Annual Report 2017-2018

Looking ahead, getting ready

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4. Standardized accessible language data

For many years now, taking the language variable into account 83 has been recognized as a critical issue in the experience of patients and their families. The efforts of the Entities have facilitated the identification and alignment of patients’ language preferences with the language skills of the health professionals. The fact remains that these processes are only partial; for example, the Entities’ websites do not quickly and systematically display information on services available in French.84

The vulnerability of seniors when they seek care reduces their confidence and even their ability to ask for help in French. The government’s interest in determining the linguistic identity of people from the health card is the key to solving this problem, which nevertheless goes beyond the access points for which the health card is required. The Commissioner would like to congratulate the previous government for having said that it was determined to include the language variable as part of the planned renewal process for the health card.85

Knowing that it will still take several years before the system is functional, the Entities and the LHINs need to work together to introduce effective ways of identifying the language profile of Francophone seniors, particularly those with dementia, to ensure that their care experiences, whether at home or elsewhere, are safe.

The Ministry of Health and Long Term Care has identified the enhancement of French Language Health Services (FLHS) data and reporting as a priority. In collaboration with the LHINs and Entities, the ministry is working to facilitate FLHS data collection across the province for the assessment of FLHS capacity and demand.

By doing so, the Ministry of Health and Long-Term Care and the Ministry of Children, Community and Social Services would be taking proactive action to standardize and generalize ways to determine the linguistic capabilities of professionals throughout the province. The expertise of Montfort Hospital could also be drawn upon to provide extensive Francophone and bilingual human resources planning.

The identification of these language variables needs to be built into the care protocols. The data should also be widely available to health care-system stakeholders for all kinds of care situations: from primary to palliative health care, from care in devitalized regions to care in cities, and from care for autonomous people to homecare.

There are many possible ways to respond. For example, the Ontario Telemedicine Network should make it possible for a family doctor to readily and systematically find a health specialist capable of working in French – which is not the case now. Online businesses that put health workers in touch with potential clients should also be required to properly capture the linguistic variables, by which we mean a genuine ability of professionals to serve people in French.

Beyond linking patients and professionals, the regular gathering of linguistic proficiency data should lead to a different way of planning health care. This new planning must consider Francophones who do not ask to be served in French: hence the vital importance of active offer and the introduction of the linguistic variable in the health card renewal process in order to create an environment conducive to Francophones being served in their language.

LHINs will only be able to secure access to beds or homecare in French more easily if the stakeholders and professionals who can work in French are known, brought together in bilingual units or included in care approaches. The recruitment and retention of bilingual staff86 could also become a part of standard practices set out in the agency designation process and evaluated annually.

And if the future Ontario dementia strategy were to include people with dementia in the decision-making process,87 then this process could set out specific procedures for Francophones, including those used for end-of-life care.


  1. The linguistic variable refers to data that capture people’s linguistic competencies, identity or preferences for the purpose of health-system planning.
  2. Cardinal, L. et al, “L’offre active de services de santé mentale en français en Ontario : données et enjeux”, Minorités linguistiques et société, (9), 2018, p. 74-99.
  3. Ontario Budget 2018. A plan for wellness and the future. p. 139.
  4. For further details: http://hhrstrategy.ca
  5. Supra note 72.

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