Official Languages Committee on Oct. 26th, 2006

[The Chair, Conservative, Guy Lauzon]

Good day, ladies and gentlemen.

Welcome to the Standing Committee on Official Languages. This morning, we are welcoming witnesses from Health Canada: Mr. Marcel Nouvet, Assistant Deputy Minister, and Mr. Roger Farley, Executive Director.

As I have explained, Mr. Nouvet, following your presentation, between five and ten minutes in length, the Committee members will ask you some questions. You can start when you wish.

[Marcel Nouvet, Assistant Deputy Minister, Health Canada]

Thank you, Mr. Chairman.

Good day to Committee members. I will be as brief as I can because I know that the questions are the most important part of the process for you.

I would like nevertheless like to use this opportunity to give you a brief overview of the work done by Health Canada in the field of official languages and for the minority communities. You have the presentation in front of you, but I would like to highlight certain aspects of it.

At Health Canada, we are exceedingly proud of our work with the communities. We are proud of the successes the communities have achieved to this point thanks to the funding we have provided, and we are proud of the results we are gradually seeing. We are also extremely proud of our approach to governance, ie, allowing the communities and the organizations that represent them to manage the funds allocated to them.

Furthermore, the Commissioner of Official Languages, in his last two reports, has highlighted the work done by Health Canada under Part VII of the Official Languages Act.

Moving to page two of the presentation,

we're just going to give you the context of Health Canada's efforts in support of official languages minority communities, and we're going to outline the results to date and future steps.

Page three deals with Health Canada’s responsibilities under the Official Languages Act: these are divided into two components.

As regards the internal component, it is our job to deal with the issue of institutional bilingualism; to ensure that English and French are being spoken in the workplace; and to ensure that each language has a significant number of representatives within the various groups. This component therefore relates to participation in the workplace.

Under Part VII of the OLA, we are required to encourage the growth and vitality of official language minority communities and it is this latter component that I will focus on in my speech to you today.

I will move now to page 4. In the year 2000, Health Canada was, I believe, the first department to create advisory communities with representatives from the Francophone and Anglophone communities. These committees offer advice to the Federal Health Minister on means of enhancing the vitality of the language communities; at Health Canada, the representatives are selected based on their expertise in this area rather than their affiliation with an organization.

I’ll now go to pages 5 and 6. What have the Committees told us since 2000? They have tabled reports. Based on these reports and on studies that have been done, it is clear that the minority language communities do not have the same access to health care services as people who speak the majority language in the broader community. And most certainly there is a shortage of health professionals who are capable of working with them in their own language.

I’ll now move to page 6. Both communities have made recommendations that move in the same direction. They are seeking funding based on five main elements: community networks; training and human resources development; service delivery models, ie, pilot projects to demonstrate how services can be improved; research; and technology. The Minister of Health received these reports from the Francophones in September 2001 and from the Anglophones in July 2002.

As a result of negotiations with the Anglophone and Francophone communities, financial support totalling $129 million has been allocated, broken down over five years and in three priority sectors. There is funding to cover the cost of creating and operating the community networks. There is support provided for training and retention. There is an error on this page. We refer here to training and the maintenance of language skills, but we should really be talking about the training and retention of health professionals. In Quebec, we tend to focus more on language training. And money has also been allocated to find ways of improving access to primary health care.

I will move now to page 8. On the issue of governance, I have told you that we are very proud of our accomplishments. We are making every effort to leave the governance and the management of these funds to the organizations created to administer the programs. These organizations stand outside the government.

The official language minority communities depend on the Société Santé en français and the Consortium national de formation en santé. I think you heard earlier testimony from Hubert Gauthier, for the Société Santé en français, and Andrée Lortie, for the Consortium national de formation en santé.

The English minority communities have been organized through the

Community Health and Social Services Network, the Quebec Community Groups Network, and McGill University.

We are proud of the results we have achieved thus far. Seventeen networks have been created outside Quebec to represent the French language minority communities. To serve the Anglophone community, a provincial health network, ie, throughout the province of Quebec, plus nine regional and local networks covering the entire province have been created. These networks make it possible to create close links among the regional organizations, the service providers and the provincial and territorial authorities. It is vital that we ensure the participation of the provinces and territories because health falls under their authority and it is important that they support the efforts that are being made. Partnerships are currently being formalized for the purpose of ensuring their long-term viability.

Results thus far.

With respect to the training and learning retention initiatives for French language minority communities, as you are aware, 10 universities and colleges are participating in the recruitment program and are promoting healthcare programs for Francophones. In fact, they are exceeding expectations by 33 per cent in terms of enrolments and by 32 per cent in terms of graduates. Thus, they are delivering much more than we had counted on. New programs have been developed and delivered, including on-line distance courses in French, continuing education courses to upgrade the skills of currently employed health professionals, and new post-secondary training programs in French.

