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Proceedings of the Standing Senate Committee on
Official Languages

Issue 2 - Evidence


OTTAWA, Monday, March 9, 2009

The Standing Senate Committee on Official Languages met this day at 5:01 p.m. for its study on the application of the Official Languages Act and of the regulations and directives made under it, within those institutions subject to the act.

Senator Chaput (Chair) presiding.

[Translation]

The Chair: Honourable senators, welcome to the Standing Senate Committee on Official Languages. My name is Senator Maria Chaput: I am from Manitoba, and I am chair of this committee. To start, I would like to introduce the committee members who are here today. To my left is Senator Comeau, Senator Champagne and Senator Fortin- Duplessis. To my right is Senator Jaffer, Senator Losier-Cool and Senator Goldstein.

Today, we are studying health care in the French minority language. We have with us Ms. Claudine Côté, Director General of the Société Santé en français and Mr. Paul André Baril, who is in charge of government relations.

We also have with us Ms. Jocelyne Lalonde, Director General of the Consortium national de formation en santé and the Director General of the Fédération des aînées et aînés francophones du Canada, Mr. Jean Luc Racine.

We welcome you here to this committee.

We have handed out the presentations that were provided to us in both official languages. When we receive documents in just French or English and we have not had the time to have them translated, we do so after the committee meeting and these documents are then sent to your offices.

Witnesses, the committee thanks you for having accepted its invitation to appear today. I would now invite you to take the floor. I would remind you that you only have between five and seven minutes for your presentations in order to allow senators to ask their questions.

[English]

Senator Jaffer: If I may, I would respectfully say that the language issue probably affects only me. In other committees, we do distribute documents as you indicated. However, I have no objection if other members want to obtain the documents now. I respect what you are doing, but if helps other members, I am fine with that.

[Translation]

Senator Comeau: It is my opinion, that we should maintain that policy, as it could have an impact for both sides.

The Chair: I agree. I would remind you then that you have between five and seven minutes each in order to allow senators to ask their questions.

You have already determined the order in which you will make your presentations. We will begin with the Fédération des aînées et aînés francophones du Canada represented here by Mr. Jean-Luc Racine. So, with no further delay, you have the floor.

Jean-Luc Racine, Director General, Fédération des aînées et aînés francophones du Canada: Madam Chair, honourable senators, on behalf of the Fédération des aînées et aînés francophones du Canada and on behalf of our president, Mr. Roger Doiron, who could not be here today, I want to thank you for having invited us to speak.

The federation is a not-for-profit organization with nearly 285,000 members in Canada and at least one provincial francophone seniors' association in each of the provinces and territories, with the exception of Newfoundland and in the 3 territories where seniors are represented by francophone advocacy organizations.

With 11 of our 12 associate members working outside Quebec, you will understand that our organization first and foremost represents francophone seniors living in minority communities. Our federation represents 23,000 senior members living in minority communities and we represent nearly 350,000 francophones aged 50 and over living outside Quebec.

We carefully read the article that recently appeared in francophone media throughout the country concerning the case of Ms. Lavoie from Toronto, whose mother has Alzheimer's and who is having a great deal of trouble finding a nursing home bed able to provide services in French. Imagine Ms. Lavoie's frustration in Toronto. Her mother has Alzheimer's and she can no longer understand English. However, there are only 37 long-term care beds in Toronto where services are provided in both official languages. The number of beds is already insufficient, so the frustration is all the greater when we learn that only 15 per cent of these beds are occupied by francophone patients, since there are simply not enough beds. Ms. Lavoie was forced to put her mother in a home in Welland and she must drive four hours to visit her.

Unfortunately this situation is not unusual, on the contrary. Our president, Mr. Roger Doiron, and I have just finished a national trip where we met with seniors' groups in all Canadian provinces and territories. There is an acute lack of services in French in seniors' homes throughout the country.

First, seniors told us that there were almost no services available in French in seniors' homes. When French services are available, they are very difficult to access, because language is often one criteria among many others.

As we travelled through the provinces, we met with some young retirees who shared with us their sometimes traumatic experience in finding a place for their much-older parents. Many of them simply could not believe the extent to which we are forcing our francophone seniors, who often have the opportunity to live in French in their communities, to simply die in English. This is what led some of them to get more involved in seniors' causes and to fight for the francophone cause.

Let me give you another example. The seniors we met in Summerside, Prince Edward Island, told us about a seniors' home that was about to be built there. However they were having a great deal of difficulty impressing upon the home's operators the importance of providing services in French.

Independent seniors with whom we also met during our trip are extremely concerned. I want to tell you what a woman from Saskatchewan said about how painful it was to see seniors from small francophone communities have to leave and move into homes hundreds of kilometres away where no French services are provided, when they become ill.

They disappear and nothing more is heard about them for months. Often the only news that we get is when their obituary is published in the newspaper. I find this unfortunate, she said, that we can do this to our seniors.

In the last few years of our lives, in our most vulnerable moments, when we need the most comfort possible, we feel it would be appropriate to be entitled to services in French and to be able to die in French. We believe that the federal government should play a leadership role by implementing measures that would further encourage the provinces and nursing homes to provide more services in French. We are aware that this is a huge challenge. These homes, as you know full well, often face significant institutional pressure. Seniors unable to go home must be put in a bed as quickly as possible and language criteria are often neglected.

We have three points. First, the provinces and nursing homes must be better educated with regard to the importance of providing adequate services to francophone seniors. Second, francophone seniors must be given more tools so that they can be community ambassadors both within institutions and nursing homes in order to make known the importance of having access to services in both official languages. Third, we need significantly more resources in order to make major changes that are needed with regard to the provision of health care services in French. We at the Fédération des aînées et aînés francophones du Canada believe that the resources invested in health, particularly in relation to the Roadmap, are clearly insufficient. We have been successful in education over the last few years because resources have been invested. We need to do the same thing in the area of health care if we truly want to meet the needs of our francophones in our communities.

