Some of the challenges deal with the fact that when you immigrate, you generate a gap because you were trained by your educational institution back in your country of origin, and these institutions train for their country.
There are differences, cultural differences, in the way things are organized. The health services are different. The protocol and the technology used in some countries are different. The way to interact with the client is different. When you're in the health system, the way to interact with pain is a cultural aspect, and the training you receive sometimes is not the training adapted to the reality in Quebec, in Canada, in North America.
There are some gaps, and people are not looking for gaps; they are looking for things that can be recognized. If it's knowledge, everybody is trained with knowledge in a reasonably equivalent way--when you deal with science, it is science. But whenever you deal with some aspect of the way to apply science, the way to interact with the client or with other professionals, the ethics, the way things are organized, then.... And also there's language. It's even important in Ontario because you're facing a situation in which people come and they don't know enough English to be able to practise. Communication in professional relations with a client is at the basis of knowing the needs, then expressing what's being offered as services, then having the consent, and then acting upon it. If you cannot even understand the question in an exam, how can you prove that you have the qualifications and then after that practise? All these things come into play for one person.
The gap is made of two shores. It's like a river. We're responsible for part of it because we've been here for a few hundred years, establishing things--standards, ways to intervene, ways to practice--based on the level of technology we can pay for. Sometimes we don't have the money, but we think we have the money for it so we have a good health system. But for somebody coming from abroad, depending on the country, there will be gaps.
Coming from Ontario, it's a minor gap. Coming from the U.S., then, whoops, it's a larger gap. And when you come from some countries in Africa.... But even in Africa, when you're coming from a Commonwealth country, you can relate to the education system because they kept the British education system in a way. Even in the former French colonies, they kept part of the French education system. If you can relate to the French education system, you can adapt.
So each time it's a challenge, and depending on the immigration wave you receive--from Southeast Asia, from the Eastern bloc countries, or northern Africa--new challenges are coming. And the challenges are getting the information for the immigrant and about the immigrant and the country of origin to make the necessary equivalencies.
Then you need to have efficient tools. Efficient means affordable but also reliable, because we're issuing a permit to act on things that carry risk of harm many times. People are saying, in their institutions in Quebec and in other jurisdictions, when you're issuing a permit, we have confidence in the permit you're issuing, so make sure we face someone who will manage the risk in a reasonable way.
This kind of information, these kinds of tools.... When calling for qualifications recognition, a lot of people are saying, look at the person instead of the papers. Yes, fine, but how? It has to be reliable. A lot of people who are saying we should look at the person and have the necessary tools to evaluate their work experience don't have a clue about the tools available. We did a survey of the tools. There are not so many, and this is why the Quebec government put aside some money to develop tools that are efficient.
It should not be a two-year process to get recognized, but a shorter time with some gap training that is available.
You're not consistent with your officials, say, and the government. You say we will open the doors to immigrants, but at the same time your education system is not on board to provide the gap training. Then the immigrant says you told him he needs that training, and he recognizes that; he knows that in his country he wasn't trained for it, but where does he get the training? Your education system is saying he doesn't have this, so he has to redo all of it. No, that's unreasonable.
This is why, in the November 2005 report of the task force that I was appointed to by the Quebec government, there are all these little things. Forget the big speeches, the big emotions about immigration or whatever; we are way beyond that. We are looking at the tiny problems that make the process a real pain for everybody.