We have seen a tripling of the enrolment rate of enrolment for health courses in French. The long-term impact of an increased number of students in the system will only known once the graduates have begun to work. The aim of these initiatives is to significantly increase the number of graduates and ultimately improve the access of people in minority communities to health care. We are focusing on developing our capabilities and research.

Anglophones.

McGill University is the lead organization and is working with the 76 health organizations in the province of Quebec. Anglophones are currently developing initiatives to recruit and retain Anglophone health personnel in the province of Quebec. Huge efforts are being made to help professionals acquire a second language. Anglophones are learning a bit more French, and Francophones are learning a bit more English, which will help them treat English-speaking patients.

With respect to primary care, 70 projects have been funded by Francophone communities to date. Some examples are offered on page 12. In the province of Quebec, 37 Anglophone projects have been funded; some examples are provided on page 12 of our presentation. All these projects are designed in a manner that will improve access, accountability and the integration of services with provincial and territorial services.

Our perspectives.

A formal evaluation of these investments is planned for early next year. Based on this evaluation, we will be able to provide governments with the advice they certainly want from us.

I am now ready to take your questions.

[Le président, Conservative, Guy Lauzon]

Thank you very much, Mr. Nouvet. I appreciate your brevity. Time is an extremely important commodity for us

Mr. Bélanger.

[Mauril Bélanger, Liberal, Ottawa—Vanier, ON]

Thank you, Mr. Chairman.

Mr. Nouvet, allow me to congratulate you, and Health Canada, for the fine work you have done over the past few years. You indicate how proud you are and you have every reason to feel that way. I have been following these issues very carefully. Of all the departments affected by the elements in the action plan, Health Canada has probably made the most progress.

As you pointed out, you were the first department to create a—

[Marcel Nouvet]

No, I don’t believe so.

[Mauril Bélanger, Liberal, Ottawa—Vanier, ON]

I think that you might check with the people from Human Resources. I think that they created a Joint Advisory Committee before Health Canada. I’m only stating that to ensure that the testimony is accurate.

Monsieur Nouvet, I would like to ask you a question on funding. I think that you can tell what I’m going to say. If I’m not mistaken, of the three funding components, one expired before the others.

Am I right? Can you tell us which one?

[Marcel Nouvet]

It was the primary care component.

[Mauril Bélanger, Liberal, Ottawa—Vanier, ON]

Is it because it was funded from another envelope?

[Marcel Nouvet]

It was dependent on another program, which expired at the end of the last fiscal year.

[Mauril Bélanger, Liberal, Ottawa—Vanier, ON]

That’s it. If I’m not mistaken, a one year extension, with $10 million in funding, was announced last fall. Am I right? The community, including Société Santé en français, was hoping for a second extension for FY 2007-2008. Am I right?

[Marcel Nouvet]

Yes.

[Mauril Bélanger, Liberal, Ottawa—Vanier, ON]

Can you tell us where the missing funding is for this year?

[Marcel Nouvet]

Are you referring to next year?

[Mauril Bélanger, Liberal, Ottawa—Vanier, ON]

Yes, I’m talking about next year. I think that the money for this has finally been distributed and that the projects were authorized a week or two ago. It was very recent, I believe.

Can you tell us where the missing money is, because we have to provide for bridge funding for another year. Where are the $10 million earmarked for primary care for FY 2007-2008, before the action plan is renewed?

[Marcel Nouvet]

First of all, I would just like to say that our priority at this time is to ensure that the funds we’ve just allocated for this fiscal year are distributed as quickly as possible, and we’re doing just that right now. We haven’t done this work for the coming year. I think that the representatives of the communities are seeking interviews with the minister and senior civil servants.

At the present time, we don’t have a plan for renewing our funding for the coming year. I would add that this past year, when we decided to allocate funds for this year, we announced the decision in November. Right?

[Mauril Bélanger, Liberal, Ottawa—Vanier, ON]

It was around this time of year, yes.

If I understand the internal administrative and financial regulations, it was defined as a sunset program, and sunset programs can only be renewed one year at a time. Am I right? The government’s intent, at that time—and I can speak with some knowledge because I was—was therefore to renew this $10 million envelope twice: once, as was done for the current fiscal year, and a second time for FY 2007-2008. At that time, we were hoping to include this money in the five-year renewal of the Action Plan for Official Languages, which was scheduled for 2008, to ensure that there would be no more breaks in funding and to allow the communities to do their planning.