In closing, I want to thank you again for giving us this time to speak with you today and I would now be pleased to answer your questions.

The Chair: Thank you, Mr. Racine. We will now move on to Ms. Jocelyne Lalonde's presentation.

Jocelyne Lalonde, Executive Director, Consortium national de formation en santé: Madam Chair, on behalf of our co- chairs, Yvon Fontaine, Rector of the Université de Moncton, and Andrée Lortie, President of the Cité collégiale, I thank you for inviting the Consortium national de formation en santé or CNFS, to testify before your committee.

I will briefly introduce the CNFS, what it has achieved to date, what it foresees for the next few years, and the impact that its national secretariat and 11 member-institutions have and will have on improving French-language health services. During the question and answer session, I hope to further inform you about the issues and opportunities associated with the greater availability of francophone health care professionals and strengthened health research.

The Consortium national de formation en santé comprises 11 universities and colleges across Canada. The original 10 academic and technical training institutions, which were joined by Collège Acadie Île-du-Prince-Édouard for phase three, offer French-language study programs in various health disciplines. The objective of this strategic alliance is to increase the presence and contribution of francophone health care professionals and researchers in order to better respond, in French, to the health needs of francophone minority communities. In so doing, CNFS makes a major contribution to the well-being and cultural affirmation of these communities. Its initiatives help to meet the objectives set by Health Canada in the ``Training and Retention of Health Professionals'' component of its contributions program to improve access to health language services for official language minority communities. In this way, they contribute to the full implementation of the Roadmap for Canada's Linguistic Duality 2008-2013 and of Part VII of the Official Languages Act.

Overall, the CNFS's member-institutions have significantly exceeded the enrolment and graduation benchmarks which were set as a function of the Treasury Board's investment in phase two (2003-2008). CNFS generated 3,181 new enrolments, thereby achieving a success rate 38 per cent higher than projected. It generated 1,318 graduates, thus attaining a success rate 27 per cent higher than projected. In order to reach these important thresholds of effectiveness, the CNFS member-institutions created and launched 35 new post-secondary programs over five years.

The hiring of CNFS graduates serving francophone minority communities and returning graduates to their province of origin are core issues for the CNFS, the communities and Health Canada. The CNFS conducted a pilot study on the placement of its 2005-2006 graduates. This analysis revealed high rates: 86 per cent of graduates work in community health institutions and organizations that serve francophone and Acadian communities.

The Roadmap for Canada's Linguistic Duality identifies francophone seniors as an important target population for government intervention. This determination is all the more important given that the proportion of the elderly in francophone communities is higher than that in the population in general. It is of the essence that the health system translates the Roadmap's commitment into organizational structures and a host of services in French that truly meet the needs of francophone citizens nearing the end of their lives.

The CNFS has been proactive, having created a variety of French health professional training programs in various fields, including personal support workers, nursing assistants, palliative care workers, doctors and nurses. Its member- institutions have also created the following programs: gerontology social work, rehabilitation therapy, gerontology and applied studies in aging. Here are a few examples of the important link between access to health services in French and the importance of French health professional training programs:

In Manitoba and more specifically in Winnipeg, several graduates from the personal support workers' program and the nursing program at the Collège universitaire de Saint-Boniface work at the foyer Valade and at the centre Taché, two health organizations for the elderly.

In British Columbia, the foyer Maillard, next to Vancouver, hires graduates from the personal support workers' program at the Collège Éducacentre. In Nova Scotia, training of medical students in the francophone program in New Brunswick greatly helped in the implementation of the Centre santé de Clare.

Furthermore, in the very near future, the CNFS is bringing together some 15 health researchers in order to develop a national network charged with examining the issue of the care of senior citizens living in francophone minority communities in Canada.

In this year of transition from phase I to phase II, the Consortium is in the process of finalizing its proposals for 2008-2013. We expect to generate more than 3,500 new enrolments and more than 1,500 francophone graduates over the next five years. We also foresee that thousands of professionals will be able to benefit from continuing education courses enabling them to adequately serve francophones in French.

The CNFS project, by its mere existence and the extent of its contribution to the improvement of French-language health care, has made many decision-makers in the health sector more aware of the need and rationale for providing French-language health training. Many provincial ministers and officials have expressed their gratitude for the important contribution that CNFS and Health Canada have made to their ability to improve access to French- language health services. Every provincial government has confirmed its support to phase III and by-laws relating to the CNFS project.

Madam Chair, I would be delighted to answer your questions.

The Chair: Thank you, Ms. Lalonde. I will now give Ms. Côté the floor.

Claudine Côté, Executive Director, Société Santé en français: Madam Chair, on behalf of our board of administration and our president, Dr. Brian Conway, I want to sincerely thank you for having invited us to appear before you today.

As you know, Mr. Hubert Gauthier recently left as head of the Société Santé en français, but he joins me today in thanking you for this opportunity to speak with you and to share with you our appreciation of the support you have shown for many years to the Santé en français movement.

Like you, we have been profoundly affected by the situation of that family in the Toronto region which is seeking a nursing home in which the mother can have access to health care services and end-of-life services in French. As poignant as this case may be, it is unfortunately not an exception, as Mr. Racine said, but rather the rule for francophone seniors.

We must also remember that a bed in a nursing home providing services in French is just one of the challenges facing our francophone seniors when it comes to health care. Home care services, diagnostic services, regular medical check-ups, mental health services, support for caregivers, initiatives promoting health care and accident prevention are all examples of gaps in the provision of services in French to francophones of all ages.

Let us be clear, in all our communities, our seniors deserve our attention because they helped build those communities. This is also a segment of the population that, for numerous reasons, is the least comfortable speaking in English particularly when it comes to health care. It is therefore important, at a time of their lives when they are at their most vulnerable, for them to have access to health services in their own language.

As you know, the Roadmap for Linguistic Duality was announced in June 2008. The amount for health is $174 million for the period from 2009-2013. In January 2009, Health Canada told us that $174 million will be allocated to health care, the envelope reserved for francophone minority communities for that same five-year period will be $126 million, and these funds will go to initiatives in three main areas as follows: networks, training and retention, and service projects.

