English health services available on request under new ministry directive

Ruby Pratka, Local Journalism Initiative reporter

editor@qctonline.com

Advocates for access to health care in English are breathing a sigh of relief after the Quebec government officially scrapped a directive that was widely seen as laying the groundwork for restrictions on the use of English and other languages in health institutions.

The initial 23-page directive, made public in July, contained a list of situations where it was acceptable for health institutions to use English or other languages, giving rise to concern that the list could be used to restrict the use of English. Minister for the French Language Jean-François Roberge repeatedly denied this was the government’s intention, and promised to replace the directive.

The new document, released Sept. 20, states that “no verification of a user’s identity is needed to access services in English or in another language.”

A language other than French “may be used when the user or their representative requests it, expresses that they do not understand or do not seem to understand French, or according to the judgment of the [professional],” the document says. Health care professionals can communicate in English or another language with a patient or their representative if they have the capacity, or work with an interpretation service if they don’t.

“This basically puts the whole issue to rest,” said Jennifer Johnson, president of the Community Health and Social Services Network (CHSSN). “If someone wants to receive services in English, they just need to ask for it – no certificate of eligibility for English education is required.

“Everyone has the right to ask for services in the language they are most comfortable in,” she added. “If someone asks for service in Spanish, the [professional] needs to do the best they can to provide those services.”

The directive applies to the entire spectrum of health and social services programming, including emergency services; public health; services for vulnerable youth, seniors and people with disabilities; addictions services and mental health, and to both spoken and written communication. It also states that a patient who is unsatisfied with the services they have received has the right to file a complaint with the local complaints commissioner.

“The difference between this directive and the one that came out in July is very clear,” said Richard Walling, executive director of Jeffery Hale Community Partners. “This categorically states that people have the ability to receive services in English or another language in all circumstances when the health of the person requires it, which is a broad definition … and there will be no need to validate the user’s identity.”

Walling, whose organization oversees Jeffery Hale Hospital and Saint Brigid’s Home in partnership with the CIUSSS de la Capitale-Nationale, said the directive “confirms our actual practice” with regard to providing care in English.

“Language should not be a political issue in the health system – it is a fundamental tool to be able to communicate effectively to get people services when they are sick and vulnerable,” he said. “This directive recognizes that and gives the user and the [health professional] the latitude to do what is needed to get informed consent and proper treatment that can be understood and followed.”

Walling said he was not aware of anyone being unable to get care in the language of their choice at Jeffery Hale or Saint Brigid’s since the initial directive came out. “I have seen staff make a tremendous effort to be able to find a way to communicate,” he said. “These professionals are people who got into the system to help people – that attitude has to prevail, and we have to find a means of effective communication.”

Creativity needed in regions

Although English speakers in the greater Quebec City area can access a bilingual full- service hospital without leaving town, people in vast swaths of the province cannot. Jeffery Hale is the northernmost and easternmost bilingual hospital in the province. The CHSSN supports access to health care in remote regions and in cities with very small anglophone populations where bilingual staff may be hard to come by. Johnson advises people who are struggling to access service in English or another language to “be gentle and persistent” and request an interpreter if necessary – the service is free, and preferable to relying on untrained family members or only understanding half of what is said.

“This directive doesn’t mean that every service will be available in any language anywhere in Quebec,” Walling cautioned. “It does depend on the capacity of the personnel – but I believe that the system will try everything it can to communicate with a person, although they have to get creative on how to do that.”