Official Languages Committee on Oct. 31st, 2006

[The Chair, Conservative, Guy Lauzon]

Good morning and welcome ladies and gentlemen.

This morning, we will hear from a witness, Gilles Patry, co-chair of the Consortium national de formation en santé. Mr. Patry, you came alone this morning, but you have some assistants.

As I explained, Mr. Patry, you have 10 minutes for your presentation, which will be followed by a first round of questions of 7 minutes each.

You may begin as soon as you are ready.

[Gilles Patry, Copresident, Consortium national de formation en santé]

Thank you Mr. Chairman. Hon. members, thank you for your invitation to appear before the House of Commons Standing Committee on Official Languages.

It is an honour to appear before you this morning as both President of the University of Ottawa and as co-chair of the Consortium national de formation en santé.

I am aware that the committee members are primarily interested in learning more about the role, evolution and future projects of the Consortium national de formation en santé in relation to the improvement of health care access in French for Francophone communities in minority situations.

But I hope you will also allow me to give you a brief overview of the University of Ottawa's contribution in promoting our official languages and the development of Francophone communities in minority situations.

I would like to start off by summarizing the situation that led to the creation of the consortium and then discuss our accomplishments to date in order to give you a clear idea of our objectives for the future.

The University of Ottawa co-ordinated a pilot project from 1999 to 2003 that launched the efforts that led to the creation of the current consortium. While our project was being developed, in June 2001, the Consultative Committee for French-Speaking Minority Communities, created by the federal Minister of Health, published a study indicating that, on average, over half of Francophones in minority communities had little or no access to health services in their own language. A report was subsequently prepared for the Minister that recommended a three-phase strategy involving networking, training, and the development of services. It was against this backdrop that Phase II of the Consortium national de formation en santé—Phase I going from 1999 to 2003 and Phase II from 2003 to 2008— was created and received, under the Action Plan on Official Languages, $63 million over five years for the component on health training and research in French.

The Consortium national de formation en santé is a nationwide organization that brings together postsecondary educational institutions, at both the college and university levels, involved in delivering French-language programs in various health disciplines. The goal is to build an extensive, French-language postsecondary training and research network that bolsters research into the health of Francophones in minority communities.

Today, some 23 university programs and 28 college programs are currently training health professionals able to deliver health services in French across Canada.

A formative evaluation was conducted midway through Phase II, which covers the period from 2003 to 2008, of the Health Training and Research Project.

The following are a few of its findings. The project has resulted in 1,428 new enrolments, which is 33% over the expected results, and almost 300 new graduates, which is 32% over the expected results.

The participating institutions made a commitment to develop and launch a total of 20 new programs during Phase II. They have already launched 16 and expect to launch a total of 28 by the end of 2008. With respect to the development of clinical placement settings, which is key to the success of the CNFS project, the institutions have managed to develop 200 new clinical placements, which is 98% over the expected results. As far as our goal was concerned, we are 100% ahead of schedule.

The research, development and implementation of a strategy to raise awareness within the research councils, along with intense efforts to build networks within the research community, played a major role in our obtaining, competitively, six grants totalling over a million dollars for research projects into the health of Francophone minority communities. I would like to point out that these projects were obtained on a competitive basis, after receiving support from the CNFS.

The primary conclusion of the evaluation report is as follows:

At the midpoint in the Health Training and Research Project, the quantitative data available are pointing toward a very successful project. Overall, the 10 institutions and the National Secretariat of the CNFS have succeeded in reaching or exceeding the expected levels for all performance variables.

The research and training project is playing an essential role in increasing the number of health professionals, and, by the same token, in ensuring that Canada's Francophone minority communities have better access to health services in French. In addition to delivering training, we must also focus on networking and the development of services, which are the two other points identified in the 2001 report to the Minister of Health.

Since 2003, the Société Santé en français has created 17 networks in Canada's Francophone minority communities, with the goal of supporting concerted action and commitment by all partners in the health discipline. In addition, these networks are being supported by over 70 initiatives designed to facilitate the implementation of accessible services to the communities.