Under the first phase of funding, 17 networks were created and became, in each region, province and territory, the hub for dialogue to improve access to health care services in French. The networks have succeeded, in each respective region, in bringing together the stakeholders interested in working to improve health services in French. Everyone is unanimous, and to repeat the words of Mr. Bernard Lord in his report on official languages, the networks have become models for cooperation and partnership that have successfully interested and involved provincial and territorial authorities in plans to improve health services in French.

We agree that all this work in the area of training and networking won't amount to much if, ultimately, francophones do not have access to more health care services in their own language. We must respond to this issue of access to health services in French.

The Société Santé en français is responsible for organizing services for francophone communities. We work in three territories and nine provinces. Between 2003 and 2008, the society supported approximately 90 initiatives throughout the country, including establishing community health care centres in Alberta, Manitoba and New Brunswick. The society facilitated the implementation of a teleoncology service in northern New Brunswick and held workshops for seniors in Saskatchewan, New Brunswick and Ontario.

Madam Chair, you know, as do we, that the needs are great but that resources are limited. However, we are not here to complain. We want you to know that the Société Santé en français is determined, along with our provincial and territorial networks and our partners on the ground, to ensure the best possible use of these resources. We hope that we will be able to begin our work immediately, once the administrative arrangements under the Roadmap have been fully defined, and we will no doubt ensure the implementation of initiatives to improve health care services for seniors.

However, we must remember that our 2009-2013 steering plan identified local initiatives for a total amount of $260 million. However, under the Roadmap, we will receive $21.5 million over five years. That said, you can count on the fact that we will spare no effort and we hope to continue to benefit from your support.

In conclusion, we would like to ask you to consider inviting us back to testify before you in 18 or 24 months from now, so as to give you a report on the progress that has been achieved under the Roadmap. Perhaps you can consider holding this meeting in one of our minority francophone communities, where we could hear from patients themselves, professionals, nursing home directors, government officials, and their opinions with regard to what has been achieved.

Obviously, as you will agree, there is a danger to exposing oneself like this. However, we are convinced that true accountability, transparency to those funding us and our communities are essential to our success.

Madam Chair, honourable senators, thank you for your interest in our organization and your special focus on the health care of Canadians living in official languages minority communities.

The Chair: We will now begin with questions. The first will be asked by Senator Losier-Cool. She will be followed by Senator Fortin-Duplessis.

Senator Losier-Cool: Thank you for giving me the opportunity to ask the first question, because I need to go to the Centre Block shortly to replace the Speaker of the Senate. So I am going to ask my questions and I will be very eager to read your answers in the minutes of this committee meeting.

My first question concerns the consortium. In appendix 2 of your document, you talk about research. Last week, university presidents criticized the fact that health care research is being neglected and the focus is instead the economy and business. Could you elaborate with regard to research?

My second question concerns, more specifically, mental health. I would like to know whether you maintain ties with the Mental Health Commission of Canada, chaired by our former colleague Michael Kirby. Is there a francophone section on mental health? Mental health is a very timely topic.

In addition to francophones, I would like to know specifics regarding gender, particularly with regard to women. A francophone woman suffering from mental illness is a minority twice over. Could you tell the committee the way in which these issues have been addressed?

Ms. Lalonde: With regard to research, like the Société Santé en français, the Consortium nationale de formation en santé had applied for $130 million over five years. We received $86.5 million. This amount will allow us to continue the work that we began over the last five years. However, it will not allow for development over the next few years, since this amount represent an increase of only $6.5 million for the next five years.

In the Roadmap on official languages, there is no funding for research on francophone minority communities.

However, with regard to health care, we will be able to work on research to a minimal extent, but in relation to training and access to health care services in French. In other words, this will be strictly related to our program objectives. That is why we are working with university and community researchers throughout the Canadian francophonie outside Quebec to implement and develop studies that will allow us to better understand vulnerable groups including seniors, people suffering from mental health issues, young people, and very young children. We will work with these target populations and we will see what ``access to health care services in French'', means, what we need to implement and what studies could help us to better understand and better serve these groups.

Ms. Côté: Representations have been made to the Mental Health Commission in the past, but up until now, there has been no follow-up with regard to measures concerning francophones in this file. As for the issue of gender, I am afraid I do not have that information with me here today. But the support of committees such as the senate committee concerning this kind of approach is most welcome. Now that I am aware of the Mental Health Commission, we will do some follow-up on this in the coming weeks.

Mr. Racine: That's good. The whole issue of mental health, especially among women, is of grave concern, especially given the increased incidence of Alzheimer's disease that is expected in the next few years. We have to address this to make sure we can provide the required services. Toronto's case is a special one and it shows how difficult it is to obtain services when you are a francophone in a minority situation. Of course, when you suffer from this disease, you lose your memory and some of your faculties, so it is even more difficult to communicate in English. These are issues that need to be addressed. We are very concerned about this.

Ms. Lalonde: I would be remiss if I did not answer, because I am a social worker by training and I worked in the mental health field for 20 years. The issue when it comes to mental health is that you cannot receive therapy or help from a social worker when you have a mental health problem if you cannot receive service in your own language. These are matters of the heart and of emotions and you cannot express your emotions properly in another language.

The Chair: Exactly. If you have Any additional information, you can always send it to the clerk of the committee.

Senator Fortin-Duplessis: Madam Chair, first of all, I would like to thank you personally and your staff for having invited our witnesses here today.

