THE STANDING SENATE COMMITTEE ON OFFICIAL LANGUAGES
EVIDENCE
OTTAWA, Monday, April 17, 2023
The Standing Senate Committee on Official Languages met with videoconference this day at 5:01 p.m. [ET] to study matters relating to minority-language health services.
Senator René Cormier (Chair) in the chair.
[Translation]
The Chair: I am René Cormier, senator from New Brunswick, and chair of the Standing Senate Committee on Official Languages.
Before we begin, I wish to invite committee members participating in today’s meeting to introduce themselves, starting on my left.
Senator Dagenais: Jean-Guy Dagenais from Quebec.
Senator Mockler: Percy Mockler from New Brunswick.
Senator Gagné: Raymonde Gagné from Manitoba.
Senator Moncion: Lucie Moncion from Ontario.
Senator Clement: Bernadette Clement from Ontario.
Senator Dalphond: Pierre J. Dalphond from Quebec.
Senator Mégie: Marie-Françoise Mégie from Quebec.
[English]
The Chair: Thank you.
I wish to welcome all of you and viewers across the country who may be watching. I am taking part in this meeting from within the unceded traditional territory of the Algonquin Anishinabeg Nation.
Tonight we are beginning our study on minority language health services.
[Translation]
We are pleased to welcome, by videoconference, the Honourable Jean-Yves Duclos, P.C., M.P., Minister of Health. He is accompanied by Jocelyne Voisin, Assistant Deputy Minister, Strategic Policy Branch, Health Canada; Nathalie Valdés, Manager, Official Language Community Development Bureau, Health Canada; and Mark Nafekh, Director General, Centre for Health Promotion, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada.
Colleagues, the minister is with us until 6:00 p.m. The officials will remain with us for the meeting’s second hour to continue answering our questions.
Welcome to the committee, minister, and thank you for being with us. We’ll now hear your opening remarks, followed by questions from the senators. You are our first witness for this important study of minority language health services.
The floor is yours, minister.
Hon. Jean-Yves Duclos, P.C., M.P., Minister of Health: Good afternoon, Mr. Chair. Thank you very much for inviting me to appear before the committee today. I am pleased to be with you for this very important discussion about a topic that is a personal priority.
As you have noted, I am accompanied by Ms. Jocelyne Voisin, Assistant Deputy Minister, Strategic Policy Branch, Health Canada; Ms. Nathalie Valdés, Manager, Official Language Community Development Bureau, Health Canada; and Mr. Mark Nafekh, Director General, Centre for Health Promotion, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada.
We all share the concerns raised by Canadians about the state of our health care system, including the repercussions of the shortage of health professionals on the ability of patients to receive quality care when and where they...
The Chair: Sorry, minister, we are having technical difficulties. We need to suspend the meeting to resolve the problem to be able to hear you properly. I thank you for your patience.
We will resume the meeting. It seems we are ready to hear from you. There are no technical problems. Thank you for your patience.
Mr. Duclos: At the same time, official language minority communities continue to face challenges in accessing health services in the official language of their choice.
In that context, last February, the Government of Canada outlined a plan to invest close to $200 billion in additional funding over 10 years, including $46.2 billion in new funding to the provinces and territories to strengthen our public health care system and improve services to Canadians.
As part of this plan, the federal government will provide $25 billion through bilateral agreements to support the specific ambitions of the provinces and territories. To receive that funding, the provinces and territories have agreed to respect certain fundamental principles, including taking into account equal access for equity-seeking individuals and groups, including those from official language minority communities.
These investments will be supported by efforts to shore up the health workforce, such as the plan to streamline foreign credential recognition for internationally educated health professionals. Together, these measures will help create better results for Canadians, no matter where they live or what language they speak.
Having said that, we know that individuals from official language minority communities encounter difficulties accessing health services in the language of their choice, which has a negative impact on the quality and safety of the care they receive. Canadians rightfully expect to be able to communicate with their health care provider in the official language of their choice.
That is why we have a dedicated program, Health Canada’s Official Languages Health Program, which works to improve access to health services in the official language of choice for people in these communities.
Over the past five years, this program has received $101.2 million under the Action Plan for Official Languages. This has allowed for a range of investments in three complementary areas: increasing the availability and retention of bilingual health service providers, strengthening local health networks that work with various partners to improve access to health services for these communities, and supporting projects that generally enhance access to health services.
[English]
To ensure that the Official Languages Health Program continues to meet the needs of the communities it serves, a consultation process was launched in early 2022. Through this process, we learned about the personal experiences of people in these official language minority communities as they attempted to access health services in their official language of choice. The results have helped inform the future of the Official Languages Health Program and its priorities over the next five years.
Budget 2023 confirmed that, in addition to the existing funding of $192.2 million that Health Canada’s Official Languages Health Program will receive between 2023 and 2028, the program will also receive an additional $14.5 million to support nonprofit organizations that serve these communities, as well as to enhance capacity to train additional bilingual nurses and personal support care workers.
In addition to the Official Languages Health Program, there are other initiatives under the health portfolio that help improve access to public health supports for official language minority communities. For example, the Public Health Agency of Canada supports projects to improve access to maternal and child health programming for these communities. The Canadian Institutes of Health Research also supports research projects to increase our understanding of health needs of official language minority communities. Finally, the health portfolio collaborates with Statistics Canada to develop surveys and analyze data that capture the views and experiences of individuals living in official language minority communities. This helps us better understand the challenges they face.
[Translation]
In conclusion, equitable access to care is one of the principles on which our health care system is built. Our government is striving to meet the highest standards of accessibility, to ensure that every Canadian receives the care they need and deserve.
I would now be pleased to answer your questions. Thank you.
The Chair: Thank you very much, minister.
We will move on to the question period. I would ask that members in the room please refrain from leaning in too close to their microphone or remove their earpiece when doing so. This will prevent any feedback that could negatively impact the committee staff in the room.
Being well aware of the time available to us, I suggest, as usual, for the first round, that five minutes be allotted for each question, followed by the answer to each one.
We will begin this round with Senator Gagné.
Senator Gagné: Minister, welcome to the Standing Senate Committee on Official Languages. I’m pleased to have you here this evening. I also thank the representatives from the department for being with us.
I’ll begin by welcoming the investments that were announced. I’m absolutely certain that the provinces, and particularly official language minority communities, were pleased with those announcements.
I’m also interested in the legislative measures that will lead the government to include permanent measures in the legislation to ensure the development of official language minority communities.
We know very well that an amendment to Bill C-13 was adopted in the House of Commons Standing Committee on Official languages. It was an amendment to section 21 that was adopted unanimously. That amendment states that the federal government must take the necessary steps to promote the inclusion, in agreements negotiated with the provinces and territories, of provisions that set out the official languages obligations of the parties under those agreements.
