News: Health

Position Statement on the Active Offer of French Language Health Services

The Regroupement des Entités de planification des services de santé en français de l’Ontario and the Alliance des Réseaux ontariens de santé en français published a Joint Position Statement on the Active Offer of French Language Health Services in Ontario. This short document, which is only three pages long, summarizes finely sum up the issue of active offer in the critical sector that is health care. In their own words: “This position statement establishes the relevance of active offer, provides a definition adapted to health services for Ontario’s Francophones and identifies the roles and responsibilities of several key actors in its implementation.”

I am delighted by this position statement. Since the beginning of my mandate, I made the principle of active offer one of my most important targets. Without active offer, particularly in the health sector, there cannot be a real understanding of the needs of the Francophone community, nor of its existence.

As I wrote in my 2013-2014 annual report: “…the current situation does not create an environment conducive to reaching those who are still hesitant to use services in French on a daily basis, nor to helping avert the constant threat of assimilation.

The Commissioner believes that many breaches of the Act could have been avoided with a decidedly active provision of services in French. And those breaches could sometimes have dramatic consequences, as in the fields of health care and access to justice. Having failed to obtain a satisfactory outcome, the Commissioner will once again have to revisit this critical issue.

As specified in this position statement :

Active offer of health services in French is the regular and permanent offer of services to the Francophone population. Active offer of services:

  • respects the principle of equity;
  • aims for service quality comparable to that provided in English;
  • is linguistically and culturally appropriate to the needs and priorities of  Francophones;
  • is inherent in the quality of the services provided to people (patients, residents, clients) and an important contributing factor to their safety.

It is the result of a rigorous and innovative process for planning and delivering services in French across the entire health care continuum.

It depends on accountability at several levels and requires partners to exercise appropriate leadership with respect to health services in French.

In concrete terms, it takes the form of a range of health services available in French and offered proactively, that is, services are clearly announced, visible and easily accessible at all times.

It is also indicated in a section on the implementation of this statement on active offer that:

Implementation of active offer of French language health services requires an appropriation of responsibility at several levels:

 The system (Ministry of Health and Long-Term Care, LHINs) that designs the policies and programs, sets the rules, allocates resources, retains providers’ services and holds them accountable;

  • The organizations that provide the services;
  • The professionals who work with patients, residents and clients;
  • And the individuals who use health services.

 Careful planning of active offer at each of these levels is necessary to ensure effective implementation and optimal conditions for Francophone patients.

I intend to come back to this issue again, during the course of the next year. In the meantime, I can only congratulate the authors of this statement for its clarity, brevity and its desire to convince the relevant stakeholders of the validity of this statement. I offer them my full collaboration to ensure its full implementation.

Honourable Mention: Identified Health Service Providers Group

The Mississauga Halton LHIN created a group of identified health service providers within its catchment area. The group led by the MHLHIN aims to improve access to culturally and linguistically appropriate health care services in French in the LHIN, as required by the French Language Services Act. This forum provides an opportunity for identified health service providers to discuss topics relating to FLS, such as the latest news and directives, initiatives and programs to support FLS development, funding opportunities, language resources, and best practices and community events.

The Honourable Mentions Series is a series of 11 blog posts that the Commissioner is releasing to individually recognize the leadership shown by government ministries and agencies that have made efforts to expand the delivery of high-quality French-language services, as listed in his 2013-2014 Annual Report here.

Honourable Mention: Collaborative Care Project for Francophone Seniors

The Central West LHIN and its Entity, Reflet Salvéo, partnered to create a collaborative care project focused on Francophone seniors. The goal of the initiative was to enable the community to identify care needs and build a business case to address them. With the leadership and support of the LHIN and the Entity, community members met and participated in an engagement and planning process in order to draft a business case.

Community members from Francophone seniors groups, community centres, health service providers and community colleges were mobilized for the collaborative care project and engaged in the development of the LHIN’s Seniors Strategy. Through community engagement sessions and a survey, this project is building capacity within the community. In addition, the community was able to better understand their health needs and the process of service planning, and provided the LHIN with valuable information and guidance in drafting its SeniorsStrategy.

The Honourable Mentions Series is a series of 11 blog posts that the Commissioner is releasing to individually recognize the leadership shown by government ministries and agencies that have made efforts to expand the delivery of high-quality French-language services, as listed in his 2013-2014 Annual Report here.

Honourable Mention: French Language Services Toolkit

The Erie St. Clair and South West LHINs put together a French Language Services Toolkit as a comprehensive resource to support health service providers in implementing and delivering quality services and meeting the needs of their French-speaking patients and clients.