I was appointed to the Senate recently and I was so moved by the article that appeared in the newspaper that I wrote to the clerk, asking him to be so kind as to invite witnesses to talk to us about the plight of francophones in minority situations. I am so pleased that you invited exceptional witnesses to explain this major problem that affects many people across Canada. As we have seen, the question of access to resources and specialized treatment in French for our seniors remains a very thorny issue in Ontario, as well as in other provinces. This is a new battle that francophones will have to wage. Under the French Language Services Act and the regulations that designate which organizations must provide services in French, only designated hospitals are compelled to provide such services. So the situation in Toronto is particularly deplorable, as you have described it. I am particularly struck by the fact that there is a residence for 37 people while only 15 per cent of these 37 can receive services in French. I found that terrible. In fact, in those circumstances, language homogeneity is essential. According to the Société Santé en français, francophone communities outside of Quebec are even more hard-hit by the aging of the population than the rest of Canadian society. This is trend that is laden with consequences and the Toronto case is a precursor, as well as being very revealing of a situation that will deteriorate if nothing gets done.

There is no such thing as a pointless awareness and mobilization campaign. However, we must also attack this problem head on and solve it. To my knowledge, the Lalonde and Desrochers decisions did not set a precedent on this particular question.

Is the Fédération des aînées et aînés francophones du Canada and the Société en français looking into possible legal action? In what areas of health care is the recruitment of francophone professionals the most concerning?

Mr. Racine: We have not yet gotten to the point of considering legal action. We have received complaints in the past and we are receiving an increasing number of them. Today, I spoke with an official in New Brunswick who said that there is an increasing number of complaints from people who cannot get services in French. I should point out, however, that seniors are not the ones complaining. Often, they have a fear of reprisals if they complain about not receiving services in French; they are very reluctant. So, their children are the first ones to complain. Specifically the baby-boomer generation, whose parents are older and who find this unacceptable; they are the ones who start filing complaints. We have not gotten there yet. It is the avenue we would like to take at this point, at least speaking on behalf of the federation, but there is no guarantee that that is something we may one day consider.

Senator Fortin-Duplessis: What aspects of the recruitment of francophone health care professionals cause the most concern?

Ms. Côté: That question is relatively easy to answer. There is a shortage of health care professionals in almost all areas and this shortage is simply exacerbated for francophone communities and francophone health care workers. Clearly the worst shortages have to do with francophone doctors, nurses and pharmacists. This is already a problem Canada-wide. So when you look at health care professionals with language ability or French skills, it is all the more important to recruit them.

Ms. Lalonde: Despite the fact there are a number of health care professionals being trained through our post- secondary institutions with Health Canada money, the fact remains that, as Ms. Côté stated, there is a significant shortage. The further you go into minority areas, the lower the numbers of francophones, the greater the shortage. The lower the numbers of francophones in certain provinces, the less they have access to institutions and health care organizations offering services in French. So, the solution is training health care professionals in French, yes, through post-secondary training institutions, but at the same time we have to work within communities to set up services and health care organizations which have the capacity to offer French-language health care services.

This is something which would be done separately, through two organizations, but with a common goal. You cannot have one without the other.

The Chair: Any supplementary questions? Senator Champagne.

Senator Champagne: The issue of recruitment spoke to me right away and I will tell you why. In the heart of Montreal, in one of the most francophone areas of the city, I recall waking up after 40 days in a coma and hearing French being spoken, but 8 times out of 10, with a very strong accent. The wonderful nurses who took care of me were either from Venezuela, Colombia or Mexico. There may have been one Quebecker, probably the head nurse. So, that is to say that there is a recruitment problem even within francophone areas. If there is a shortage of nurses and health care staff in the heart of Montreal, imagine the situation in francophone minority areas. Whether we are talking about Ontario, Alberta or New Brunswick, the problem is even more acute.

Next week I will be speaking to francophone health sciences students at the St. Hyacinthe CEGEP. What can I tell them? How can I motivate them to find jobs in areas where francophones are in the minority and need their help?

Ms. Lalonde: You are absolutely right in saying that it all starts with the youth. We have to give them the desire and the motivation to study in the field of health care. We should also enhance the image of health care professions in this day and age where there is a lot of pressure on people working in the field of nursing. That said, working in francophone minority areas is motivating. It is a type of life experience you cannot get in Montreal or Quebec City and I think that is a specific argument that needs to be raised. The Consortium national de formation en santé focuses on recruitment and promotion. If you want 3,400 people to register for health sciences programs, you have to do recruitment and promotion. You are absolutely right, we must continue in that vein.

Senator Champagne: Perhaps we should create specific training programs for immigrants who have health care training. I can assure you that when I came out of the coma, I was wondering on what planet, in what country I had landed. Was I sick? Clearly, the accents of people speaking to me were not those from my area.

When it comes to recruitment, we have to ensure that there are more people working here or in francophone minority settings, and I think we can do that.

Ms. Lalonde: There currently exists programs for immigrants who already have health care training, but need upgrading to work in our communities. We have developed retraining programs to help newcomers become health care professionals in our francophone communities.

Senator Goldstein: I thank all of you for sharing your views with us on this very important matter. Earlier on, you were referring to the problems seniors experience. Could the problem be related to the nature of the institutions?

Obviously, hospitals provide health are services. The provincial health care departments influence policy in these institutions. There are also seniors' homes which offer services to seniors in various states of health. These homes are also under provincial jurisdiction.

You have all referred to the efforts you have made with respect to federal institutions. But I would like to know whether you have also worked at the provincial level and, if so, what you have done?

Ms. Côté: I very much welcome the opportunity to discuss this matter with you because it is very topical for the Société Santé en français. One of the many roles played by networks is that of liaison, partnership building, collaboration and the potential provision of francophone expertise as advisors to provincial governments.

Currently, in several provinces, some networks have managed to attain this level of provincial recognition with their government authorities. That is one of the roles played by networks, to create relationships with the various orders of government.

With respect to health care institutions, because health is a provincial area of jurisdiction, it varies from province to province and networks have to deal with that fact. Depending on the policies which already exist respecting francophone health care services in a given province, some find that their work is easier than others, like New Brunswick for instance, where there is good recognition.

In other provinces, however, it is much more difficult and things are moving ahead at a snail's pace. At the national office, it is possible to meet with government authorities also, but most of the consultation and exploration work is done through the Société Santé en français networks acting locally.

The Chair: Did anyone else want to comment?