Official language minority communities had long been seeking that amendment. In my view, it is a first step. We hope that the amendment will be adopted at third reading and that the bill will reach the Senate very soon. The issue of language clauses is certainly an extremely important one. I’d like to hear from you on that, but I’d also like to ask you a question about an entirely different topic.
Do you think it would be appropriate to consider a possible revision of the Canada Health Act to include a specific commitment to official languages, that would attach official language conditions to the federal government’s spending authority?
Mr. Duclos: Thank you very much, Senator Gagné. I’m pleased to hear your question, especially since, coming from Manitoba, you know the importance, resilience and pride of living in an official language minority community.
You asked two questions. The first is related to language clauses. I agree entirely, which is why, in our discussions with the provinces and territories and in discussions we’ve already had since February 7 with the provinces and territories, we have clearly indicated that federal government investments must be used to ensure equitable access to health care, including for people living in official language minority communities.
That requires commitment, recognition of key indicators and subsequent reporting to be able to monitor progress in the commitment to equitable services. The indicators, for example, can be the rate of access to a family physician for people living in official language minority communities, or access to various appropriate mental health services; it could also be the hiring of workers, nurses and physicians in those communities.
This has been clearly stated, in black and white. The discussions we’ve had to date have reiterated it several times. It is on that basis that we will continue to ensure that those agreements include those clauses and commitments on both sides, because the Government of Canada must also lead by example and provide the financial support needed.
With respect to the Canada Health Act, there are several principles, as you know. If I can summarize two of those principles into one, it is equitable access. Yes, there is the issue of access, but access must also be fair, based on health conditions, obviously, but also living conditions.
As part of our relationships with the provinces and territories, when we assess whether the provinces are meeting these access conditions, we look at whether people living in official language minority communities receive, in an equitable way, the health care to which they are entitled.
Of course, we do this in a manner that respects provincial jurisdictions, as provinces have the ultimate jurisdiction to determine their health care actions.
Senator Gagné: As for the specific commitment to official languages, I know that a bill was already introduced almost 20 years ago, if not more, in which a specific commitment to official languages was requested.
Could you elaborate on that?
Mr. Duclos: In the bill before the House of Commons, which we hope will reach the Senate very soon, health care is among the priority areas, if memory serves me. The officials will be able to confirm that.
Senator Mégie: I welcome you, minister, and the officials who are with you. Thank you for coming to testify at our health study.
The order of reference for this study, which discusses minority language health services, mentions the need to look at telemedicine and the use of new technologies in the health sector, including the language challenges that arise. That echoes your mandate letter.
Minister, could you explain how the government is ensuring that the development and use of health applications that use artificial intelligence are accessible in both official languages? How will you ensure that they comply with the Canada Health Act?
Mr. Duclos: Thank you. I’d like to say three things about that. First is that these technological developments, as you’ve mentioned, are both quick and generally positive. Telemedicine, digital health and virtual health care all contribute not only to greater efficiency in health care delivery, but also to greater speed in some cases.
Clearly, the safety of health care is often better ensured when the information in the medical files circulates more easily, but that can also ensure greater equity, particularly for those living, for example, in remote or rural areas. There are also a lot of minority francophones and anglophones who live quite a distance from the centres where most health workers are located.
If that technology is used correctly, virtual care and digital information sharing can help foster greater equity and greater access to that health care.
That said, the third aspect is the jurisdictional aspect, meaning that it’s the provinces and territories who will ultimately determine the specific actions they’ll want to put in place and the populations to be served more quickly through those technological developments, which also include not only technological developments, but also developments in scopes of practice.
As a health professional, you know very well the extent to which jurisdictions can be better used when scopes of practice are appropriately expanded or enhanced. Sometimes, in minority settings, there are not a lot of specialists, but there may be nurse practitioners, nurses or physician assistants who can provide appropriate health care, always in the official language of those communities.
From a health and language standpoint, we believe that these technologies and this greater flexibility in scope of practice can improve equity and access to care in minority settings.
Senator Mégie: Thank you. I have a question that is related more to health in terms of Canada’s new guidance on alcohol and health. I don’t know the extent of your jurisdiction in this respect, but you know that, with these new standards, policy changes are being proposed, particularly with respect to the labelling of alcoholic beverages. Given the effectiveness of health-related labelling, which has been scientifically demonstrated, would you be in favour of such an approach to better inform the public about health problems? Have you thought about this within your department, in terms of how to go about getting such a form of information to the public?
Mr. Duclos: Excellent question. Thank you for asking it. There are three examples. The first is the report you correctly referred to, which is obviously available. The media have covered it a lot in recent weeks. People have been able to consult it in many cases.
The second thing: some would like that report to be even easier to access, on a Health Canada website, for example. We’ll see if that is useful. When I say “we,” I’m referring to my colleague Minister Bennett, who is very familiar with both the file and how to pursue her discussions and her work with specialists and partners on the issue.
The third thing: in terms of labelling, Ms. Bennett has already addressed it and said that it was one of the options being considered. That’s a good question for her. Again, she’s the best person, the most committed and the one who has done the most work with experts, including clinicians like yourself, Senator Mégie. In your work over the years, you know how much information can help people make the best possible decisions for their health.
Senator Moncion: Minister, thank you for being with us, as well as your staff.
My question is related to the comment you made in your speaking notes. You talked about credential recognition for people arriving from abroad.
I’d like to hear from you about provincial and federal jurisdictions in this area and on how you would verify those credentials.
Mr. Duclos: Thank you for your question. As you mentioned, this is in fact a matter of provincial and territorial jurisdiction. Under the Constitution, the provinces and territories are responsible for the conditions and criteria that govern the health care duties performed by people such as physicians, nurses, pharmacists or other health professionals. Often, the provinces and territories delegate that regulatory work to professional bodies, which are managed and governed by legislation and regulations passed by those provinces and territories.
That said, the Government of Canada works closely with the provinces and territories on immigration issues, which are quite complementary to issues related to the recognition of credentials. That is why, in recent weeks and months, the work has accelerated and together — the provinces, the territories and federal government — we can see how we can better coordinate the arrival of people in the country with respect to immigration. Once they are here, we must facilitate and accelerate the recognition of their foreign credentials so that they can easily put their talents and skills to work in communities, including minority language communities.
We believe that this issue must also be considered. If the arrival of foreign workers is facilitated, the arrival of workers who can then live, grow and work in the minority language environment can also be facilitated.
So, this is a collaborative effort and we see, by looking at what’s been done in the Atlantic provinces in the last few weeks — where they announced that they would be creating a regional registry of physicians — how we could extend that regional registry across the country for provinces that would like to take part in that initiative. It could also be done in a parallel fashion with other health care professionals.
