing services and front-line services on all reserves? These services should be provided in both official languages. If there are ever any problems on this front, please let us know.

[Paule Brunelle, Bloc, Trois-Rivières, QC]

Do you have a formal, written agreement with the Government of Quebec regarding the services you provide?

[Marcel Nouvet]

I think that, in general, the provinces are happy that on-reserve health care is a matter of federal responsibility. This could be debated, but overall they are happy that the federal government assumes this responsibility. Consequently, there are no specific agreements on this.

[The Chair, Conservative, Guy Lauzon]

Thank you Mr. Nouvet, thank you Ms. Brunelle. I apologize for forgotting you.

Mr. Godin.

[Yvon Godin, NDP, Acadie—Bathurst, NB]

Let us turn our attention back to Mr. Petit's example. I am a little confused. You said that reserves come under federal jurisdiction. There are only two federal hospitals in Canada. Yet, when Mr. Petit was talking about reserves, you told him that health care came under provincial jurisdiction.