Official Languages Committee on Oct. 17th, 2006

[Jean-Pierre Corbeil]

Yes. All of the francophones living outside Quebec whose mother tongue is French, as well as those whose first spoken language is French—often allophone immigrants—are included in the sample.

Questions are asked about migration, in other words, where were these people living five years earlier, why did the move, et cetera. That is the type of questions that we ask. It is certainly an important point to consider. At census time, even though none of the questions deals with health, we are nevertheless able to obtain a wealth of information on the mobility of Quebecers outside Quebec. We can determine where they come from, where they were born, where they lived one year ago or five years ago. So the information is available.

I would agree that there has been a great deal of mobility. Between 1996 and 2001, the number of francophones outside Quebec has increased by almost 10 000, and most of them came from that province.

This is a reality that must definitely be taken into account, particularly when things appear to be going well, since there has been a growth in the number of francophones living outside Quebec. We know that large number of them have moved, mostly to Alberta and, to a lesser extend, to British Columbia.

I know some people who work in French at the Société Santé. Migration is an important issue that must be addressed.

For example, professionals who leave Ontario to work in Quebec often have a higher socio-economic status than those who do not migrate. This point must be taken into account when analyzing health requirements.

In many provinces, but not Quebec, francophones are much older. In Saskatchewan, the number of people over the age of 65 is four times greater than those who are 15 years of age. That is a very different reality when it comes to providing health care.

[Le président, Conservative, Guy Lauzon]

You have ninety seconds left.

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

I would like to ask one last question.

A little earlier, M. Godin asked you about something that I have often wondered about myself. I am not familiar with the questionnaire, so I might repeat an aspect that you have already measured. My question might seem a little strange. You have already answered it, but I would like to hear you again.

When a francophone is asked about health care services, he might say that, if necessary, he would be prepared to seek cancer treatment in an anglophone setting. In Quebec, for example, a number of patients were sent to the United States for cancer treatment, because the Quebec hospitals could not keep up with the demand. That is not unlike what happens to francophones in other provinces. If the demand for health services in French cannot be met, what will the francophone patients do? They will seek treatment in English, whether or not they speak the language. When you have cancer, you want to be treated as quickly as possible.

Is that something that you may have taken into account in doing your health care survey? I find it interesting. When you are sick, all we want is to get well, and language takes a back seat.

[The Chair, Conservative, Guy Lauzon]

A very brief answer, Mr. Corbeil.

[Jean-Pierre Corbeil]

It is an important issue. A number of people, including the late Roger Bernard, have studied the development of a bilingual identity. This is an emerging trend in Quebec. More often now, when people are asked why they did not request services in French, they say that they are bilingual.

We want to understand why they do not have access to these services and why they do not request them. Has this bilingual identity or the tendency to downplay the importance of services in French become widespread?

This is something that must be considered if we want to understand the dynamic and the issue of supply and demand for French language services outside Quebec.

[The Chair, Conservative, Guy Lauzon]

Thank you, Mr. Corbeil.

We will now begin the second five-minute round with Mr. D'Amours.

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

Thank you, Mr. Chairman.

Thank you for coming this morning, Mr. Corbeil and Mr. Hamel.

I have two questions, one that you raised or something that you touched upon earlier, namely, services.

We are not talking about immigrants but about citizens who already live in Canada and who move from one location to another or about people like myself, who may come from New Brunswick but who, for other reasons, may look elsewhere for treatment. When the language of work is English — for example, in a hospital where employees can provide service in French but who work in English and who may converse in English when treating patients — do you think that maybe bilingual francophones are a little shy about asking to be treated in French?

[Jean-Pierre Corbeil]

There is an important consideration, namely, the active offer of services in French. You have no doubt been to places where there is a little sign that says: English-French. Your instinctive reaction is to ask the young lady behind the counter if you can be served in French or if she speaks French. If there is no sign, or if you are in an anglophone neighbourhood, you will most likely not even bother asking the question. So the active offer of services must be taken into account.

With respect to our survey, we do ask people if the offer was made to them to be served in their own language or if they had to ask for it, and if they did not ask, then why not?

I believe that it does indeed happen. When you go to the hospital, you are more worried about your health than you are about demanding language rights. That is an important part of the equation.

I will draw a quick comparison. Every year, 300,000 young anglophones come out of French immersion schools or are enrolled in immersion programs. These young people leave school without having an opportunity to speak French and they lose it. There are also francophones who feel that, in any case, they will not speak French because they are surrounded by anglophones. Communication is lacking and one group does not realize that the other group can speak the language.

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

Now I would like to address immigration and immigrants.