Senator Moncion: Thank you. My second question is more about the latest iteration of health transfers that you negotiated with your provincial counterparts. Certain conditions were attached to the transfers this time. Could you tell us about some of those conditions?
Mr. Duclos: It’s really about the 3 Rs: respect, responsibility and results. Respect for jurisdictions: The Government of Canada can never claim that it wants to or can manage hospitals, professional bodies and physicians. That is a shared responsibility, as we all have the same responsibility for caring for the same people, with the same dollars and with a focus on outcomes. That’s what is new here. Based on lessons we’ve learned and the implementation of the 2017 agreements concerning mental health, community care and home care, we’ve seen that we can go further and do more by asking the provinces and territories to provide action plans outlining the priority areas where additional resources from the Government of Canada would be invested.
Overall, family medicine, mental health, workers and modern data systems are the four main areas in which the provinces want to invest the federal government resources, and they want to associate those investments with targets and timelines — for example, how many more people will be able to access a family physician, including in rural areas and official language minority communities. So, it’s about targets, timelines and subsequent reporting by the provinces and territories on whether or not it was possible to meet those targets within the timelines.
Senator Moncion: Will the federal government set the targets or will that actually be done at the provincial level?
Mr. Duclos: The provinces set their targets, and the timelines are over three years because the first phase of the action plan will be over the next three years. So, the targets are set by the provinces to ensure better access to family medicine and other indicators related to the key priorities I summarized.
Senator Dagenais: Good evening, minister.
When we talk about respecting the two official languages and actions to improve the situation, I admit that I often have reservations about the effectiveness of the appropriate measures. Let me explain: I welcome the emphasis on bilingualism for access to the highest positions in the health field.
You’re a francophone and you have meetings with decision makers in your department, who are in Ottawa and across the country. When you are there, it is surely because the meetings are important.
To what extent can those meetings you attend be held in French in Canada? Do you sincerely believe that, when francophones and anglophones are around the table, the meetings can be held in French?
Mr. Duclos: Thank you for the question, Senator Dagenais.
I recognize, emphasize and support the importance that we place on linguistic duality in Canada, including within the government. You are an ally and a strong advocate for the importance of bilingualism within the federal government and in the senior public service.
I can assure you that all meetings with my senior officials are held in French and English. In any case, if I want to use French or English, I can do so, because I know that my officials will be able to understand what I’m saying and respond in the language of their choice.
Senator Dagenais: I’d like to talk to you about the hospital sector and the particular situation in Quebec.
In Montreal, anglophones have access to an English-language school board, and English-language CEGEPs, universities and hospitals. The reverse is far from true in the rest of Canada.
How do you react when anglophones in Quebec present themselves as a minority and feel that the services they already receive in their mother tongue could be threatened by some of the provisions of Bill C-13?
Mr. Duclos: Thank you for highlighting the importance of this bill. As I said earlier, I look forward to seeing this bill supported by the Senate.
This is a bill that makes a big difference in the context you described. For the first time in Canada’s history, it is being recognized that there are anglophone and francophone linguistic minorities across the country. It is also recognized that French must be defended across the country, including in Quebec, because, as everyone knows, French is a minority language in Canada, on the continent and around the world. There must be genuine equality. It must be recognized that French is more fragile and threatened, not because Canadians think that French is less important than English, but simply because the linguistic weight of French in Canada and on the continent is not conducive to the survival and promotion of French as a language of work and of life. That’s why Bill C-13 is so important.
I look forward to the senators studying this bill. We will be able to build on this foundation to move to another stage, which often makes a statement that should be clear. I think it’s clear that French is a minority language not only in other provinces in Canada, but elsewhere in North America as well.
Senator Dagenais: Thank you, minister.
Senator Clement: Good evening, minister.
I’m pleased to see you here with your colleagues. I thank you for being with us.
My question is about the intersection between language in a minority context and Black and racialized communities. The pandemic had a negative impact on the health of all Canadians, but it also had particularly negative consequences for Black and racialized communities. Senator McCallum tabled a motion in the Senate to add a sixth pillar to the Canada Health Act that would address anti-racism.
Without taking a position on that motion, I would like to hear your comments on the federal government’s role in intersectionality in the context of health and how the federal government could measure success or progress in that area.
Mr. Duclos: Thank you very much for the question, Senator Clement.
I will take this opportunity to talk to you about what you already do very well, namely intersectionality.
We are a people with multiple identities. It is the intersection of those many identities that make us richer. However, that intersectionality sometimes presents significant challenges in terms of inclusion, and it’s important to recognize that. That multiplicity of identities is sometimes more visible or more hidden. It makes us stronger, richer, but it is important to recognize that in the case of racialized and francophone people, there can be significant challenges related to participation and inclusion.
For the first time in history, we reached the target of 4.4% francophone immigration in 2022. Since 2015, we have seen four times more francophone immigrants settle in provinces other than Quebec. That is major progress that many of you had been hoping for for a long time. We met that target last year. That doesn’t mean that we should stop there. We must continue our efforts. For a very long time, there has been a deficit in francophone immigration outside Quebec.
We must continue and do even better. Most francophones who arrive from outside Canada are from sub-Saharan Africa, North Africa and West Africa. Some are also from other regions in Europe. When they come from Europe, they come from other communities that may be racialized. When we strengthen French-language intake services, we help these populations, who are often racialized, to integrate, to participate, to feel included more quickly and more effectively in the communities.
As you said, we have to recognize that this is not just about language. It can involve other aspects that may lead to exclusion and discrimination.
I look forward to working with you and my other colleagues to ensure that we all have the same opportunity to live healthy and safe lives in Canada, regardless of the colour of our skin, our language, our backgrounds and who we are.
Senator Clement: Thank you, minister.
Senator Dalphond: Welcome to the Senate, minister. I have a few questions that stem from those that were already asked.
My first question follows up on the question from Senator Moncion concerning the agreements with the provinces, namely the additional $196 billion over 10 years. First, I congratulate you because everyone recognized that it was an impossible challenge, and you met it.
Does every agreement with every province include provisions concerning access to health care in the minority language? If not, do only one or two provinces have that type of provision?
Mr. Duclos: Thank you very much for your question, Senator Dalphond. I thank you for the expertise you bring to the Standing Senate Committee on Official Languages.
In fact, all the provinces and territories received the same offer. When they accept a letter of agreement in principle, they must essentially and explicitly respond that they agree on the importance of having indicators in their plans and measures which support people living in official language minority communities.