The Toolkit provides an overview on a variety of subjects related to the delivery of services in French. Each section is designed to provide useful information and practical tools to make delivery of services in French as easy as possible. Providers will find basic information on the Francophone community, active offer of French-language services, human resources, training, translation and interpretation, supporting legislation and thehealthline.ca. The Toolkit also contains fact sheets, lists of resources, flyers, badges, a lanyard and signs to promote the delivery of services in French. It can be easily adapted for use in other areas of the province or for non-health service providers.

The Honourable Mentions Series is a series of 11 blog posts that the Commissioner is releasing to individually recognize the leadership shown by government ministries and agencies that have made efforts to expand the delivery of high-quality French-language services, as listed in his 2013-2014 Annual Report here.

Follow-up on the Report: The Application of the Act on Third Parties

July 1 marked the coming into force of Regulation 284/11 on the provision of French-language services on behalf of government agencies. You will recall, in light of my previous recommendations, that I have long wanted a clear commitment from the government to ensure that ministries fulfil their linguistic obligations when they contract with third parties to provide services on their behalf.

The Office of Francophone Affairs did a great deal of work in developing and implementing this regulation, in conjunction with all of the ministries. It would appear that the majority of government agencies introduced mechanisms and processes to ensure the adoption of a systematic approach and compliance with accountability mechanisms.

However, a serious threat looms. We have learned that it had been determined that health service providers were not subject to the third-party regulation because of their particular relationship with the Local Health Integration Networks (LHINs). The argument goes as follows: though funded by the government, health service providers have agreements with the LHINs. Since the LHINs have no responsibility for direct service delivery as such, they cannot “delegate” that responsibility to health service providers. Therefore, they do not provide services “on behalf of” the government in the meaning of the French Language Services Act, which means, in their view that the regulation does not apply.

In other words, if the LHINs did not exist, some service providers in the health field would be subject to the Act, on the basis of Regulation 284/11. In my view, this argument does not hold water. I cannot accept it. To me, it seems that these legal gymnastics, of which Franco-Ontarians are well accustomed to, are contrary to the lawmaker’ intent.

I have expressed my concerns to the most senior authorities in the government, who seemed receptive. The discussions are relatively promising, suggesting the possibility of regulatory action that would explicitly target certain health care providers and define their French-language service responsibilities in black and white. However, these piecemeal initiatives will take time, resources and effort and may ultimately fail.

This is not a recommendation, since we are talking about ongoing discussions, but if we do not address the issue, this stumbling block will jeopardize the successful implementation of Regulation 284/11 as a whole. 

Follow-up on the Report: Helping the Most Vulnerable When They Need Help the Most

This is a series of blog posts that the Commissioner is releasing to follow-up on the annual report and to individually highlight some parts of it that remain current. We will have the occasion during the fall to add more information on the interactive version of the report available here.

In my 2011-2012 Annual Report Straight Forward I broached the subject of the plight of Francophones living with HIV/Aids, followed by a blog post commemorating World Day Against Aids in 2012, and an update on the subject in my 2012-2013 Annual Report A New Approach, which spoke of some positive signs taking place in this highly specialised and very important area of health care.

People living with HIV or Aids are literally fighting for their lives, and they have to both share and understand complex and sensitive information, all while not feeling well. They have to be able to describe physical and mental conditions, symptoms and side effects in precise terms. They have to receive and understand critical advice regarding lifestyle, the legal and health consequences of certain practices, how to obtain long-term and emergency assistance, and how to take medication. This is no easy feat to accomplish even in one’s mother tongue, but the intellectual gymnastics required by Francophones living with HIV/Aids makes their unenviable position even more challenging.

Francophones dealing with the life-limiting illness that is HIV/AIDS are often faced with choosing between a facility that specializes in HIV/AIDS (in English), and a facility that caters to the Francophone public at large, thereby losing all the cultural sensitivities that accompany this disease.

The Commissioner’s Office continues to receive complaints from this vulnerable community, who are a minority within a minority. Because this is an area that is so sensitive and touches on several vulnerable populations (LGBT, immigrants, women, youth, the elderly, those living with mental health issues and drug addictions), the Commissioner’s Office will be looking at picking up where the 2011–2012 Annual Report ended, looking for a strategy from the Ministry that will fully integrate French-language services for all those living with HIV/AIDS throughout their medical journey.

To get an in-depth view of the current situation of Francophones living with HIV/AIDS, I will look into launching a thorough province-wide investigation with a view to making carefully crafted, well-researched recommendations to the Ministry of Health and Long-Term Care that will impr ove the quality lif e for Francophone HIV/AIDS patients from all walks of life.

I invite you to view these infographics that illustrate which populations are mostly affected by HIV across the country, and how the situation differs in every region, particularly in Ontario.