As you said earlier, one third of the population of New Brunswick is francophone, but most of those francophones live in a rural setting. When it comes to health care, it is always a challenge to attract professionals to work in remote areas. We had a group of witnesses a few weeks ago and I asked them about the expectations of health professionals; they will be getting back to me on that. How do you attract them to rural francophone areas and how do you get them to stay?

I believe that you said, earlier, that 1 per cent of francophone immigrants settle outside Quebec. That is a low number. In light of your studies, do you think that is because they are afraid that they wont receive the services they require in their own language? Perhaps they are unilingual francophones who decide against considering other provinces to settle in because of concerns about receiving services in their own language. So they chose Quebec, a region that is universally recognized as being French, which is not the case for other provinces.

There are still people in Canada who don't understand that one third of the population of New Brunswick is French-speaking. During my first term as a member here in Ottawa, even fellow parliamentarians expressed surprise that I spoke French since I came from New Brunswick. People are often unaware of that fact. And if parliamentarians don't know, then I imagine there are others who are equally ignorant of that fact.

So do you think there might be a relationship between this misconception and the low 1 per cent immigration rate?

[The Chair, Conservative, Guy Lauzon]

Once again, Mr. Corbeil, I would ask you to be brief.

[Jean-Pierre Corbeil]

There is an ongoing debate, and a great deal of interests in regionalizing immigration. Most immigrants are concentrated in urban centres and they are being encouraged to move out into the regions. This has been going on now for 25 or 30 years. There have been successes, but there have also been failures. If you can understand why immigrants settle in large urban centres, then you will have gone a long way towards answering the question.

There are many factors to explain this phenomenon, and I will venture my own theory on the matter. A number of bilingual immigrants belong to what we can call our pool of francophone immigrants. These people are often surprised to see that almost everything is done in English. There are also a number of unilingual francophone immigrant who are encouraged to settle in communities but who realize that they can't function because they don't speak English. These are undoubtedly some of the factors that would cause unilingual francophone immigrants to chose homogeneous francophone areas to settle in.

[The Chair, Conservative, Guy Lauzon]

Thank you.

Mr. Lemieux will ask the next question.

[Pierre Lemieux, Conservative, Glengarry—Prescott—Russell, ON]

Thank you very much.

You have helped us to understand various aspects relating to the health of populations. Last March and April, Decima Research did a study for the Department of Canadian Heritage. When asked about access to health services, 60 per cent of anglophone and 42 per cent of francophone living in minority language communities stated that access had either improve or had remain the same in recent years.

In my opinion, there is the difference between the degree of satisfaction and the effect on one's health. The real effect is important. When you see a doctor, you have to be able to understand and follow his advice. You must also do whatever it takes to get better.

Have you any comments on the difference between the level of satisfaction with health services and the real effect on health? Has the question ever been asked?

[Jean-Pierre Corbeil]

We do, of course, usually ask a question relating to health. The Canadian Community Health Survey, which I mentioned earlier, includes a number of health indicators. I believe there are about 120 or 130.

[Marc Hamel, Assistant Director, Population Health Surveys, Health Statistics Division, Statistics Canada]

There are more, but this survey also includes satisfaction indicators. Satisfaction does not necessarily depend on services that are received. We take measurements based on general opinions. Some people base their opinion on what they read or heard, whereas others base theirs on a real personal experience. Generally, when we measured the level of satisfaction with respect to health care services received, it amounted to approximately 75 per cent. I did not however do a language breakdown of these figures.

[Pierre Lemieux, Conservative, Glengarry—Prescott—Russell, ON]

Were people afraid they may not understand what was going on in the doctor's office and did they suffer from that? Wanting to receive health care services in one's own language is one thing, which I understand, but suffering certain outcomes due to that is another.

[Jean-Pierre Corbeil]

As everybody knows, the situation for anglophones in Quebec is far different than that outside Quebec, for a number of reasons. Clearly francophones outside Quebec are far older and more likely to need health care. Far more francophone seniors are unilingual. For these people the stress or concerns associated with the need to be understood and receive services in one's own language is far greater than for anglophones in Quebec, who have an easier access to English health care services.

There is also the issue of community networks. I know they are much more developed among Quebec anglophones than francophones outside Quebec. The Post-censal survey on the Vitality of the Official Language Minorities asked whether respondents have health problems and who they turn to, apart from their doctors or health care professionals. We noticed, in past studies, that Quebec anglophones make greater use of family networks and personal networks than do francophones outside Quebec. The reality is significantly different for these two groups.