These three components are essential to achieving our ultimate goal—better access to health services in French. As the midway evaluation has demonstrated, the CNFS formula is a winning formula. For the first time in our history, a network of postsecondary institutions is making a whole range of health professions accessible, in French, to young people from every region of the country. The CNFS is thereby helping to reduce the country's shortage of health professionals. Despite the great success it is enjoying, the consortium still has a tremendous challenge ahead of it. It will have to build on the work it began in Phase II. This phase runs to March 2008. In the next Phase, beginning in April 2008, it will be important for the federal government to invest more to allow us to strengthen our current programs, develop new programs, and increase our capacity to deliver training in the health professions in French.

In a speech he delivered on April 12, the Minister of Health stated that addressing health human resource issues was one of the cornerstones of the transformation of our health care system. This is exactly what the Consortium national de formation en santé is working on. In coming months, the support of each and every one of you will be crucial in ensuring the success of the next stage of our endeavours.

Allow me at this point to say a few words about the contribution of the University of Ottawa to promoting official languages. Since its creation in 1848, the University of Ottawa has been Canada's university. Distinguishing characteristics include our status as a bilingual university, our commitment to the promotion of French culture in Ontario as well as in Canadian and international Francophone communities, our leadership in advancing Canadian bilingualism and our openness to cultural diversity. Due to an ever increasing number of programs—undergraduate, graduate and professional—offered in French, the university attracts a growing population of Francophone students. Last year there were more than 10,000 Francophone students at the University of Ottawa making it a leader in Canada for French studies outside Quebec. In addition, this year alone—and this is important—the university welcomed more than 3,000 students in high school immersion programs from across Canada. The university has also been very active in the area of research in French, and we have created eight research chairs in Canadian Francophonie.

From January 2004 to December 2005, the University of Ottawa conducted an important strategic planning exercise entitled Vision 2010. As part of this exercise, the University placed as a priority its leadership role concerning Canada's official languages. This initiative is confirmed by two of the key elements of our mission: “A bilingual university that values cultural diversity” and “ A university committed to promoting Francophone communities.”

Moreover, in order to improve linguistic balance at the University of Ottawa, the University Senate approved a few months ago the creation of a task force on programs and services in French at the university. In the context of the university's strategic plan, two major initiatives were launched: the French immersion studies program and the Institute of Official Languages and Bilingualism. The French immersion studies program began in September of this year in 54 programs of study at the university. The program is unique in Canada. It allows students from French immersion programs or basic French programs as well as Francophiles to pursue an undergraduate program of study in their second language in the discipline of their choice, while at the same time perfecting their second language. In addition, language competency will be recognized on the student's diploma. Our goal is to have 1,100 students register in the French immersion studies program over the next five years.

The University is also working on the creation of the Institute of Official Languages and Bilingualism.

Its aim is to make the university a national and international centre of excellence in second-language teaching and in researching and developing public policies on bilingualism and language planning strategies.

Thank you very much for your attention.

[The Chair, Conservative, Guy Lauzon]

Thank you Mr. Patry. You provided a lot of information in exactly 10 minutes and 10 seconds. That is very good.

We will now move on to the first round of questions. Each person will have 7 minutes.

We will start with Mr. Murphy.

[Brian Murphy, Moncton—Riverview—Dieppe, Lib.]

Thank you Mr. Chairman.

Thank you for your presentation. I come from New Brunswick, the Moncton area in particular. As you may know, the Université de Moncton is a very important institution for Acadians. Recently, we announced a joint program with the Université de Sherbrooke. It is a new agreement to train doctors. It is a cooperative agreement between two major universities.

I am proud of it. I certainly know that you are aware of the level of support for training bilingual doctors and health workers.

I have a few questions for you. Do you think that financial support for programs of instruction for our young people is inadequate, not only in New Brunswick—I am aware of these problems—but also elsewhere in the country, outside Quebec?

The answer to these questions would help me to really understand whether there is greater need in the provinces and whether we should give our support.

My second question is the following. Is it true that many graduates work in Quebec even though they received their training in New Brunswick, for example? In New Brunswick there is a problem that should not even exist. Life is great in New Brunswick. The cost of living is much lower and we all live near the ocean. However, we know that salaries are much lower than they are in Ontario, Alberta and Quebec.