Mr. Chairman, I feel a little ill at ease because I’m replacing Mr. D'Amours in this forum. But I am certain that if I spoke to him and to other members of the Committee the Committee might agree to adopt a motion encouraging the government to renew this $10 million envelope for FY 2007-2008.

I is my opinion, Mr. Chairman, that there may be a motion to that effect, so that these communities can plan their activities effectively.

Mr. Nouvet, can you tell us how the Department plans to proceed with this renewal? Is this a Departmental initiative? Does it have to come from outside?

[Marcel Nouvet]

We have no plans at this moment to renew our funding for the coming year. Our role is to advise the Minister at the proper time and then implement the decisions taken.

[Mauril Bélanger, Liberal, Ottawa—Vanier, ON]

Mr. Nouvet, I’m somewhat perplexed because you say that the Department has no plan…when in fact there was one. Last year, your plan was to seek renewal in two stages. Has that changed?

[Marcel Nouvet]

To speak frankly, last year there were indications that there were plans to renew the funding for the following year. What I understood, what was hinted at, was that the following year we would take another look at the funding for the fifth and final year. Last year, our department focused on allocating $10 million additional for the fourth year of the program, ie, the current year.

[Mauril Bélanger, Liberal, Ottawa—Vanier, ON]

We’d have to take another look, but I don’t know if these documents are still available. Since the regulations stipulate that sunset programs can only be renewed one year at a time, your intention at that time was to seek renewal in two stages and then to include this in the action plan. So I will now speak about the renewal of the action plan after FY 2007-2008.

Is it the intention of the Department to include, in this renewal, the funding needed for this third component, ie, primary health care?

[Marcel Nouvet]

For the renewal to start on April 1, 2008 anything is possible, because we’re going to conduct an evaluation. Under these circumstances, following the evaluation we plan to do and given the concrete findings we will obtain, I think that we will have options for continuing and improving the program and other options that the government will be able to consider.

[Mauril Bélanger, Liberal, Ottawa—Vanier, ON]

Thank you, Mr. Chairman.

[Le président, Conservative, Guy Lauzon]

Thank you very much, Mr. Bélanger.

Ms. Barbot.

[Vivian Barbot, Bloc, Papineau, QC]

Thank you for coming here today.

I’ll begin with one comment. In your references to what is happening in the so-called minority Anglophone community in the province of Quebec, one notes a huge disparity between the situation faced by the latter community and the Francophone community outside Quebec. This issue is not addressed anywhere in the report. I think, however, that this would offer an interesting point of comparison because this situation is found both in the networks and in the projects being proposed. So it would have been interesting to know, given an equal population, what this means. I know well that there are regional disparities faced by the more remote regions, but I don’t feel this is an element which offers a real insight into the situation of Anglophones vs that of Francophones. This may be applicable to other situations and help us make decisions.

More specifically, page 5 of your report refers to what the communities have said on this issue. You note that this report on French language minority communities demonstrated, first of all, the following:

There are major regional differences, but as a rule French language minority populations are poorer than the Anglophone majority population.

In regard to the English language minority communities, you say:

There are major differences with respect to Anglophone access to services in the various regions of Quebec: specific local initiatives are needed.

In other words, you do not provide the same information for the two communities.

I would like to know, therefore, what can be said on the issue of equivalency. What

And on the latter point you say that:

Unaffiliated physicians are viewed as the most reliable source of information in English; CLSCs and Info-Health are perceived as less reliable.

Can you tell me why this difference exists? As far as I know, unaffiliated physicians are rather few and far between in the province of Quebec.

[Marcel Nouvet]

I will try to answer your question, Madame. The situation of Anglophones in Quebec is different from that of Acadians or of Francophones living outside Quebec. Anglophones living in large urban centres— Montreal for example—manage quite easily to obtain services in their language. When they live in more remote areas, their experience is quite similar to that of Francophones. And relative to the people around them—if we refer for example to the Gaspé and the Côte-Nord—they are less educated than the average. This also reflects to some degree the experiences of Francophone minority communities. So the situation is the same, except in large urban centres like Montreal where Anglophones are able to obtain services in English.

There are one million Francophones living in Quebec, and a million people living outside Quebec whose first language is French. The funding for Francophones is greater, however, because their situation still ultimately more problematic than that of Anglophones, since not all Anglophones live in remote areas.

A recent CROP poll—conducted I think in 2005 and organized by Anglophone groups—showed that only 48 per cent of Anglophones in Quebec are able to access the services they need in their mother tongue. So there are always major shortages in Quebec, whatever one might think.