Senator Dalphond: The third part of the equation is outcomes based on targets and timelines. That means that every agreement contains targets and timelines for access to French-language care in predominantly English-speaking settings, and the same is true in Quebec.
Do those agreements set out means for verifying whether those objectives have been met? In other words, will the information shared go beyond simply indicating who received what type of service on what date, but also indicate the language preferences of users and the professionals who provided the services?
Mr. Duclos: I would say that it is a progression. The reason those agreements are possible now is that there are already a certain number of high-level indicators. I would be happy to ask my team to share them with you. We already have benchmarks for eight of those indicators, such as mental health, family practice workers and data use, among others, to ensure that health professionals can work together.
The basic data we have are not very disaggregated. In most cases, we have no information about access to family medicine in rural areas, for example. On the other hand, the data we have is used to build these agreements with the provinces and territories.
Within those agreements, there is also a commitment to go further by working with the Canadian Institute for Health Information to validate those higher-level indicators — we’ll call them aggregated indicators — and disaggregate them for the communities where we want to provide more equitable access to health. Work will focus on that over the next few years, obviously.
We need to identify groups for which our data needs to be refined in order to support better public policy.
Senator Dalphond: Am I to understand that seniors living in a rural setting in a francophone community, for example, and who must move to another city to receive the best care for their condition, are likely to receive care in a language other than their own, or even a language they don’t speak?
Will it be possible to measure that phenomenon and ensure continuity of services in the minority language, especially for the most vulnerable people?
Mr. Duclos: That is a very good question, and it’s the kind of indicator we hear a lot about from experts. People like you who are interested in these issues will very likely propose that the actors involved, including the Canadian Institute for Health Information, develop these indicators, first on a conceptual basis, and then on a needs-assessment basis in terms of administrative and survey data, in order to validate this reliably, but also over time.
Senator Mockler: Minister, I am seeking clarification on some of the comments and questions that were asked previously. For the past few years, the federal government’s position has been that French is declining across Canada.
Although I more than agree with that statement, particularly after the health care I have received and that I still qualify as the best in the world — and by far — I believe that minority language communities must be given the means to flourish within our great country.
However, the agreements reached between the federal government and the provinces and territories concerning early childhood education do not ensure that the funds will go specifically to the targeted communities. In that case, as Minister of Health, how can you assure us that you will not make the same mistake?
Mr. Duclos: Thank you, Senator Mockler, for making the connection between early childhood and health. In 2018, when we first reached agreements to support early childhood education in New Brunswick, there were clear provisions by which New Brunswick committed to investing in better access, greater affordability and greater quality of child care services, including for francophones in the province.
However, it is clear that, ultimately, we must not simply be satisfied with a signature and an agreement. We must also be able to validate all of this. I have heard francophone rights groups in New Brunswick say that they would use this commitment from the province to see how the commitment would be respected. This is the result of transparency. When you make a commitment to do something and when an agreement is public, you can then demand accountability and expect results.
The same thing applies to the health agreements. The federal government will never be able to micromanage provincial health decisions and determine how many workers will be hired, where they will be deployed and what type of services they will offer.
However, with the transparency that comes with these agreements, New Brunswickers and others will be able to see if they can work with the province to ensure that that commitment leads to results.
Senator Mockler: Thank you, minister. I would like to get more clarification on your mandate letter. When we read your mandate letter, we see that it unfortunately contains no mention of the health of official language minority communities. Our health needs are different; so are our challenges.
In the context of the post-COVID era and the aging population, and according to the latest data, such an omission worries many people because of the decline of the French language. How is your department responding to the health needs of official language minority communities, and what barriers are you facing? Also, what consultation mechanisms do you use to fully understand what is happening on the ground?
Mr. Duclos: Thank you for your question. You are correct in noting that mandate letters are always a little too short, although some people find them a little too long. Certain elements may not be clearly stated in them, but they are implied.
Without wanting to sound partisan, I would say that my own presence as a francophone in cabinet leads me to work with others for greater justice and better access to essential services such as health care.
First of all, agreements will be signed with the provinces and territories. Although the mandate letter does not specifically state that these agreements must include provisions for access to appropriate health services in minority language communities, this requirement is there.
Secondly, in Budget 2023, the government announced a funding increase for Health Canada’s Official Languages Health Program, or OLHP, from $192 million to $207 million. This is a substantial increase in the amount of funding, which had already been increased through the 2018 Action Plan for Official Languages. In both cases, as you aptly pointed out, the goal is to ensure that, even if it’s not mentioned in a government mandate letter, when the opportunity arises — such as a budget or an agreement with the provinces — access and equity in this area will be strengthened.
The Chair: Before we go to the second round, I have a few questions for you as well, Minister Duclos, including the question of access to bilingual human resources.
I recently participated in the Summit on the Recruitment of Bilingual Health Care Professionals, which was held in Newfoundland and Labrador and brought together policy makers and academics. The shortage of bilingual health professionals emerged as a significant issue. That is why it is important to focus on international recruitment and to continue to employ bilingual health professionals to ensure the active offer of health services.
What is Health Canada doing to address this shortage of bilingual health professionals?
Mr. Duclos: Thank you for the question, Senator Cormier. I will limit myself to two or three points.
First of all, immigration is obviously the key, and as we heard earlier, that is why we achieved our target of 4.4% for francophone immigration outside Quebec. This is good news. Some 16,000 francophones immigrated to provinces and territories other than Quebec in 2022. Many of them went to work in the health care sector because the demand is obviously enormous. In New Brunswick, even though there is always room for improvement, we know that efforts are being made to hire more francophone immigrants to serve francophone communities in the province.
Secondly, there is the matter of training. Over the past 20 years or so, the federal government has trained nearly 10,000 bilingual health professionals through Health Canada’s Official Languages Health Program. We are talking solely about federal government investments that do not require the linguistic training provided by the provinces and territories. These 10,000 health professionals are now able to work in both languages and meet the needs of minority language communities.
Third, I would add that Budget 2022 provided close to $115 million over five years to streamline recognition of foreign credentials. This will help roughly 11,000 health professionals — who will immigrate or have already immigrated to Canada since 2022 — to quickly find jobs in minority language communities. One of the issues is that we want people to go work in a minority language setting, whether rural or even farther from major centres — as is the case in New Brunswick. They need to be confident that, if they make the effort to work in these communities, their talents and skills will be recognized quickly.
I will limit myself to those three points. As you said, this is a big challenge.
The Chair: Thank you. That brings me to a question about private institutions.
There is a shift towards obtaining health services from private institutions. What role should the federal government play in this regard? As you know, the use of private institutions could lead to francophones or anglophones in minority communities being deprived of services in the language of their choice.
What can you tell us about that?
Mr. Duclos: Indeed, privately funded versus publicly funded health care is a major concern for many people.