Those are my two questions.

[Gilles Patry]

Thank you for your question Mr. Murphy. First, the Université de Moncton is an integral part, as you know, of the Consortium national de formation en santé, the CNFS. The university's president, Yvon Fontaine, is the other co-chair of the consortium.

We work closely together. I am also aware of the Acadie-Sherbrooke program for training doctors. This program works quite well and will be set up in Moncton, as you just said.

The challenge you are talking about, and your two questions, concern the needs of the other provinces, and the students' return to their home province once they have received their education. These are the two main directions of the CNFS, the purpose of the CNFS, and why the federal government is involved in this type of project.

For example, every year as part of Phase II of the CNFS, the University of Ottawa trains eight doctors to serve Francophone minority regions. We are trying to train students from Saskatchewan, British Columbia, Alberta and even New Brunswick—students from across Canada.

As far as your question on the need for doctors elsewhere in the country is concerned, I would say that indeed this need exists. This need is filled for the most part by the University of Ottawa, which trains doctors not only for Ontario, but for all the Francophone minority communities.

As for how we will make sure these students return to the communities, I would say that in all our health training programs, the key aspect is ensuring that the clinical placements are done in the home regions of both nurses and doctors.

Doctors have what we call 13 weeks of rotations. Students take specialized training at a hospital. Yes, we do a lot of work with the Montfort hospital, which is how the CNFS was created in the first place, as you well know. We also serve the receiving areas and the hospital areas in the regions. We send students back to the hospitals and the local health community centres to make sure they go home. When students go back home they are offered attractive jobs outside major urban centres. Ensuring that every student does a placement in their home region is part of our report, of our formative evaluation. There are no guarantees, but more students go back to their home region this way. When we work with CNFS students, we notify the University of Ottawa. We try to instill this culture in them, a sense of moral obligation to go home and serve their community.

[The Chair, Conservative, Guy Lauzon]

Thank you Mr. Patry. I now call on Mrs. Barbot to ask the second question.

[Vivian Barbot, Bloc, Papineau, QC]

Thank you Mr. Chairman. Mr. Patry, thank you for meeting with us this morning.

Obviously, we have received a number of people to discuss health. There seems to be a general consensus that there is great need and that the initiatives that have been taken have been quite successful for the most part. It is becoming increasingly difficult to challenge what seems to be a success. However, certain aspects got our attention. As far as the work of the consortium is concerned, the issue of evaluation in particular has our attention.

You spoke of the formative evaluation, which gave you indications about the locations of the placements to encourage students to return to their home regions, which is quite nice. However, in my opinion, formative evaluation also has a role to test the education at issue to see whether it corresponds well to need and to make possible corrections to it.

I would like to know whether, during the course of the formative evaluation, you had to make changes to the education based on the needs of the various communities.

Furthermore, the evaluation itself seems to be posing problems in terms of the people involved in the evaluation. In other words, it is not an independent evaluation. For example, we saw in another file that the parameters were changed when evaluating people who spoke French. That made a difference. Is this true in your case? Does the fact that people involved in the case are in charge of the evaluation, namely Mr. LeBlanc and Mr. Bisson, have an impact on the results of the evaluation? I would like to know whether you intend to use the services of the same firm for the final evaluation.

[Gilles Patry]

First, I would like to clarify the following: Mr. LeBlanc and Mr. Bisson are not employed by the CNFS. They are independent consultants.

Mrs. Barbot, that which you are alluding to is in fact a personality conflict. The independence of the evaluators is not at issue here. I can assure you that these evaluators do not have the slightest link to the 10 institutions they evaluated.

No one likes to be criticized. To be subjected to a formative evaluation and therefore to be criticized is always difficult. As far as we are concerned, all our university programs are evaluated by peers and third parties alike. It is always difficult to be part of a critical evaluation by our peers. The purpose of the midterm evaluation was to do a critical assessment of what was going well and what was not going so well. I must admit that we were generally quite pleased with the quality of the evaluation.