Mr. Racine: You know as well as I do that in many cases, residences are subsidized yet private, and that sometimes the language issue is but one of many criteria used in a predominantly anglophone residence.

In Toronto only 15 per cent of beds are taken up by francophones. If, however, you go to Manitoba, to the Youville residence for instance, 95 per cent of beds are occupied by francophones because there is a sensitivity to language and therefore an ability to respond to francophone needs. I would image that anglophones in minority settings in Quebec have their own institutions and people are sensitive to these issues.

Senator Goldstein: When it comes to quasi-public residences or subsidized private-public residences you are leading me to believe that most of the work is being done at the provincial government level in the province where the residence is located.

Mr. Racine: I know that health care services are a provincial government responsibility, but I believe the federal government has a leadership role to play. From our perspective, if we could count on that leadership, it would be much appreciated.

Senator Goldstein: Can you tell us exactly how you believe this leadership could be demonstrated? Through a federal-provincial conference? By allocating funding? By changing the program? In short, how can we help you to bring the federal government to support provincial governments in order to deliver these services to francophones outside Quebec?

Mr. Racine: I do have some suggestions, but first, I would like to give my colleagues a chance to speak.

Ms. Côté: Suggestions are welcome, Mr. Racine, but I just wanted to mention that the Société Santé en français and the networks do this on a daily basis: the money received from Health Canada is used as leverage to facilitate local initiatives. The 90 initiatives I referred to earlier on were all funded, for the most part, by the federal government. A bit of money on the ground can actually go very far.

There is the example of the Notre Dame de Lourdes Health Care Centre in Manitoba which after having receiving $30,000 from the Société Santé en français managed to collect $1.5 million and then received the balance of the $3 million from the provincial government thanks to a community fundraising effort. As I said, a little bit of money can go very far and it is often through Health Canada funding that we manage to accomplish great things.

The Chair: One supplementary question before moving to Senator Goldstein. How long has this network been in existence and is it funded solely by Health Canada?

Ms. Côté: The network began to be established in 2002. In 2003 a funding period began and lasted until 2008 and the networks gradually appeared over that period. The federal government, through Health Canada and the Public Health Agency funds most of the work carried out by the networks.

Ms. Lalonde: I would like to add that funds provided by Health Canada to the national consortium are an important source of leverage. For instance, if the provincial government subsidizes 25 spots in a post-secondary nursing program, the funds received from the federal government allow for an increase in the number of registrations for other programs. So, it is an important lever and it also covers some additional costs for the implementation of new programs which would not be covered by the provincial government. I think we need to continue to support federal government funding for official languages health care programs.

Now, from a broader health care standpoint, if the federal government, through transfer payments to the provinces, could ensure in some way that part of these funds are used to offer French-language health care services, I think that could be of great assistance to us.

Mr. Racine: I would like to mention the remarkable work done by the consortium and the Société Santé en français. Within our provincial federations, we benefit from the effect of this work: it is far easier now to speak with a provincial government, through this intermediary, which the networks represent. They have opened doors. That has facilitated a number of things.

The same applies to training: we are starting to see young professionals in training who are interested in our communities. Too many francophone professionals have ended up in English-only institutions in the past. Things are changing now and that is thanks to the consortium's initiative. Showing leadership would be good way to express this and support these activities.

Senator Tardif: I thank you for your excellent presentations. I wanted to point out to what extent I am pleased to see the progress accomplished by the training consortium and the Société Santé en français. I was part of the negotiations at the start, when we set up the training consortium. I was dean of the Saint Jean Campus at the time and that money in fact allowed us to create a new training program which did not exist beforehand, a bilingual baccalaureate in nursing science, the first to give the French language its place in Alberta. In fact, two years ago, the first diplomas were granted. So, it has been very successful, and I think it is absolutely correct to say the federal government must play a leadership role in this area to comply with its obligations towards official languages and Part VII which refers to ``positive measures.''

I would like to get back to the budget issue, and perhaps this question is more specifically for Ms. Côté from the Société Santé en Français. Could you tell me how much money you will be receiving from the Roadmap to implement senior services?

Ms. Côté: No specific program has been planned to date, however, we will be receiving $21.5 million over five years for service projects. Service projects are chosen locally. They will come from the national office and be chosen based on the priorities in the Roadmap: early childhood, youth, seniors.

We expect to receive many service projects in this area given the situation for shelters like that in Toronto. There is also the Foyer Maillard in Vancouver which may be shut down because it no longer meets provincial health standards. In Toronto, there was the case of Ms. Tremblay-Lavoie, but at the Foyer Maillard in Vancouver there are approximately 50 francophone seniors who may no longer have a place where they can receive specialized long-term care. That will be the subject of excellent service projects on the health care side totalling $21.5 million.

Senator Tardif: You mentioned $4 million per year?

Ms. Côté: Five million this year and $5.5 million in subsequent years.

Senator Tardif: That is a very modest sum in order to accomplish the huge task of offering the services you want to provide. Can you tell us how you plan on allocating this money or what initiatives you intend to carry out with so little money?

Ms. Côté: Thank you for pointing out that is indeed very little money; we had hoped for much more. Communities know what their needs are. For instance, people in Vancouver are very much aware of the problems facing the Foyer Maillard, and they are also aware of the service projects component. We are therefore expecting those types of project proposals from the province of British Columbia.

While communities have to respond to the crying needs of their seniors, these projects will be directed to the national office, on to Health Canada, and then funded from there on.

Senator Tardif: Is it because the $5 million is not allocated exclusively to seniors?

Ms. Côté: No, not at all.

Senator Tardif: In your opinion, is Health Canada sufficiently aware of all the health care needs of second-language minority communities?

Ms. Côté: I would point out that before coming here today, I was in a meeting with people from the Official Language Community Development Bureau to talk about how this $5 million will be managed and distributed.

Mr. Roger Farley and his team are entirely aware of what is going on in the communities. They want to help us. Unfortunately, that is all the money they have received. The health care envelope has $174 million. Education received almost three times that amount. As such, we have to make do with what we receive. Based on the projects submitted last year, I can assure you that we receive very creative projects.