When it comes to fear or anxiety surrounding the ability to receive services in one's own language, we do not have a survey like the one that exists for anglophones in Quebec, but we can assume that if the issue is intimately related to the availability of services in one's own language, it is less of a problem in Quebec than outside Quebec.

[Pierre Lemieux, Conservative, Glengarry—Prescott—Russell, ON]

Thank you.

[The Chair, Conservative, Guy Lauzon]

Ms. Brunelle will be asking the next question.

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

Hello gentlemen, thank you for your attendance here this morning.

When we think about the relationship between health status and language, we visualize a sick person or someone who is in crisis. In these cases, it can be very difficult for a person to describe what is wrong and especially to understand what is going on. People who are really sick sometimes find they cannot understand what is happening to them. They go into a state of panick. Health is also related to prevention and daily check-ups.

Are you able to establish a correlation between a general state of health and the language in which medical treatment is provided?

[Jean-Pierre Corbeil]

It is a bit difficult, but there is some rather innovative work currently underway. The U.S., over the last few years, created what is referred to as the Literacy and Health in America Index. The International Adult Literacy Survey measures adult skills. It is a literacy test and people are asked to answer a number of questions, some directly related to health, namely the request for services, the issues of prevention and awareness. The results of this survey revealed that francophones fare far worse than others and are at risk. If people have less schooling and are less literate, their self-confidence is lessened, they also have a lesser sense of being able to understand what is happening to them when they are sick and what to do.

The literacy survey asks very elaborate questions. It is kind of like an exam which includes essay-type questions where people are asked to understand some information and use it in order to obtain answers. The issue of knowledge, the way in which to request health services, the issue of awareness and steps to take, are all major aspects of the survey and research has shown that francophones are far more vulnerable in this respect than anglophones.

The situation in Quebec is remarkable. We know where the anglophone population in Quebec stands, they have done very well on these tests. They are the population with the highest level of schooling among anglophone communities in Canada. The situation is clearly completely different, the problems are completely different as well.

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

I have another question.

In your presentation, the second chart shows the proportion of immigrants whose first official spoken language was French in 1996, and then in 2001. I see an increase in the number of immigrants to Quebec for whom French is the first spoken official language.

We know that Quebec has an immigration policy with respect to the number of immigrants it receives. For years, we asked to have francophone immigrants or immigrants who could become francophones. These are people who come from countries where the second language may be French.

Is the rise in the number of people whose first official language is French due to these Quebec policies, or to the higher birth rate amongst immigrants?

[Jean-Pierre Corbeil]

With respect to birth rate among immigrants, upon their arrival, they often have a higher fertility rate than other Canadians. But over time as they settle in, a balance is created and the significant gap between immigrant populations and others no longer exists.

To answer your question, when we look at census figures on language use among immigrants, it is clear that the source countries for immigration have had an effect.

For instance, when you compare the geographical origins of immigrants settling outside Quebec with those of immigrants settling in Quebec, you see two completely different pictures. Of course, there are still many immigrants from China and Asia in Quebec, but it is not comparable to the situation in Toronto, for instance and Vancouver.

In Quebec, we have noted that many immigrants comes from the Middle East, North Africa, Haiti and France. They already have a tendency to use French before they arrive in the country. Because of Quebec language laws, children are sent to French schools, so, there is already a process underway with respect to the use of the French-language at home and the public space. So, clearly the geographical origin of immigrants does have an effect on the ease with which they turn to French or not.

There has been an attempt in some minority communities outside Quebec to have francophone African immigrants settle there, who only spoke French. Obviously, that does improve their ability to integrate into the society but, on the other hand, if they don't know English, they are limited, for the reasons we all know.

[The Chair, Conservative, Guy Lauzon]

Thank you, Mr. Corbeil and Ms. Brunelle.

The last questioner on this round will be Mr. Godin.

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

Thank, Mr. Chairman.

I have a question about the statistics compiled for regions outside Quebec only. I will take New Brunswick as an example, but I think my comments could apply to any other province.

I know that you think that the situation is different in New Brunswick because one third of the population is French speaking. Did these studies focus on the regions, or did they cover the entire province? I will explain what I mean.

There are some francophone villages like Tracadie and Caraquet. However, I know there are doctors in those villages who do not speak French at all. Were any studies done in the Bathurst region, where 80 per cent of the population is francophone?

I am going to mention the example of the former Minister of Health in Mr. Bernard Lord's Government who said—and this disturbed me—that if he were ill, it would not brother him to go to a hospital where only French or only English were spoken, provided he received care. He is lucky to speak both languages. However, the poor individual who is ill and speaks only French would not be able to explain his problem to the doctor. He would be in a bad way if they take out his spleen rather than his ruptured or inflamed appendix.