News: Health

Forum on French-language health services

Last week, I had the pleasure of attending the forum on French-language health services organized by the Ministry of Health and Long-Term Care (MOHLTC). Those present included not only the Minister, though he was there only to kick off the discussions, but also senior managers of the MOHLTC and the Local Health Integration Networks (LHINs), the French Language Health Planning Entities, and the members of the French Language Health Services Advisory Council. It was only the second time such a forum has been held (the last one was in 2014). One of the good things to come out of the meeting was certainly Minister Hoskins’s commitment to make the forum an annual event.

At the meeting, everyone was brought up to date on the latest regulatory changes (Regulation 515/09), and an effort was made to renew the relationship between the LHINs and Planning Entities and focus on the common goal of improving access to French-language health services. It is important to work together to assist Francophones who do not have equitable access to French-language health services in their area and are unable to find out which health service providers or professionals might help them and where they are located. In my brief talk, I attempted to address these particular issues. It is important to bear in mind that the LHINs have been around for just 11 years, and the Entities 7 years. That is not very long, but it is well past time to stop ignoring the mistakes that have been made for so many years. The key word is “collaboration.” The intent of the amendments made in the Regulation is clearly to ensure that the Entities are seen as the LHINs’ partners, and not as mere subordinates.

What’s more, the MOHLTC has published a new guide on French-language health services requirements and obligations. The guide is extremely well designed, and I am very hopeful that it will help all those who were not present at this important meeting to better understand the roles and responsibilities of all parties in the health system and the need to truly focus on integration and collaboration as they go about their work. I have been told the Guide will be available on the MOHTLC website soon.

 

 

MORE CONSTRUCTIVE COLLABORATION BETWEEN LOCAL HEALTH SYSTEM INTEGRATION NETWORKS AND FRENCH LANGUAGE HEALTH PLANNING ENTITIES.

TORONTO, September 5, 2017 — In response to a notice of amendments to Regulation 515/09 concerning engagement with the Francophone community, the Commissioner, François Boileau, has made new recommendations for encouraging more productive collaboration between local health system integration networks (LHINs) and French language health planning entities.

The amendments will help to strengthen the existing collaboration between LHINs and the entities; they will make that collaboration more concrete and focused than before when it comes to access to health services in French. With the planning and accountability tools that will support that collaboration, it will guarantee better delivery of health services that are adapted to the needs of Francophone patients in Ontario,” Mr. Boileau said.

In the notice, the Ministry includes a recommendation that LHINs be required to work with the entities to implement new strategies for improving access to health services in French.

While the amendments to Regulation 515/09 as proposed now by the Ministry of Health and Long-Term Care could have provided for a greater level of collaboration between LHINs and the entities, they do represent a major step in the right direction, and are certainly an improvement over the present situation,” Commissioner Boileau added.

The Commissioner supports the amendments as proposed now by the Ministry of Health and Long-Term Care and reiterates that he will continue to collaborate with the Ministry and other stakeholders to ensure that Francophone patients are a priority in the healthcare system.

Quick facts

• In 2006, the Government of Ontario decentralized the health system. The Local Health System Integration Act, 2006 (LHSIA) then created 14 LHINs (Local Health Integration Networks).

• When the government created the LHINs, it did not include the needs of Francophones in health services planning at the local level, an omission that resulted in over 100 complaints being filed with the Office of the Commissioner between 2007 and 2008, and led to the preparation of a special report.

• In May 2009, the Commissioner released the Special Report on French Language Services Planning in Ontario, which prompted the government to make Regulation 151/09 concerning engagement with the Francophone community in relation to health services in French, and to create planning entities.

• In November 2016, during the process of enacting Bill 41, the Patients First Act, 2016, the Commissioner, along with many others, hoped that the role of those entities would evolve into a partnership with the LHINs for planning services in French. Unfortunately, the bill was enacted without being amended to reflect that.

• In his 2016-2017 annual report, the Commissioner recommends that the Minister of Health and Long-Term Care amend Regulation 515/09 to give the French language health planning entities a larger role in planning health services in French, particularly in relation to the integrated health services plans to be produced by the LHINs.