I have two things to say on that topic. As mentioned earlier, technological advances, increased geographic mobility and expanding scopes of practice are all positive in most cases. This allows people to avoid going to another community to receive health services faster, sometimes even in the language of their choice. Greater mobility, recognition of credentials and a broader range of responsibilities can also help to better serve communities and people with specific needs.
This said, there should be no cost for accessing health care. Health services can be provided using new technologies and with the help of physicians who are, by definition, self-employed, but the funding should remain private. In Canada, essential health services must be provided free of charge. This remains a challenge.
As you have likely noticed, there is a risk that new technologies and increased mobility will be privately funded. This means that people would have to pay to have access to this health care, and if they can’t pay, they won’t have access to the care or it will be provided to those who can afford it.
The Chair: The federal government is helping to fight this trend. How can the government deal with it through agreements, for example? Is this solely a provincial or territorial area of jurisdiction? Does the federal government have a role to play, and if so, what role?
Mr. Duclos: There are three ways to do this. The first and most important is to have an open and transparent dialogue. I meet with my counterpart, the Minister of Health, on a regular basis. We have met nearly 15 times in the past year and few months, so we talk often. Obviously, our teams are always working together, and our officials are too. It is through discussing these issues that we will be able to move forward in the right direction — the same direction.
Second, if there are provinces where essential medical care is provided privately — sometimes even without it being known — the federal government can deduct from health transfers the amounts that people have paid to access this care.
This is my responsibility. I had to do this just a few weeks ago. It gives me no pleasure, but it is a requirement of the Canada Health Act.
Third, in the agreements we negotiate, it is clearly stated that federal funds must be used to strengthen the public health care system, not the private system.
The Chair: Fellow senators, we have a few minutes left with the minister. I would like you to keep your questions short. Minister, please provide short answers, whenever possible.
Senator Gagné: There has been a lot of talk about the barriers to recognition of foreign credentials. Another barrier that we need to talk about is interprovincial mobility. The pan-Canadian action plan is going to address the shortage of health care workers in an effort to reduce these barriers.
I know that the majority of provinces agree that interprovincial barriers should be eliminated. Ontario has introduced a bill to this effect to ensure mobility, and the Council of the Federation has promised to cooperate in this area. I am not sure about Quebec’s position; I believe it recently indicated that it was less interested in that cooperation. This is probably one of the biggest challenges facing our federation, that is, reaching consensus on barriers. We all agree that the barriers often make no sense.
I have seen situations where language was one of the barriers. For someone who moves to British Columbia or Manitoba, they have to take English tests that require an excessive level of proficiency.
In your view, is there a consensus in the works or a way to reach agreement with the provinces and professional bodies to ensure mobility between the provinces for professionals trained in Canada? It seems like a no-brainer to me.
Mr. Duclos: Thank you, Senator Gagné. I very much appreciate that question. The short answer is yes. I believe a consensus will be reached over the coming months. A consensus has already begun to emerge in recent months. Earlier, it was mentioned that the four Atlantic provinces had agreed to put in place a regional registry of physicians. A physician working in one of the four provinces who is listed in the regional registry can choose to work in one of the other provinces. As you mentioned, Ontario and British Columbia have indicated that this type of measure would be beneficial for their own populations.
The Council of the Federation has mentioned this as well. The council, which brings together all 13 provinces and territories, indicated that it agrees with the approach.
Furthermore, as you have already suggested, this facilitates cooperation among physicians. We are living in an increasingly virtual and digital world. We also live in a world where health professionals are increasingly specialized and do not always have the specific credentials needed to respond to equally specific circumstances and needs.
Specialists are working together more and more within their own province, as well as between provinces. Recognition of credentials across the federation could facilitate interprovincial cooperation. This applies not only to health professionals educated in Canada, but also to foreign-trained health professionals.
I think we’ll reach an even stronger consensus and achieve greater progress over the coming months. That way, when one province recognizes the credentials of foreign-trained workers, they will be able to move around more easily or provide services virtually and cooperatively, to help patients located elsewhere in the country. This includes populations living in minority language communities.
The Chair: Thank you for your answer. Thank you, Minister Duclos. For our second hour, we will have the officials from Health Canada and the Public Health Agency of Canada with us. We will be able to continue the discussion with them.
Minister, thank you for your participation and your presence here this evening. Your comments and thoughts will help us with our study. We are very pleased that you were able to join us.
We are going to suspend just long enough to thank the minister.
Mr. Duclos: Thank you all.
The Chair: Fellow senators, we are now resuming. We have with us Ms. Voisin, Ms. Valdés and Mr. Nafekh. Thank you for being with us for our study.
We are going to continue the question period. Senator Moncion, since you were on the list, do you have a question for the witnesses?
Senator Moncion: Thank you for being here this evening. I would like to hear what you have to say on the federal government’s commitment with respect to requirements for the modernization of equipment, services, technologies and digital data access cards in the federal-provincial agreements. What work is being done on that?
For example, with regard to magnetic resonance imaging equipment, we met with people who told us that faxes were still being used for appointments. Modernization of the system provides an opportunity to generate significant efficiencies. The same is true for digital access cards, which contain more information. There is also the matter of provinces sharing access to patients’ records. I would like to hear your thoughts on the modernization of Canadian medicine as a whole.
Jocelyne Voisin, Assistant Deputy Minister, Strategic Policy Branch, Health Canada: Thank you for the question. First of all, in the agreements we expect to sign with the provinces and territories, there is a commitment regarding the sharing of some data and information. At the deputy minister level, an agreement on interoperability was recently signed with the provinces and territories. This means that, in most cases, the existing systems in all the provinces and territories — in physicians’ offices, for example — are electronic. Your doctor may have an electronic copy of your file, but the doctor’s computer is not linked to the other computers or systems found in other hospitals and health centres.
What we want to have is a plan to make all the systems communicate with one another. This means there will be standards for the exchange of technical information and standards for data sharing. The data will use the same terminology so they will be comparable.
The plan was developed by Canada Health Infoway in partnership with the provinces and territories. All the provinces and territories, except for Quebec, have indicated that they would use these standards to make progress, so that data will be comparable across the country and systems can communicate better.
They are international standards. They weren’t developed in Canada. It means more international business opportunities for Canadian companies. The provinces committed to this in relation to the funding we announced in February for the provinces and territories.
Senator Moncion: How many years will it take?
Ms. Voisin: Canada Health Infoway has already entered into an agreement with the provinces and territories. They are going to accelerate the implementation of the plan over the next three years. Some provinces and territories have already taken the lead and are making good progress. Quebec already has a bill that addresses existing policies to ensure that data can be shared more readily between the different health care systems, so that citizens and residents can have access to their own electronic records, as you mentioned.