What you are talking about is in fact a personality conflict to do with one of the evaluators. This conflict was brought to the attention of the executive committee and the board of directors and was resolved two weeks ago. It was decided that during the next phase, the firm would continue to do the evaluation. It is possible that the interlocutor will not be the same. We do not want to change the criteria, in other words, apply criteria that varies from one institution to the next. I think you would agree with the idea of maintaining some uniformity, of ensuring that funds are used well, and so forth. That was Health Canada's objective when it ordered a formative evaluation.

I must say I do not agree with you on the independence of the consultant. He was independent. His personality may have rubbed certain people in the network the wrong way, but this was brought to our attention. We will look at the issue and resolve it. Around the table, at CNFS, in Moncton and at the Collège universitaire de Saint-Boniface, people were quite satisfied. Some institutions had a slightly more difficult experience with the evaluator, but that is normal. That is part and parcel of a critical evaluation. For example, if the behaviour and role of this committee were examined, some might say it needs some improvement. That is what happened in this case. It is possible that certain personalities clashed too much. As I was saying, we will address this issue. Furthermore, it has already been brought before the board of directors. I think people will be quite pleased.

I think it is important to realize, Mrs. Barbot, that notwithstanding this personality conflict, CNFS's achievements far surpass the objectives that had been set. It is a model that works and works very well. True training partnerships were developed with the regions, the Collège universitaire de Saint-Boniface, the Acadian regions and the institutions of British Columbia. Some 10 institutions will work together to train nurses, physiotherapists, occupational therapists and even doctors, in the case of New Brunswick.

At the University of Ottawa, where I manage 34,000 students, I find this type of collaboration within the framework of the CNFS, but not in the rest of the university. I think we can be very proud of that. The Government of Canada can also be very proud of initiating this network of institutions, which benefits from partnership and collaboration. I find this quite extraordinary.

[The Chair, Conservative, Guy Lauzon]

Thank you Mrs. Barbot and Mr. Patry.

Mr. Godin now has the floor.

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

Thank you Mr. Chairman.

Welcome Mr. Patry.

As far as the $63 million over five years is concerned, I would like to know how the results are checked after the projects have been approved and the money distributed. What kind of follow-up is assured in terms of managing the projects and the money? Certainly it is not just a matter of a report given over the phone.

[Gilles Patry]

That is my heartfelt appeal to you.

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

We will take care of it.

[Gilles Patry]

We have to ensure the sustainability of this program. We cannot allow this program to end in 2008.

The program already has several students involved in it. Some students are taking this program this year—in medicine, nursing, in all disciplines—others will register for it next year. They will be in the middle of training. We have to ensure the sustainability of this program. It has to continue to expand and increase its capacity.

It would be disastrous if this program ended in 2008. We would be back at square one. I think it is essential that this program continues.

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

That is one of the problems.

Usually there are joint federal and provincial programs full of good ideas. There are programs, the federal government announces assistance, it implements these programs, but after three to five years, as planned, the government changes direction, says it did its part and that the establishment or institution must now do its part alone because the government is pulling out.

We have seen these types of projects implemented so often and at the end of the pilot project, the governments withdraw and leave people empty handed. People show up on a Friday wondering whether the funding needed to pay expenses and other things will arrive.

I understand your heartfelt appeal because this same thing happened again just a few weeks ago in some health programs. In the same week, the associations phoned us to say that they had not received their money from the government. They wondered if they would have to start laying people off on the Friday.

No one can work with such uncertainty.

[Gilles Patry]

That is why we worked together with Health Canada and made sure—perhaps there are some Health Canada representatives here—that this was a permanent program, that it was a program without end. That is the first point.

The second point is that we have to continue to develop this training capacity. We are at the beginning stages in terms of training health professionals in minority situations. Training in minority situations is a responsibility of the federal government. The federal government has a responsibility to help these communities.

I would like to describe the role the University of Ottawa has played in the first two phases of the CNFS project. This might change somewhat in the third phase, but during the first two phases, the role of the University of Ottawa was simply to train health professionals, not for Ontario, which is a province where the Francophonie is a minority and needs as much investment as the other provinces, but for the rest of the regions of Canada.