The Office of the French Language Services Commissioner reports directly to the Legislative Assembly of Ontario. Its principal mandate is to ensure compliance with the French Language Services Act in the delivery of government services.

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A look back on the saga surrounding the closure of Penetanguishene General Hospital.

Yesterday was a day full of interviews following the submission of our brief to the Minister of Francophone Affairs, the Honourable Marie-France Lalonde, as well as her Ministry and the Ministry of Health and Long-Term Care. The purpose of the brief was to point out that the process of revoking Penetanguishene General Hospital’s designation constituted a violation of the French Language Services Act. I certainly didn’t mince my words, but I had to do it because, after all, it is the patients who have been suffering the consequences all these years. The process set out in the Act was quite simply ignored. It’s an undeniable fact. I therefore recommended a series of measures to prevent future violations of this kind.

I also stated in the brief that we had been receiving complaints since early 2017 concerning the French-language services provided at Georgian Bay General Hospital (GBGH). I’d like to thank the hospital administration for acquiescing and requesting designation, even if it was partial, under the FLSA. Since July 1, GBGH has been partially designated under the FLSA, and we should be pleased about that. It means that, technically, admission services and ambulatory services must be available in French.

I’d like to salute the efforts of the hospital’s senior management and bilingual employees, as they are working very hard to provide the area’s Francophones with quality services. The Commissioner’s Office acknowledges the hospital’s efforts and is working with its staff to address the non-compliance problems. Since designation, we’ve received a few complaints, but they are not about systemic issues.

You can rest assured that the Commissioner’s Office will continue to work with all parties concerned to improve the delivery of designated services by GBGH for the benefit of Francophone patients. In this regard, the Minister of Francophone Affairs’ initial response shows that the government is receptive to making changes, and that is a good sign.

 

 

THE CONSULTATION ONTHE REVOCATION OF THE DESIGNATION OF PENETANGUISHENE GENERAL HOSPITAL: TOO LITTLE, TOO LATE.

TORONTO, August 21, 2017 — In a brief submitted to the Minister of Francophone Affairs, the Honorable Marie-France Lalonde, the Commissioner of French Language Services, Mr. François Boileau, reminds her Ministry and the Ministry of Health and Long-Term Care that there has been a breach of the French Language Services Act with regard to the revocation of the designation of Penetanguishene General Hospital.

The process required under the French Language Services Act was not respected, and the government players are therefore in breach of the Act. This situation perfectly illustrates the impact that the lack of accountability and compliance verification has on the offering of French-language services: these Ministries were not thorough and the patients were the ones who suffered. It is unfortunate that Francophone patients are prejudiced and are not able to access health care services in their language,” states the Commissioner Boileau.

Before eliminating the designated services offered by Penetanguishene General Hospital, the North Simcoe Muskoka Local Health Integration Network was required to ensure that all reasonable measures were taken to comply with the Act. The Ministry of Francophone Affairs and the Ministry of Health and Long-Term Care also had the obligation to respect the process required under the Act for revoking a designation.

Commissioner Boileau emphasizes that “this overdue public consultation serves no purpose because it is taking place nine years after Penetang Hospital’s designated services were eliminated. Also, the mere fact that Georgian Bay General Hospital was ordered to request its designation is not a ‘reasonable measure’ within the meaning of the Act.”

In his brief, the Commissioner also recommended a series of specific measures to remedy this situation, and to prevent future violations. Among other things, these recommendations seek to improve accountability, organizational efficiency, and the prompt identification of compliance deficiencies in the delivery of French-language services.

 

Quick facts

• The Office of the Commissioner received 19 complaints about the closure of Penetanguishene General Hospital, all filed in November 2014.

• According to Ontario Regulation 398/93, Penetanguishene General Hospital is designated under the French Language Services Act for admitting, reception, ambulatory services, people systems, and business office services. It was not until July 2017 that these same services were designated at Georgian Bay General Hospital.

• Penetanguishene General Hospital closed its doors in March 2016.

• At the end of 2016, the Office received nine new complaints about the inadequate delivery of the designated services by Georgian Bay General Hospital.

 

The Office of the French Language Services Commissioner reports directly to the Legislative Assembly of Ontario, and its primary mandate is to ensure that the delivery of government services complies with the French Language Services Act.

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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.