Ms. Lalonde: It is impossible to overstate health care needs to the government. Right now, we are talking specifically about the health care needs of our French-speaking minority communities. The federal government is spending a lot of money on health care. However, given the portion of money spent on the francophonie, there is hope for increased funding.

The amount we received is acceptable, and we are very happy about that. Health Canada is nonetheless the department that receives the most funding, after Heritage Canada. Still though, the needs are enormous. The $86.5 million for training and the funds allocated to Société Santé en français allow us to make progress on this issue, but we cannot solve everything, especially the problems facing the most vulnerable.

Senator Tardif: I would like to continue on that point. Under Part VII, that provides for ``positive measures,'' do you perceive a will at Health Canada to fulfil its obligations under Part VII and introduce ``positive measures,'' as stated in the Official Languages Act?

Ms. Lalonde: Without a doubt, Health Canada is on the right track to meet these requirements. However, financially speaking, to what extent can these commitments be fulfilled?

We have received funding that allows us to continue what we started. We need much more to guarantee access to health care in French in minority francophone communities.

Senator Tardif: In fact, Health Canada received the best rating in terms of compliance with Part VII of the Official Languages Act.

Ms. Lalonde: They are meeting the terms of Part VII of the Official Languages Act very well.

Senator Comeau: Ms. Côté, you talked about what Mr. Bernard Lord said about your organization and Health Canada, in terms of serving as a model to other sectors that have relationships with the federal, provincial and local governments.

We have seen your success over the years, since you managed to convince the federal government to get involved in areas of provincial jurisdiction without causing too many problems — we are talking about nine or ten provinces and three territories. What approach did you use to achieve such success? Could we use that model of cooperation, with a few adjustments, for other sectors of society?

Ms. Côté: My humble experience only goes back three weeks. As a matter of fact, I have just been reading the WHO model regarding working with partners. Many years ago, the Société Santé en français adopted the model for working, cooperating and coordinating plans with five partners in this sector. In my opinion, the secret to the success of the networks is due to the fact that they do not work in isolation, but rather inclusively, by cooperating, coordinating and adopting integrated approaches with all partners in the sector. I would like to list them again: we are talking about health care institutions, educational institutions, health care professionals themselves, communities, and of course government authorities at the provincial level.

Some networks only include one person. However, these networks bring people closer to the community and establish contacts between individuals who otherwise would not seek to discuss health care, nor access to services, nor the availability of French-language services within minority communities.

Paul-André Baril, Government Relations, Société Santé en français: One of the important partners sitting at the table is the government authorities. Needless to say, the others are important especially for service delivery and organization. However, the central point of this approach consisted in obtaining the cooperation of the departments of health and regional health authorities in order to define action plans and cooperation with other partners.

Senator Comeau: My next question is for Ms. Lalonde. I did not have the chance to examine the budgets, and one should never ask questions without examining them in depth. However, we have heard certain concerns here this evening. Senator Losier-Cool alluded to the rector of the University of Moncton, Mr. Fontaine, who raised some concerns regarding the amounts set aside for health care. You also pointed out the fact that you do not have enough money.

If I understand correctly, the Roadmap provides for $174 million, which means an increase of $55 million. We are not talking about small amounts of money here. It goes without saying that everyone would like to have as much money as possible. But is that $55 million added to the Roadmap truly insufficient? I would like to put things in context.

Ms. Lalonde: Unfortunately, I do not have Mr. Fontaine's statements here in front of me.

Senator Comeau: It was Senator Losier-Cool who raised that point.

Ms. Lalonde: In 2008, the Consortium national de formation en santé received $16 million for the 10 post-secondary education institutions that offer training to health care professionals. If you multiply these $16 million by five, you get $80 million. We have received $86.5 million for the next five years. That represents an increase of $6.5 million. Training implies very significant costs. This increase of $6.5 million over five years barely covers salary increases.

We can continue to enroll students and grant degrees in existing programs that were developed over the past five years. However, it will be more difficult to develop new programs with this $6.5 million increase.

Senator Comeau: Should that amount of $55 million be distributed differently, through the aspects targeted by the $174 million?

Ms. Lalonde: There are huge needs to be filled. I do not see how a different distribution of the amount would help; we need an increase in the overall envelope.

Senator Comeau: The $55 million was exceeded?

Ms. Lalonde: The needs of the Société Santé en français, in terms of the network and the organization of services, are much larger. We are very happy with the amount we received. It allows us to continue what we started. However, the needs are greater. It is not a matter of distribution, but of a larger envelope.

Senator Comeau: Perhaps we should re-examine the Roadmap in its entirety as well as future distribution. I do not remember what the total increase was for the Roadmap.

Ms. Lalonde: That is a difficult question because different departments were added to the Roadmap.

Senator Comeau: You say you received $16 million. Was that money obtained from the federal government to try to get the provinces to contribute? At the end of the day, the provinces are responsible for education. Do you receive money from the provinces?

Ms. Lalonde: That is a question I cannot answer. I do not know what the provinces would have done. What I can tell you is that we have a model through which we developed our funding. In its report, Health Canada clearly indicated that the CNFS had used the funding it received in a very worthwhile way. That is something concrete that tells us that at this point, the additional money received from the federal government allows us to increase enrolment. We are talking about approximately 1,500 new graduates over the next five years. That is quite significant. With these funds, we are training people who will work in francophone communities and who will offer services in these communities.

We could certainly train more, but the reality is that we will continue to make do with what we have at this point.

Senator Comeau: Mr. Racine, you referred to the increase in complaints that you received regarding seniors' residences. Are you considering going to court? How would this be possible? On what basis could you do so?

Mr. Racine: We have not reached that point.

Senator Comeau: This is an area of provincial jurisdiction.

Mr. Racine: Honestly, we would have to consult lawyers for that. We have not given that much thought. We are not at that stage. Since I am not a lawyer, this is rather difficult for me, but I will think about it anyway.