We helped train nurses at the Collège universitaire de Saint-Boniface. There is a program in cooperation with the college that allows courses to be given at the college itself. I would not ask the Government of Ontario to pay to train nurses at the Collège universitaire de Saint-Boniface through the University of Ottawa. It is the role of the federal government to support these Francophone minority communities.

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

Is there a lack of clientele? When I say clientele I mean those who want to become nurses or doctors. Are there enough people? Has the university done studies to determine roughly how many doctors New Brunswick needs? Three or four Francophone hospitals have just closed. How many doctors are needed to reopen these hospitals? The reason cited for the closure was a lack of doctors and nurses.

I know some men and women who wanted to become nurses, but there were no spots available. They want to go to college or university, but there is no room. It is not clientele that is lacking, because there are enough people who want to register. Has a study been done by the university for each province to get these people out of the hallways? As I was saying in the House last week, our grandfathers are in the hallways, children are in the hallways, and most of the time—

[Gilles Patry]

You are absolutely right, Mr. Godin. In fact, a few studies have been done.

In 2001, the Consultative Committee for French-Speaking Minority Communities established the grounds for an assessment of health needs. That is how Phase II came to be. The needs were so critical that the government truly supported this initiative.

You alluded to that which we are trying to address. Students want to study nursing in the regions and cannot be admitted to the programs. They cannot even travel because the capacity to accept them is not there. Even with additional resources, I could not accept 1,000 or 500 more students at the University of Ottawa next year, especially if I am training them to go back to New Brunswick. The capacity for training needs to be increased and that is the objective of the CNFS project.

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

I will speak to you again during the next round.

[The Chair, Conservative, Guy Lauzon]

Thank you Mr. Godin and Mr. Patry.

I call on Mr. Petit to ask the fourth question.

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

Thank you.

Good morning, Mr. President. First I want to thank you for being here. I read your curriculum vitae; it is quite impressive.

I would like to draw your attention to the following: you are a university president and you work in the private sector as far as I can tell, and you are a member of several boards of directors, including that of the Cardiology Institute at the University of Ottawa, the Ontario Research and Innovation Council, a centre of excellence of Ontario, and the National Research Council of Canada, which makes you a sort of expert in boards of directors.

You are also a University of Ottawa alumni—you are an Ottawa student—and you became the president, which is quite rare. At the Université Laval, in Quebec City, this does not happen often.

I myself have benefited or, at least, my children have benefited, in Alberta, from the education offered at the Collège Saint-Jean. The Collège Saint-Jean—as you know—is a Francophone institution. My children are Franco-Albertans, even though I am from Quebec. They attended this college, which is now associated with the Consortium national de formation en santé.

I know that as president you manage millions of dollars—among other things—and I know that the University of Ottawa is showing leadership within the Franco-Ontarian community. What I want to know is when you are allocated millions of dollars—and you know the Conservative Party has a tendency to focus on financial responsibility and that we still have not managed to pass our bill, which is being held up in the Senate by the Liberals—what mechanisms allow you to ensure that the money invested—some millions of dollars—is managed effectively? I gave you examples that I have, but the rest I do not know.

[Gilles Patry]

Thank you Mr. Petit for this question.

If there is one thing the CNFS is very proud of it is its achievements. We were committed to training a certain number of students, and, as you could see in my presentation, we greatly surpassed this objective.

What I would like is perhaps to do another presentation for the government to say that if subsidies are linked to financial responsibility, then it owes us money. We have trained more students, in fact 30% to 40% more, then we set out to do. There is a responsibility—and I totally agree with this concept within universities—to ensure that the money received from the federal government, which comes from taxpayers, is well spent and that we can present concrete projects in return for the money we are given.

That is why we proceeded with this evaluation exercise midway through Phase II of the health research and training project. I must say that out of a number of our projects that received provincial or federal funding, this is perhaps the only one that does not get questioned about its success and accomplishments.

The member institutions of the consortium reached individual contribution agreements and that is important. Each institution reached a contribution agreement with the Department of Health. The University of Ottawa committed to training a certain number of health professionals, doctors, nurses, physiotherapists and occupational therapists to serve linguistic minority regions. This commitment is included in a contract signed with Health Canada.