This is one of the issues that we really want to address moving forward, in other words, giving patients access to their own electronic records. Moreover, this is one of the indicators we put in place for funding in conjunction with the provinces and territories.
Senator Moncion: In the agreement, time is always a consideration. We know that, if a file belongs to a patient, as in the case of a financial institution, the data belong to the person. Therefore, they can share their data with whomever they want. A patient could eventually own their own medical records and share them with a new physician after moving to a different province. The patient’s medical history would thus be shared. Is that where things are headed?
Ms. Voisin: That’s our vision, yes, but it will take time, and it isn’t simple. That is why we put in place certain indicators, such as the eight indicators the minister mentioned, so that patients will have access to their own electronic records and patient records can be shared among physicians and different health care systems.
Senator Moncion: Very good. That is where we can achieve efficiencies.
Nathalie Valdés, Manager, Official Language Community Development Bureau, Health Canada: I would like to add something. You spoke about health cards, and I want to share an example of cooperation that took place a few years ago between Health Canada and the Prince Edward Island health board. Officials decided that health cards should identify patients’ preferred official language, so that they could better gauge the potential demand for services in French in the province, better plan the distribution of staff, and refer patients to these resources to prevent further language mismatches in health care facilities. Therefore, from the beginning, an individual who would prefer to be served in French can be referred to the appropriate existing services. It may not be a cutting-edge planning tool, but what a great idea.
Prince Edward Island wants to determine the potential demand for services in French. Officials also used it as an opportunity to learn a lot more about the diversity of the population served. They collected data not just on the two official languages, but also on the other languages that users speak. They were surprised to discover that, on their small island of 100,000 people, more than 100 different languages and dialects are spoken within the population. This provided the province with a better understanding of the diversity of the population it serves and fostered more sensitivity to cultural and linguistic differences in order to better meet the population’s needs.
Other provinces are interested in this type of initiative, including Saskatchewan, Manitoba and Ontario. Through Health Canada’s Official Languages Health Program, we expect to receive additional funding under the new action plan, and we would like to support such initiatives in the future.
Senator Mégie: Budget 2023 proposes to provide close to $160 million over three years to the Public Health Agency of Canada to support the implementation and operation of the 9-8-8 helpline.
It’s expected that, as of November 30, 2023, Canadians will be able to phone or text the number any time for immediate access to suicide prevention services and mental health crisis support.
Will the 9-8-8 helpline be available from day one in both official languages across the country? Will a francophone have to press 1 or 2, only to discover that the service is not available in the early days? Do you have a timeline?
[English]
Mark Nafekh, Director General, Centre for Health Promotion, Health Promotion and Chronic Disease Prevention, Public Health Agency of Canada: Thank you for the excellent question.
I can speak to the intent, but in terms of the actuality and the very first day that it’s launched, I don’t have that information readily available. I could provide that information back to the committee in writing and confirm.
[Translation]
Senator Mégie: We are counting on you to send us the answer through the clerk of the committee. Thank you.
Senator Clement: Good evening and welcome. I would like to follow up on some of the comments made by Ms. Valdés.
First, the minister mentioned that we had finally reached the target of 4.4% for francophone immigration. How will Health Canada ensure that it meets the specific needs of that population, needs that reflect the intersection of language and racialized communities?
Second, the minister mentioned cooperation with Statistics Canada and referred to a survey. Could you tell us a little more about that partnership? It is always important to have disaggregated data.
Third, how will the Health Portfolio Advisory Committee support Health Canada’s vision of better cooperation?
Ms. Voisin: Thank you for your question. I’ll start by addressing the question on disaggregated data and the intersection of needs, and then I’ll let Ms. Valdés answer the other ones.
Regarding our cooperation with Statistics Canada, the minister was talking about the eight indicators that we announced, which are part of the commitments made by the provinces and territories under the bilateral agreements.
He said that most of the indicators already exist, as do the data. There are surveys, for instance. One example is access to a family doctor. Indeed, 14% of Canadians do not have regular access to a family doctor in their community.
One of the indicators that we want to examine is the progress made with these data. However, we don’t have detailed disaggregated data on that. The purpose of the partnership between Statistics Canada and the Canadian Institute for Health Information is to work together to get more complete data on the health system, to cooperate with the provinces and territories to obtain data on the health system — not just a survey — and to work with Statistics Canada to see whether we can match these data with other data from Statistics Canada. That will give us access to disaggregated data on official languages, individuals’ or communities’ preferred languages, and racialized populations. This partnership should help us obtain a larger amount of disaggregated data on the indicators.
Ms. Valdés: Thank you for your question. Regarding racialized communities, we are now more aware of the increasing diversity of official language minority communities, or OLMCs, and that such factors must be taken into account in trying to better meet those communities’ health needs. Therefore, it’s a matter of not only language, but also culture, the approach to health and interactions with health care providers.
At Health Canada, through the Official Language Community Development Bureau and funding program, we work with community stakeholders who, in turn, work with these communities to understand and document their needs. In addition, various partners are involved — including the provincial and territorial authorities, health institutions and other community agencies — in order to bring forward these issues, see how the system can adapt and determine which measures should be taken so that the system can better respond to these needs. There’s a lot of interest.
Here’s an example. A network in British Columbia has done some research on people who recently immigrated and their experiences interacting with the health system. This entire process has to be documented, and discussions have to be held with the authorities, the ones able to effect change.
Quebec anglophones have the Community Health and Social Services Network, a support network dedicated to better understanding the issues faced by recent immigrants and English-speaking visible minorities in the province. It works to raise awareness among government authorities so that they adapt their delivery of health services.
That is a very effective and quite practical way to promote these tools.
During our program’s final funding phase, we took on and funded a research project to develop new models of care for Black anglophone communities in Montreal dealing with mental health issues.
Therefore, these phenomena must be explained in their cultural context, where talking about these issues with families is not so easy, nor is supporting families and patients in their journey through a health system that can be challenging. Therefore, initiatives with documented results have been shared across the network, which is active throughout Canada.
I would also like to expand on what Ms. Voisin said. For several years, we have worked with them whenever it’s time to update the content of certain surveys, including the Canadian Community Health Survey.
Together, we have developed a dedicated official languages module, which will likely be used in the field in the coming years. The purpose is to document not only what these communities are experiencing, but also the extent to which their experiences are different from those of the linguistic majority. The idea is to fully understand their issues and perspectives.
We also worked with them to develop the content of the post‑censal survey. Data collection was just completed, and a health module was developed. This will enable us to obtain a wealth of data from across the country. Owing to some issues with the responses, we decided to lengthen the survey period to maximize the number of respondents.
