The French Language Services Commissioner’s reaction to Bill 74, The People’s Health Care Act, 2019

Bill 74, The People’s Health Care Act, 2019 (PHCA), if adopted, will impact how health services are planned, coordinated, funded and provided and will have major implications for French-language health services.  Bill 74 creates Ontario Health, a single agency to operate and oversee services throughout the province and eliminates the 14 Local Health Integration Networks.

Ontario Health will designate Ontario Health Teams at the local level.  These teams will be responsible for coordinating and providing care to specific populations and geographic areas.  These Teams will include, for example, hospitals, long-term care homes, community care agencies and community health centres.  They will be clinically and fiscally accountable for delivering a co-ordinated continuum of care.

Several proposed initiatives may have a positive impact on accessing French language health services.  First, the government will introduce new tools to improve how patients and their families navigate the health system.  This is promising for Francophones who face access barriers.  Secondly, the government wants to optimize the use of digital resources to increase access to specialists. This is also a promising initiative for Francophones living in smaller more isolated communities.

Minister of Health and Long-Term Care, the Honourable Christine Elliott, insisted yesterday on improving access to online health records. It is going to be critical to ensure that these tools are fully accessible in French. Don’t let this begin the wrong way, as we know, from past experiences how difficult – and costly – administrative and program revisions are.

The Minister reiterated numerous times that this new system would let patients have a say in their health care journey.  For Francophones, this ability to influence the provision of health care services in French will be established by maintaining the French Language Health Services Council and the French Language Health Planning Entities.

What is not clear at this stage is the scope of responsibility of the Entities, and to whom they will be able to provide advice. Their voice must be equally heard at the local and at the provincial levels. Their role in the planning, design, delivery and evaluation stages is crucial. Section 44 of Bill 74 seems promising in terms of the relations between Entities and Ontario Health. But their role goes deeper as they need to be able to interact daily with the newly created Ontario Health Teams across the province.

In its preamble, Bill 74 outlines the obligation to respect the requirements of the French Language Services Act but provides little language on how this will be done.  The commissioner’s office would like to see this part of the bill amended to clarify that this requirement applies to the planning, design, delivery and evaluation of the French-language health services.

While the Commissioner’s office agrees that centralizing the planning and coordination of health services may be beneficial to issue stronger, more systemic directives with regards to French-language health services, it will be up to the senior management of Ontario Health to issue and implement such directives.

When Ontario Health Teams are established, and the integration of community health service providers within these teams takes place, the government will have to ensure that health services providers that are fully or partially designated under the French Language Services Act maintain the designation of these services.  This obligation should be clearly specified in Bill 74 so that no French-language services are eliminated.

As in all transitions, the process of designating Ontario Health Teams and integrating service providers may also provide an opportunity to evaluate and vet the capacity of service providers to provide French language services.  Through this process, health services providers that have some capacity to provide French language services should be supported in seeking their designation under the FLS Act. It might be an opportune time to test the new designation process under the French Language Services Act that I have recommended ever since the Minister of Francophone Affairs, the Honourable Caroline Mulroney, took office.

The new legislation unveiled by the Health and Long-Term Care Minister yesterday creates mechanisms for collaboration between the new Ontario Health agency and the existing French Language Health Planning Entities. I applaud the fact that Bill 74, The People’s Health Care Act, 2019, recognizes the important role that Entities can play in advising Ontario Health.

In the weeks to come, I will recommend that this role be further clarified to include all aspects of the planning, delivery, evaluation and deployment of health services for French-speaking communities.   In addition, while the Bill confirms that their voices will be heard at the provincial level, we strongly recommend that provisions be added to confirm the role of Entities at the local level, and their ability to guide the integration and coordination of services by Ontario Health Teams.

As this reform unfolds, my office will continue to provide constructive advice and collaborate with the Ministry to ensure the best possible outcomes for the provision of improved French language health services in the province.

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