Senator Comeau: I hope we will have an opportunity to follow up on your testimony and that we will see results coming from what you do in the regions. We should try to choose a region that is not completely francophone.

Senator Tardif: Alberta.

Senator Comeau: That is an excellent idea. We have to choose a region where it is more difficult for people. I hope you will monitor the steps that have been taken regarding mental health services. We would be interested in your results.

[English]

Senator Jaffer: Thank you all for being here. You have sensitized me to this issue. Mr. Racine, I was especially struck by your comments about dying in not your maternal language. I will never forget that. It is important to be reminded.

I have questions about my own province of British Columbia. I heard some comments about B.C. How do we fare in B.C. compared nationally, and what more could we do in B.C.? As Senator Comeau said, we need to look regionally. I want to get some help from you as to what my homework should be. That is my first question.

[Translation]

Mr. Racine: I could give you some idea for seniors. With regard to seniors in British Columbia, there is a restructuring going on right now in terms of takeover. After Ontario and New Brunswick, British Columbia has the largest population of seniors. They have had the most difficulty if I compare them to Alberta or Manitoba where they are very well structured, and the same is true in Nova Scotia. In British Columbia, they are currently taking charge of their affairs with regard to the francophonie. There are some good things going on. They have just received support from Canadian Heritage. Things are being done for British Columbia and I know that with regard to the network, a lot of things will be done.

Mr. Baril: When we started to implement networks in 2002 and 2003, francophones in British Columbia were telling us: ``You know, in our province, you can forget about this because really, our government will not be interested.'' We were almost told we could keep our money and use it elsewhere. Pioneers established a network and I think that British Columbia is the province that has achieved the most progress. The network managed to elicit the interest of the health care authority, Vancouver Coastal Health. There is the Provincial Health Services Authority that was invited to take part in their forum. Together, with health professionals, with the school board, the Ministry of Health, they were the first initiatives that the Société Santé en français accepted.

To my mind, this shows that with concrete initiatives that will change things in the field, with the means at our disposal, we do manage to get cooperation. However, I would like to get back to the case of the Foyer Maillard. Maillardville is a community within Coquitlam, which is a suburb of Vancouver, a community that was francophone from the outset and that had a parish church. These people built a 90-bed residence to house their seniors 40 years ago. Gradually, the home was split in two, half for long-term care and the other half for apartments and rooms rented to individuals. The doors are narrow, the rooms are small, and that means that some medical equipment cannot be brought into the room, that the person's bed cannot be changed because there is not enough room and so on. Right now, out of 90 residents, 45 are francophone and if we want this home to be there to serve its clientele, it is quite simple, it has to be rebuilt. It has to be demolished and rebuilt.

People do have a renovation and rebuilding project for the home that they have been hoping for since 1992. In 1992, the provincial government had agreed to the idea and in 1992-1993, there were changes. The Regional Health Boards were created and now people are trying to find their way around that which has meant that here we are in 2009 with a home that is 17 years more obsolete than it was in 1992 and where the staff are doing almost the impossible to serve their clientele.

If no decision is made soon and if no support is provided, something will disappear. Ms. Lavoie's case in Toronto is poignant. There are 45 people in a home in Vancouver who receive services in French, and where their living environment is francophone. If nothing is done in the coming months, or perhaps in the coming years, these people will lose their French home.

To come back to your initial question, yes, truly interesting things have been accomplished with the government and health care authorities in Vancouver, British Columbia.

Ms. Lalonde: I would like to answer your question in terms of French-language post-secondary training. In British Columbia, there is the Collège Éducacentre, but it is not in a position to grant post-secondary degrees since it has not been recognized by the province. Nevertheless, over the past five years, the college has worked closely with the Cité collégiale, in Ontario, in order to offer programs in British Columbia. Its students, who pursue their training in British Columbia, are awarded their degrees from the Cité collégiale in Ottawa, given that the institution has not been officially recognized. The Collège Acadie Île du Prince Édouard has recently been established and been granted the authority by the Government of Prince Edward Island to provide post-secondary programs. We have therefore included it as part of the consortium and are providing it with development funding over the next five years. We would like to do the same with the Collège Éducacentre, but it first has to be recognized by the Government of British Columbia.

[English]

Senator Jaffer: As I already told you, I have found this very informative. I work with francophone communities in my province, a francophone community that comes from all over the world, on something you have not as yet spoken about, especially around the issues of mental health, because often they come from conflict zones. When I go outside at night, I see a number of people from francophone communities sadly homeless.

I would like you to tell us the situation for francophones who come from outside Canada, not just in British Columbia but across the country. What kind of health services are they getting?

[Translation]

Ms. Lalonde: I do not have a magic answer to your question. That is a complex issue because those people arrive here with their own culture, language or dialect, and settle in communities that are mostly anglophone. From the outset, they have to find health care services and, in many cases, mental health care because they have experienced traumatic situations, have lived through wars or enormous difficulties before coming to Canada. They must therefore find French-language services that are culturally adapted to their needs. That often complicates matters. As a society, we have to address the problem in terms of language, but also in terms of culture for our francophone immigrants.

We are currently focusing on that issue and will continue to do so over the next five years. Immigration will not come to a halt any time soon; it is here to stay. Canada needs francophone immigrants. We have to work with our newcomers and establish appropriate services so that they can work in our communities and become full-fledged citizens. There is enormous work to be done.

Mr. Racine: Seniors do not account for a large part of those communities. That will change with time. Today, we are receiving more young families. However, I can tell you that great efforts are made to integrate those newcomers. As Ms. Lalonde indicated, they form part of our communities.

Mr. Baril: I visited the Collège Éducacentre, to which Ms. Lalonde referred. It resembles the United Nations. The people there come from all parts of the globe. They told me, and I quote: ``This place is important to me because it helps me become part of the community. I speak only one of Canada's languages, i.e., French, and that allows me to integrate into the community.''