All this is paired with data collection initiatives involving public opinion research, for example. During the last consultations, which were part of our program renewal process, we managed to reach over 2,000 members of OLMCs. They were asked very concrete questions to help us better prepare the next funding phase, identify new and ongoing issues, and determine how we can continue to support the efforts of our partners on the ground and of the post-secondary institutions that receive our support for training bilingual human resources.
Senator Clement: Thank you for that very thorough response. Today, the senators of African descent met with representatives of the group Parents of Black Children. These local networks are growing and have important things to say. It is important to know that the federal government is communicating with local networks. Thank you.
The Chair: Thank you for your answer. I have a follow-up question for you, Ms. Valdés, on the subject of vulnerable communities. The order of reference for our study refers to LGBTQ+ communities and official languages. Are there components in your initiatives that are intended specifically for these communities, and, if so, what have you learned?
Ms. Voisin: Thank you for the question. I will give the floor to Ms. Valdés, but I know that the Public Health Agency of Canada has carried out initiatives in that area.
Ms. Valdés: As was mentioned, we’re working closely with community networks that are attuned to the realities on the ground experienced by the communities. In terms of LGBTQ2 communities, we are keenly aware that it is important to be sensitive to these realities — for example, seniors in residential facilities having to come out all over again in those settings. How can staff be educated on those issues? For example, when we renew our training agreements, a sex and gender sensitivity component must be part of the training of future health care professionals. That is a way to promote the importance of being sensitive to this reality and of adequately meeting these populations’ needs.
[English]
Mr. Nafekh: Thank you for the excellent question.
The Public Health Agency of Canada uses data that my colleagues have mentioned, along with Statistics Canada’s health inequalities reporting initiative, to identify those LGBTQ+ communities or individuals in OLMC communities to get an idea of exactly where the gaps are in the needs, and we then support programs which address those needs. I can give a few examples, but it’s a public basing tool that may be of interest to this committee in their analysis. As an example of the programs that we offer, we do offer one program for seniors in residential centres to ensure that they are receiving health services in the language of their choice. It includes training caregivers to deliver those services.
The Chair: And to add to that, how do you measure the result and the real impact of those programs? It is one thing to give them, but how do you measure that? It is part of the challenge we all have. What you can say about that?
Mr. Nafekh: Measuring the impact is very challenging because you need time to measure the impact in some of these cases. The health inequalities reporting tool does look at health outcomes by various demographics, but again, you would need some time to see some change. For the programs that target those populations, we always require recipients to come back with a report that demonstrates what was achieved through the programming that they offered.
The Chair: Thank you.
[Translation]
Senator Dagenais: I have two quick questions. The first is for Ms. Voisin. The Parliamentary Budget Officer, in a fairly substantial report, casts some doubt on the government’s ability to achieve the objectives of Bill C-13 on official languages and to be able to truly protect the French language.
If we look at things such as labour mobility, which is a key factor in the health sector across Canada, what are the numbers? What investments is your department making to ensure medical services are available in French everywhere in Canada, particularly for Quebecers who have to work outside Quebec? If they want to be seen quickly, are they forced to receive services in English? When you are sick, you usually don’t have time to get a translator.
Ms. Voisin: I would point to the recent investment in Budget 2023 to improve health services, as mentioned by the minister. A total of $200 billion will be provided over 10 years for the provinces and territories. I can follow up on the specific amount for Quebec in terms of what was announced publicly.
We are waiting for an agreement with Quebec, which will improve health services, to implement the expected plan for the province, but federal funds are also available to improve services for Quebecers.
In addition, under our program, investments are earmarked for official language minority communities. Ms. Valdés can speak in greater detail about the different components of the program, which aims to improve access to health services in an individual’s language of choice.
Ms. Valdés: Before getting into what our program does, I would like to draw your attention to one point. Last year, Health Canada once again worked with Statistics Canada to gain a better understanding of trends in language skills and bilingualism in the health workforce. What we found, from 2001 to 2016, by examining the data available when we began the study, was that the level of French use by health professionals in Quebec was over 98%. Therefore, most of them speak French. When you compare this with the use of French outside Quebec, you see that the number of health professionals who are bilingual or identify as such has increased.
However, since the health sector has exploded in recent years, their proportion in the health care system has decreased to around 11% of respondents. As you can imagine, that depends on the province or territory, ranging from 30% in New Brunswick, in the Atlantic provinces, to a low percentage in British Columbia. This report is publicly available, and I can give you the link if you like.
In terms of training, the approach adopted under the Health Canada program is to support the vitality of francophone communities outside Quebec. We provide the option of post‑secondary training in French for francophones living outside Quebec, so they can continue their education in French. That way, they don’t have to study at anglophone universities or colleges, which are sometimes far from their community, something that could lead to their not coming back to their community.
We support 16 francophone training institutions, colleges and universities that belong to the Association des collèges et universités de la francophonie canadienne and provide over 110 training programs. As the minister mentioned, this program has supported over 10,000 bilingual health professionals. The existing training programs supported by the provinces and territories have produced roughly 30,000 graduates since 2003, when we began to collect the data. Follow-up surveys have been carried out to find out where these graduates work and whether they serve OLMCs. Roughly 96% have remained in their own communities, and 98% state that they provide services to official language minority communities. More effort is still needed, of course, since, as we mentioned, the numbers have increased but the proportion has decreased. The government recently announced, in Budget 2023, additional funding for training nurses and personal support care workers, which we hope to begin administering with our partners in the next few months.
Senator Dagenais: Is the delivery of French-language services to a francophone in a hospital in Alberta or English‑language services to an anglophone in a hospital in Quebec a federal or provincial responsibility? If someone wants to make a complaint, who do they address their complaint to?
Ms. Valdés: The obligation to serve the public in both official languages varies by province and territory. Some have legislation. Ontario, for example, has the French Language Services Act, but that is not the case across the board.
However, across the country, there are policies encouraging the provision of services in the second official language spoken. Thanks to training, we’re seeing something interesting at the community organization level. There are discussions with public authorities, and training is available in areas such as the active offer of services. This means that, when patients arrive, you can ask them what their official language of choice is in order to steer them to existing services in French. Of course, all services may not be available in French. It depends on where they live.
Senator Dagenais: Thank you very much, madam.
Ms. Voisin: Obviously, like the delivery of health care services, it’s a provincial and territorial responsibility. Although we can encourage the provinces and territories to provide services in the language of choice, it is the provinces and territories that decide how the services are to be delivered.
Senator Dagenais: Thank you very much.
The Chair: In negotiating agreements between the federal and provincial or territorial governments, isn’t there room to require more accountability from the provinces on providing services in both official languages? Isn’t that an instrument that can be used, so as not to run the risk of giving the provinces maximum flexibility when it comes to the delivery of services in both official languages?
