3. The Francophone community as a stakeholder

Citizen participation in the health system has been advocated in the form of “patient partner” principles that promote the inclusion of patients in planning and delivering services with a view to enhancing safety, quality and innovative solutions.⁸⁰ In Ontario, the Patients First Act takes a step in this direction by acknowledging the importance of patients’ voices in local care and services planning.

Nevertheless, Regulation 515/09, Engagement With the Francophone Community Under Section 16 of the Act explicitly recognizes the particular nature of this community. It also requests Francophone participation in care planning, within the structure of the French-language services planning entities (Entities) and collaboration with Local Health Integration Networks (LHINs). While the recent amendment to this Regulation would appear to imply greater recognition from LHINs and the Entities, from the standpoint of regional Francophone communities, its application at the local, institutional and service levels, particularly in highly minority settings, remains work in progress.

Different experiences need to be generalized in order to identify and specify the Francophone community’s role in the care continuum.

With a view to a more collaborative approach, the Guide de planification et de prestation des soins de longue durée en français⁸¹ makes community engagement one of the six attributes to be incorporated into an optimal French- language long-term care model for Ontario.

This means going well beyond mere consultation and moving towards a form of collaboration in care planning and organization that includes families, communities, care providers and other stakeholders. Montfort Hospital‘s track record with patient partners and the attention it has received for its Francophone expertise could also be put to effective use. It would also benefit from taking various forms:

(…) [translation] whether in terms of informing French language health or senior services; an organization‘s strategy, values, policies and programs; or getting patients, residents, families and caregivers involved in planning care and disease self-management.⁸²

However, these initiatives do not quite address the essence of the active-offer-of-service concept, in which, following the planning and delivery of services, the opinion of Francophones is sought to evaluate and enhance the quality of the services provided in French. But evaluation is a broader issue, insofar as the performance of designated agencies under the French Language Services Act is not always evaluated on an annual basis. A serious discussion on the safety and quality of care for Francophone seniors can be held only when a transparent evaluation of designated agencies that factors in the perspective of Francophone seniors becomes a reality and is incorporated into the annual evaluation of departments.