Our President, Dr. Brian Conway, set up a francophone wing in the Pender Community Health Centre, a community clinic in the Downtown Eastside, one of the projects funded by the Société. Dr. Conway realized that there were three or four francophone doctors, some with English names, who were part of his neighbourhood network, but lost in the vast anglophone health care system. If we do not look out for them and provide them with francophone training or special programs, those people may at times treat francophone clients in English. Dr. Conway realized that it was possible without great effort to mobilize the system's francophone professionals. All that is needed is to give them the means to serve their clients in French.

[English]

Senator Jaffer: I understood that you would be, in the future, reporting on the mental health situation of people, and I would ask that you also look at the situation with the newcomers who are francophone. Thank you.

[Translation]

Senator Champagne: If I may, I would briefly come back to what my colleague from Nova Scotia said earlier. The latest funding has indeed been increased by $55 million compared to the previous cycle. You indicated that you were able to accomplish extraordinary things in terms of building your networks with the money you received in the past.

I was also delighted by what Health Canada presented to us about three weeks ago. The department gave a presentation to francophones on February 2 and to anglophones on February 5. The funding is available, but the programs to assist people have not yet been truly defined and set out. I am greatly encouraged by the contribution program for official languages in the health sector, the program description and strategy to measure performance. Various types of programs will be created, and there will also be ways to measure their effectiveness, to find out whether mistakes were made or whether things are running smoothly. Are my hopes unfounded? People are saying that they cannot obtain services in French because of a shortage of professionals. There was talk earlier about recruiting. The ``positive measures'' amount to the same thing: the development and promotion of linguistic duality in the health sector, and the crafting and implementation of policies and programs.

Are we headed in the right direction? Should we be encouraged?

Ms. Lalonde: Yes, we really are heading in the right direction. Over the past five years, extraordinary work has been done to improve access to health services in French, both in terms of networking and training of health care professionals. We need to be able to continue doing that over the next five years and then reassess the situation. Looking back on the past five years, we also have some quite detailed assessments showing that progress was made and that there were more health care professionals in our minority francophone communities providing people with services. Our communities had access an increased number of health services in French. Extraordinary work has been accomplished.

When I look to the future, I say to myself that what we are implementing today and will continue to implement over the next five years will certainly be of benefit to our francophone communities and the health of its members, given the link between health, language and culture. Truly, the ultimate objective is to improve the health of our francophone population.

Senator Champagne: We were talking about a residence that was in a state of disrepair, where major problems had been identified. That is understandable after 40 years. Take for example the Chez-Nous des Artistes, which I opened in 1984. That has not been in existence for 40 years, and yet some things need to be renovated.

I think this year is a timely moment. We believe and hope that our Liberal colleagues will adopt the budget within the coming week. This could be the year to carry out renovations, with the support of the department responsible for families and seniors. This is a timely moment because there are new programs that will certainly be of assistance. If you come into contact with our friends from Maillardville, whom I have not seen in over a year, please tell them that this could be a good opportunity for them and that we would be pleased to help them carry out the necessary renovation work.

Mr. Baril: I understand that you are offering to help.

Senator Champagne: I can certainly open the right door.

Senator Tardif: I have a question concerning evaluation. Have the results of the previous action plan been evaluated? Do you know whether results have been evaluated?

Ms. Lalonde: Under the previous action plan, there were summative program evaluations of the Consortium national de formation en santé and Société Santé en français. The Official Language Community Development Bureau at Health Canada conducted a summative evaluation of its program for Quebec's francophone and anglophone communities. Those evaluations found that much progress was made. They examined how more specific information could be obtained over the next few years in order to better assess to services. As you know, this is a very complex issue. Data concerning our minority francophone communities are not always available because the language variables for our francophone communities are not always requested. However, additional efforts will be made over the next five years to carry out more research in support of our work.

Senator Tardif: As we speak, have you been given details as to how the Roadmap will affect your work plan?

Ms. Côté: Yes, we received a great amount of detail concerning the evaluation process that will be implemented over the next four years and this covers everything from the activities for recipients to the crafting of performance indicators over that period.

Senator Tardif: Are they clear?

Ms. Côté: The process has been set out, but we now have to negotiate certain things with the Development Bureau, because we want to make sure that we are evaluated on those things we can measure, taking into account our networking capacity, given that some networks are made up of only one person, as I indicated earlier. So evaluation is one thing, but the networks need to be able to measure that which is asked of them.

Senator Tardif: Thank you.

The Chair: Ms. Côté, could you provide us with a copy of those evaluations? Could you send that to the clerk of the committee?

Ms. Côté Are you referring to the summative evaluations that were conducted?

The Chair: It would be useful to have those were conducted and those that have been requested from you. That way, the committee will read them attentively and better understand your work.

Ms. Côté: We can share with you the summative evaluation that was conducted and the evaluation that is currently required, and which is part of the contribution program to which Senator Champagne was referring.

Senator Fortin-Duplessis: The Roadmap identifies three vulnerable groups in terms of access to health care services in minority situations. There are young people and seniors. We have spoken a lot about seniors, but very little about children and young people. I would ask you to briefly describe the specific challenges faced by children and young people, and the solutions that you would like to see to alleviate those problems.

Ms. Côté: The needs of small children, youth, seniors, women, men and all segments of Canada's minority francophone communities are very well known by the communities themselves, and we have seen projects intended to settle these problems for many years.

We have been awaiting funding to implement some 30 integration projects since 2007. We are ready to launch those projects. There are some that deal with all areas from early childhood to old age, and communities of practice to support health care professionals. We are pretty confident in that regard. When the time comes to launch calls for tenders, we are absolutely convinced that people will look to fill the needs that were identified as priorities in the Roadmap. There is no shortage of projects for those categories, that is certain.

The Chair: That said, if there are no further questions, I would sincerely like to thank, on behalf of the committee, the individuals who appeared before us this afternoon. You were invited at the last minute and did not shy away from meeting the committee. Your loyalty is greatly appreciated, and I sincerely thank you.

The committee is adjourned


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