Ottawa, May 28, 2002
Notes for an address to the Commission on the Future of Health Care in Canada
Dr. Dyane Adam – Commissioner of Official Languages
Check against delivery
Ladies and gentlemen, good day.
Research is unanimous in confirming that health is neither a static nor a one-dimensional phenomenon. Health depends on a set of living conditions that have to do with economics, education, the physical environment, work, age, and access to high-quality health care services. Governments, which have a role to play in all these areas, are responsible for providing equal health opportunities for all citizens, regardless of whether they are members of the linguistic majority or minority community. As Commissioner of Official Languages, of course, I take a special interest in the future of the official language minority communities, which are more vulnerable and at greater risk.
Introduction
Today, Canada's French-speaking and English-speaking official language minorities are asking questions about the connections between health, language and culture and about the fact that your Commission has not yet made these connections explicit.
I am particularly interested in these connections because I know that health, like language equality, does not exist in a vacuum. Health is a concrete, day-to-day experience. Health is practised and developed on the ground. Fully recognizing its interrelatedness with every aspect of life is a prerequisite for setting up a genuine health care system. For example, a recent study by Ontario's Public Health Research, Education and Development Program pointed out the existence of especially vulnerable groups, in terms of health determinants, within the French-speaking community. This study emphasized the importance of outlining an optimum health profile for this community and of better focusing programs and services.
Health and communication
Clearly, communication is central to providing high-quality health care. If we are to meet people's needs, we must first be able to understand what they are telling us. My career as a psychologist taught me that caring is primarily listening, but also making sure I have understood correctly. Helping people depends on language, and on the cultural code that is linked to language. Often, the effectiveness of care is closely related to the atmosphere of trust between the patient and the health care professionals.
In fact, many health care services are provided to individuals at times of extreme vulnerability. Obvious examples include front-line services, mental health services, home care services, long-term care and, especially, care for young children and senior citizens.
We can readily see how important it is, for members of the official language minority communities just as for members of the majority communities, that we facilitate delivery of these services in their own language. A recent study on language barriers in access to health care, conducted for Health Canada, highlighted the negative effects of language barriers on access to health care. As a priority, this study identified the need to develop standards of practice and models of service that are appropriate to Canada's situation.
In the health care field, as in others, an ounce of prevention is worth a pound of cure. And prevention starts with education about the healthy habits and living conditions that are vital in maintaining health and improving well-being. The strategy of boosting health and closing gaps between vulnerable groups and the population in general will benefit all Canadians. Awareness and education programs about healthy habits could be offered through the nationwide network of school systems and also, of course, in the schools of the official language minority communities.
A two-point strategy
Health care services form an integrated continuum that calls for an integrated approach, encompassing planning, delivery and follow-up. Planning is based on a two-point strategy for creating and providing services that respect the official language minority communities' specific characteristics. It is urgent to complete research--often sadly lacking--on these communities' access to health care. The second step is to create or to perfect service delivery models that best respond to these communities' respective situations.
Fortunately, a number of models are already being developed, particularly in Quebec, Ontario, New Brunswick and Manitoba. Our task now is to fine-tune these models and to create similar models in the other jurisdictions. Planning is based on effective training networks for health care professionals--and not only networks, but also enough professionals (including psychologists, speech therapists, and nurses)--equipped to provide the awareness-training and the education that will foster vitality and equality for our young people within the school systems of the official language minority communities.
Recommendations
One purpose of the Romanow Commission's Interim Report, tabled in February 2002, was to situate Canada's health care system clearly in its social and physical setting. Under Part VII of the Official Languages Act, the federal government, in co-operation with its provincial partners, is committed to enhancing the vitality of Canada's English-speaking and French-speaking linguistic minorities in concrete ways. I cannot see how this objective can be achieved without addressing an issue as basic as the linguistic dimension of health care. Indeed, the need to address this issue is one of the basic lessons to be learned from the unanimous Ontario Court of Appeal decision in favour of the Montfort- Hospital.
I therefore recommend that the Commission on the Future of Health Care in Canada explicitly address the linguistic and cultural contexts in which health care is provided. Furthermore, I would invite the Commission, in writing its recommendations, to carefully assess their impacts of those recommendations on the official language minority communities and to include that assessment in its Final Report.
I also recommend that the Commission propose that governments establish databases on the linguistic and cultural dimensions of health care and on the impact of health determinants on the official language minority communities. This information would allow governments to develop integrated strategies for prevention and for the promotion and delivery of high-quality health care services.
Lastly, I recommend that, in its Final Report, the Commission emphasize the need to implement the recommendations of the Consultative Committee for French-Speaking Minority Communities and the Consultative Committee for English-Speaking Minority Communities, both specifically set up by Health Canada to identify ways of improving health care services for these communities.
Conclusion
Canada's health care system, like linguistic duality, is something we value as Canadians. That is why, as far as it is in our power, we must find a solution to situations in which minority English speaking or French-speaking Canadians have to choose between their right to receive health care and their right to use their language. Ultimately, in that tradeoff, we all lose!
I consider that health and linguistic duality are two inseparable aspects of a single objective: promoting greater well-being for all Canadians.
Thank you.