The Université de Moncton, the Collège Saint-Jean, the Collège universitaire de Saint-Boniface, the Cité collégiale, Boreal College and Laurentian University all did the same thing: they all signed contribution agreements. Each of these institutions signed a contribution agreement with Health Canada, which includes a direct responsibility. Each institution has a responsibility to Health Canada. If this works well, Health Canada will cut us a cheque; if it does not work well, Health Canada will sound the alarm and tell us that something is not working or that it does not entirely understand what we are doing.

I can tell you that this approach works quite well. As they say, I'm all for accountability. I totally agree with this concept of responsibility found much more in the private sector, but with which universities also agree and can very well adapt to.

[The Chair, Conservative, Guy Lauzon]

Thank you Mr. Petit and Mr. Patry.

Mr. Jean-Claude D'Amours now has the floor.

[Jean-Claude D'Amours, Liberal, Madawaska—Restigouche, NB]

Thank you Mr. Chairman.

Mr. Patry, I will first address some of the comments you just made.

The accountability process you refer to does not date to 2006. It was underway well before that. It was the work of the previous government that made sure these rules were applied. Furthermore, I am pleased to hear you say that the system is working very well.

I would also like to mention this. We want to make sure that health training services are available. I too am from New Brunswick. In fact, three hon. members on this side are. It is quite pleasant. We understand full well the reality of official language minority communities living in small rural communities. In Edmunston, my home town, there is a Université de Moncton campus. It has a section dedicated specifically to nursing training.

As far as I can tell, you did more with less. You offered more training than planned with the money you received, which is very good. The fact remains that in our rural communities it is still very difficult to meet the minimum needs in manpower. In reality, we are talking more about maintaining manpower. The entire baby boomer effect will catch up with us shortly. Many members of my family, for example, work in health care. Not too long from now, the health care situation will become shaky.

It is good to train people, but are we able to train enough? If you tell me we could train more, that means the federal government should keep its promises and commit more funding to postsecondary education. Perhaps then we would manage to make up for the shortfall that is just around the corner.

[Gilles Patry]

You have before you a university president. I am not going to tell you that federal transfers would not be welcome. I think that in the provinces, the need is critical in terms of postsecondary training. Obviously these transfers would quite welcome.

To come back to your question on health training, I would say that this bill allows you to kill two birds with one stone. We are talking here about training health professionals. We know that in almost all health disciplines need is critical. At the CNFS, we have made a special effort to target front-line services. When a person is sick, they are sick in their language. I am quite fluent in English and French; I am bilingual. Nevertheless, a number of years ago, when I ended up in an emergency room where services were available in English, I was unable to express myself in that language even though I am quite fluent in it.

As I was saying, this allows you to kill two birds with one stone: first, we will be able to train more professionals for Canada and also we will be able to train them to serve Francophone minority communities. Everyone wins in this situation. There is no need to question the validity of this project. I think that the accommodation capacity of our institutions will be sufficient if we encourage them to work together.

We do not want to set up a program in medicine at the Collège universitaire de Saint-Boniface. Similarly, we do not necessarily want to create a physiotherapy program at the Collège Saint-Jean. What we want is to work in partnership with these institutions. It may be that some of them are equipped and able to provide distance education. I have not talked about that aspect, but, in fact, distance education is one of the main objectives of the consortium.

It is a matter of distributing courses across Canada through videoconferencing. In the framework of the Association des universités de la francophonie canadienne, or AUFC, in other words all Francophone universities outside Quebec, the University of Ottawa is the bridge to serving 90 sites across the country through videoconferences. This project has been funded by the federal government, by Heritage Canada, over the years. It is another project of which you can be very proud. It allows us to come into contact with all the regions, including Nunavut and the territories.

I think that by investing in this project, we will allow the training capacity of the regions to continue to expand and for partnerships to be established with these communities. In my opinion, everyone wins.

[The Chair, Conservative, Guy Lauzon]

Thank you Mr. Patry and Mr. D'Amours.

Mr. Lemieux will ask the next question. You have seven minutes.