Chapter 2
A Human Story
2.6 Health
In his 2011-2012 Annual Report, the Commissioner made some positive comments on the progress made by the Ministry of Health and Long-Term Care in response to his Special Report on French Language Health Services Planning in Ontario, published in 2009.
This was in sharp contrast to the 2008-2009 Annual Report, in which the Commissioner criticized the Ministry for mismanaging the issue of the proposed regulation to make the French Language Health Planning Entities compliant with the Local Health System Integration Act, 2006, and for taking a somewhat passive approach to
its legal obligations under the French Language Services Act (FLSA).
In any case, the six entities established in 2010 are currently operational and have signed funding and accountability framework agreements with the Local Health Integration Networks (LHINs) in their respective regions. Each LHIN also now has a French-language services coordinator.
In the same vein, the government responded to repeated requests from the Peel-Halton community for French-language health care services in the region by supporting the opening of the Credit Valley Family Health Team office in April 2012. The Commissioner first presented the results of his investigation on the subject in his Investigation Report on the Centre de services de santé – Peel et Halton inc., published in March 2010.
In view of the positive impact of the recent initiatives in the health sector, the Commissioner remains optimistic, especially because of the Ministry’s change of attitude. Indeed, the Ministry is now exhibiting a real desire to find pragmatic, lasting solutions that meet the needs of Francophone citizens instead of merely adhering to the letter of the FLSA.
HIV/AIDS
On the occasion of World AIDS Day, December 1, 2012, the Commissioner wrote a blog post providing a detailed picture of the issues faced by Francophones living with and at risk of HIV. While the Ministry has maintained that organizations operating in the HIV/AIDS sector have no legal obligation to provide service in French (since they are not government agencies and do not provide services on the government’s behalf), it has nevertheless taken a more active role to ensure that Francophones living with HIV have access to HIV-specific services in French.
The Ministry has contributed to the funding of community organizations operating in the HIV/AIDS service sector to help them make their resources available in French and train their employees. In the Commissioner’s view, the fact that consultations on the renewal of the provincial strategy on HIV/AIDS have been held in French is also promising. He is hopeful that the specific needs and characteristics of the Francophone community will be taken into account.
Regulated health professions
Under the Regulated Health Professions Act, 1991, Schedule 2, section 86, a person has the right to use French in all dealings with, in particular, the College of Nurses of Ontario. Despite this explicit provision, however, the College still seems to have difficulty complying with it, a recurring problem that the Commissioner raised in his 2008-2009 Annual Report and his 2009-2010 Annual Report.
In 2012, a French-language health services provider asked the Commissioner’s Office to intervene in the case of a Francophone nurse practitioner whom it had hired more than a year earlier but who had still not been able to obtain her licence to practise in Ontario. She had apparently waited more than seven months for the translation of her file alone, and each time she contacted the College, she was unable to obtain service in French.
Since the Ministry is responsible for the statute in question, the Commissioner’s Office requested its assistance in identifying options for resolving the issue.
The College then promised to revise its current practices to ensure that similar situations do not occur in the future. The case of the nurse in question was also resolved in less than a week. The Commissioner is pleased that the Ministry made a commitment to contact Ontario’s other health profession regulatory bodies and offer them training on their obligations concerning the provision of French-language services and on the importance of active offer.
Clinical assessment tools
To meet patients’ needs more effectively, a number of standardized clinical assessment tools were made available to health service providers (HSPs) in the community care sector, such as the Ontario Common Assessment of Needs (OCAN), the interResident Assessment Instrument Community Health Assessment (interRAI CHA) and the Integrated Assessment Record (IAR), which is an assessment viewer. Unfortunately, French versions of these tools were not provided at the same time. However, the Ministry acknowledged that this process had not been properly planned and promised to remedy the situation.
Since the initial concern regarding the lack of French assessment tools was raised, the Ministry has taken the following actions to remedy the situation: both of the assessments — OCAN and interRAI CHA — are now available in English and French, along with supporting training material. The Ministry will also take the necessary steps to encourage vendors to develop bilingual products as prerequisites in any future updates.
Consideration of the Francophone community’s specific characteristics
As part of its response to the first recommendation in the 2009 Special Report on French Language Health Services Planning in Ontario, the Ministry included funding for the Réseau de recherche appliquée sur la santé des francophones de l’Ontario (RRASFO) in the Applied Health Research Networks Initiative (AHRNI). The RRASFO’s objective is to observe, measure, document and evaluate health conditions and access to health services for the Francophone population of Ontario.
Though laudable, these efforts have not yet translated into the acquisition of reliable data for use by the LHINs in planning health services. All too often, the results of studies conducted by and for Francophones are not translated into French and are therefore not incorporated into the knowledge community. For example, there are still no data on the number of Franco-Ontarians who have diabetes.
Similarly, there is no consensus on how to identify Francophones in the planning and delivery of health care services. The data of some agencies are still based on language spoken or language preference, while others, including the Commissioner’s Office, want the Inclusive Definition of Francophone (IDF) to be used.
The development of Open Minds, Healthy Minds, Ontario’s Mental Health and Addictions Strategy, is an example of how the Ministry is careful to consult the Francophone community but in some cases neglects to follow up with Francophone communities on how their feedback has been used. As a result, many in Ontario’s Francophone communities feel wrongfully marginalized.