Ms. Voisin: As the minister said, it really comes down to respecting the provinces’ and territories’ jurisdiction over the delivery of health services, although we can use the agreements as a tool to improve services to OLMCs.
In the agreements that we are currently negotiating with the provinces and territories, we have ensured that there is a commitment from the provinces and territories to improve services for equity-seeking populations, including official language minority communities. It’s one of the points that we address when we discuss action plans with the provinces and territories, in order to do more and ensure that they include commitments in their action plan and concrete measures to meet those communities’ needs.
The Chair: Like the minister, you used the term “equity,” but is the term “substantive equality” part of your department’s vocabulary when you deal with official languages matters?
Ms. Voisin: I don’t know whether I can answer that question. It’s true that we talk a lot about equity. We have a program dedicated to OLMCs. We try to advance the principles proposed in the bill.
The Chair: Thank you for your answer. The purpose of my question was not to trip you up, Ms. Voisin.
Senator Gagné: Ms. Valdés, you said that the Association des collèges et universités de la francophonie canadienne and the Consortium national de formation en santé are certainly key players, because of the support they provide to communities through colleges and universities. I just wanted to point out that the federal government also plays a key role, because it participates in these organizations. On behalf of my community in Manitoba and the Université de Saint-Boniface, thank you for this support.
From a comparative standpoint, you stated that a great deal of work still has to be done to ensure continued progress toward substantive equality between both official languages. Yes, there is still a lot of work to do. I just wanted to reiterate that.
The minister spoke about assessing health inequalities. I gather from what you said that language is one of the factors to be considered in assessing health inequalities. Did I understand you correctly? The list of determinants of health includes income and social status, employment and working conditions, education and literacy, childhood experiences, gender, culture, and race and racism. Was language considered as a determinant of health in the studies?
Ms. Voisin: I am going to call on my colleague from the Public Health Agency of Canada to answer that question, since determinants of health are an extremely broad issue. Health Canada focuses more on the delivery of health services. The Public Health Agency of Canada is better suited to speak to issues involving a broader analysis of public health.
[English]
Mr. Nafekh: It is important to identify all the social determinants of health because the Public Health Agency of Canada designs its programs to target those in most need. Many of those factors are intersectional, including language. I’ll go back to the health inequalities reporting tool that I mentioned. The first official language spoken is one of the indicators that we use to look at those intersecting factors. When you intersect first official language with geography and with many of the other factors that you mentioned, it helps us to identify the communities in which we need to target our programs, the stakeholders that are the official language minority communities, and the stakeholders that work in those communities and may offer programs. We then encourage them to apply for funding to deliver those programs in those communities. I guess my short answer is yes, we do consider language as one of those intersecting factors.
Senator Gagné: Thank you. But it’s not necessarily identified as a determinant of health, though, when we look at the list. It’s just part of all the determinants that are included in the list; is that it?
Mr. Nafekh: That would be correct.
[Translation]
Ms. Valdés: Yes. Other elements that perhaps are not on the list are also considered. That includes all the things that set remote and rural populations apart. That means not only the communities’ geographical location, but also the whole issue of disabilities and persons with disabilities. All of that comes into play. Furthermore, it’s part of what we do in sex- and gender‑based analysis. It goes beyond sex and gender. All the facets of diversity in Canadian society are considered, such as socio‑economic status and so on.
Senator Gagné: Thank you.
The Chair: This ties in with the question from Senator Gagné. Culture is, in my opinion, a determinant of health, so it would be interesting to understand how culture is defined as a determinant of health. Since language and culture are intrinsically and inextricably linked, is language considered when culture is taken into account as a health determinant?
[English]
Mr. Nafekh: Yes. I know that we’ve done public opinion research in official language minority communities among specific demographics, like the 2SLBGTQI+ demographic, and we know that they experience discrimination twofold and isolation more so when you add that as a social determinant or as a factor. In terms of culture, I’m not quite clear on the reference to culture versus language.
The Chair: When you think about culture in terms of a determinant, I was just wondering if the language is part of that, because it’s linked together, right? I guess it’s more a philosophical question that I’m asking but —
Mr. Nafekh: The answer is yes.
The Chair: Thank you.
I have a couple of questions that I will ask to Mr. Nafekh. Is the Public Health Agency of Canada able to comply with its linguistic obligations when working with third parties? Has, for example, the Public Health Agency of Canada developed an action plan to ensure that communications and services delivered by third parties comply with obligations set out in Part IV of the Official Languages Act, as recommended by the Commissioner of Official Languages?
Mr. Nafekh: Thank you for the question.
The short answer is yes. The way we do that is through — well, it depends. For contractors, for example, we write requirements into the contracts that they provide all materials in both official languages. For our funding recipients, we include clauses that are the same and also encourage offering programs that target official language minority communities and the needs of those demographics that we’re trying to target in those communities.
The Chair: There again, how do you measure the results and the impact and if they have done what they were supposed to do?
Mr. Nafekh: Through annual reporting. We examine exactly who the recipients were at the end of the day, and through those reports, we do extensive monitoring and reporting back.
The Chair: Thank you.
I have one last question concerning the Dementia Community Investment. What have been the main achievements, and how many projects targeted official language minority communities? Did this funding serve to improve access to minority language health services, and if so, in what way?
Mr. Nafekh: I can provide a list of projects and their funding to the committee in writing, but I will give some examples. We have seen some success.
In terms of targeting the programs, again, we conducted public opinion research to be able to identify the needs in those communities. Then we worked with stakeholders to deliver programs. For example, la Société Alzheimer Granby et région is receiving funding to counter stigma and reduce social isolation for people with mild cognitive impairment and to provide support for caregivers, including in the anglophone and francophone minority communities in Quebec and Nova Scotia.
[Translation]
The Chair: Thank you.
I would like to thank the witnesses for their contribution this evening and for the work they do, day in and day out, to help Canadians live healthy lives.
Before we adjourn, fellow senators, I would like to alert you to the fact that our order of reference authorizing the committee’s study of the application of the Official Languages Act is set to expire on June 15. Next week, I plan to give notice of a motion to extend the deadline for the report to December 31, 2025. That way, we won’t need to seek another extension before the dissolution of the Forty-fourth Parliament. This motion deals with our general mandate.
I would also like to inform you that, next week. I plan to move the adoption of the francophone immigration report and to request a government response from the Minister of Immigration, Refugees and Citizenship in consultation with the Minister of Official Languages. That will be done next week.
Thank you, honourable senators. If there are no other comments or questions, the meeting is adjourned.
(The committee adjourned.)