Good morning, everyone.
My name is Aurel Schofield. I am a family physician in New Brunswick, or at least I was because now I am director of the Centre de formation médicale du Nouveau-Brunswick and associate dean of the Faculté de médecine et des sciences at the University of Sherbrooke for the francophone Atlantic region.
With me are Colette Rivet, executive director of the Société Santé en français, and Denis Fortier, who is a physician in Manitoba, a member of the Conseil communauté en santé du Manitoba and vice-president of medical services at the Regional Health Authority Central Manitoba Inc.
We are going to divide up our presentation. I'll address the Réseau de santé en français, whereas my colleague Denis will touch more on services. We have prepared a kit for you containing additional information. Perhaps we can look at it in the second part.
Mr. Chairman, ladies and gentlemen members, on behalf of the Société Santé en français, we thank you for this opportunity to tell you about the progress made in the health field in the context of the Roadmap for Canada's Linguistic Duality and to share with you our ambitions for the future because we do have ambitions. We would also like to express our gratitude for the interest the committee has shown from the outset in the work we have done. In 2006, when your committee met in Moncton, I had the opportunity to welcome it to the Centre de formation médicale.
Health is a very big priority for the francophone communities. That's understandable because the language of communication is a central factor in offering high-quality services. We often hear about people who were unable to obtain an appropriate service because it wasn't offered in their language, one of this country's two official languages.
We thought we would present to you some cases that have arisen in the context of the Société Santé en français in recent years. These are actual cases, which show the importance of offering health services in French.
The first is the case of a woman from the Ottawa region who suffered a stroke. Of course, her situation left her vulnerable to disease. She had trouble speaking and was unable to receive services in French, her language, at nearly every level of care. The experience was very negative for that woman.
There was also the case of a young man from northern Ontario who suffered a mental illness and did not respond to treatment provided because, since his health was deteriorating, he did not understand what people were trying to tell him. When it was understood that there was a major communication problem, he was transferred to an institution where French-language services were provided, and that individual returned to normal after receiving appropriate treatment.
Lastly, a francophone father from Manitoba who was living out his final days in an anglophone care facility told his son: "Léo, I don't want to die in English." He felt very vulnerable and incapable of expressing his needs as he lived out his last days.
Illness leaves us all vulnerable, and, unfortunately, we will all need appropriate services in our language one day or another.
We rely to a great extent on studies conducted on Spanish-speaking communities in the United States. Some very interesting studies have shown, based on very convincing data, that language and cultural barriers make it difficult to access high-quality services, undermining the determination of an accurate diagnosis and compromising the patient's commitment to his or her treatment. This has consequences for the system and for patients themselves. There is an increase in the incidence of inappropriate treatment, deteriorating patient health, greater need for care, more hospitalization and increased treatment costs for those patients.
The entire issue of cultural and linguistic skills has become very important in more than one respect. At the Association of Faculties of Medicine of Canada, requirements respecting cultural and linguistic competencies are increasingly high and will probably even become accreditation standards for our Canadian faculties of medicine.
The study conducted in 2001 showed that 45% to 55% of Canada's minority francophone communities did not have access to health services in their language. That finding formed the basis of the strategy to improve access to French-language health services.
That strategy is based on three major axes. The first is networking, which promotes concentration and cooperation among all partners wishing to improve the situation. In fact, when you work in a minority community, people are often remote and isolated from one another. Networking is therefore absolutely necessary in order to bring all those individuals together.
The second axis is professional training. Ms. Lalonde just did a very good job of addressing that. The third axis is the organization of services, that is to say all the initiatives and levers that can be put in place to enhance the establishment of health services in French.
For budgetary reasons, we have had to downplay two areas of action. For lack of funding, they were not given priority like the first three. Those two axes were the development of new technologies to support service organization and delivery and the development of strategic information, that is to say how to obtain convincing information on the francophone communities that enables groups to make the appropriate decisions to establish better services.
The networking approach that we adopted was the key factor in the success of the Société Santé en français. It was based on a World Health Organization model called Towards Unity for Health. That model promotes joint action by partners and involves all principal partners: communities, health professionals, academic institutions, service facilities and political decision-makers at the federal, provincial, territorial and regional levels.
This close matching among the partners makes it possible to identify needs and to adopt common strategies to address them. The networks are known as the agencies that can facilitate or put in place projects to accurately meet the needs of the scattered and often remote minority francophone communities.
We have always wanted to put the emphasis on the quality of health services in French and patient safety. Through that, the networks have managed to build bridges promoting communication and joint action among the partners, including the provincial and territorial departments.
For your information, since 2009, we have had nearly 500 cooperation agreements which we develop and maintain every year with partner agencies. Furthermore, in a report on implementation of the Roadmap, the Hon. Bernard Lord said we were a model of federal-provincial/territorial and community cooperation. I believe that model is definitely very promising.
The Santé en français networks have carved out a place in the health system across Canada. In Ontario, two of the Santé en français networks have been recognized as French-language services planning entities to regional health authorities.
In Manitoba, the departments of health and social services have designated the Conseil communauté en santé as the principal liaison for the francophone community. The Conseil communauté en santé has also been assigned important responsibilities for which it receives additional funding from Manitoba's health department.
In Prince Edward Island, the network is a joint entity of the provincial government and the francophone community. The Alberta Health Services Authority has just established an advisory committee with the Réseau santé albertain on French-language services. I could continue this way for virtually all the provinces whereTowards Unity for Health networking model has been adapted and shaped to suit local systems.
The networks have established close cooperative arrangements with the provincial health departments across Canada.
As you will agree, this collaboration with all partners is not a goal in itself, but rather a win-win strategy.
The really important point is that it has given rise to hundreds of actual achievements that improve the access of francophone populations to high-quality health services in their language. In your kit you will find a document listing all the projects that have been carried out in recent years.
Through this close collaborative effort, the Société has managed to provide financial support to more than 225 initiatives across the country promoting access to health services in French in widely varying fields under the Roadmap for Canada's Linguistic Duality, whether it be primary or community care, general or specialized institutional care, health promotion, disease prevention or support for human resources.
A lot of these initiatives are ongoing and have now been integrated into the health system. This is another one of our successes because the efforts made and projects put in place have been integrated into the existing system. These actions have affected seniors, children, youths and immigrant families. Very recently, in cooperation with the Mental Health Commission of Canada, the society has begun to shape a development strategy for the issue of mental health.