By Ruby Pratka

Local Journalism Initiative

No eligibility certificate or other proof of identity will be required to access health care services in English, according to a new directive released last week by the Ministry of Health and Social Services.

The directive replaces a previous directive, published in July, which laid out a detailed list of case studies in an attempt to explain when health care professionals could use English or another language with patients or their family members. The list alarmed advocates for access to health care in English, who feared it could be used to restrict care. The first directive also mentioned eligibility certificates for English public education as one basis for serving patients in English, although many English speakers – particularly immigrants, seniors and people who grew up outside the province – don’t have one. After English-speaking community groups raised concerns, Minister for the French Language Jean-François Roberge said he planned to scrap the directive and publish a new one. More than two months later, that promise is now a reality.

The new directive – a compact five pages compared to its 23-page predecessor – states that “no verification of a user’s identity is needed to access services in English or in another language” and that 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 [health care professional].” It states that 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.

“The Charter of the French Language contains all the tools necessary to preserve the status quo in terms of access to health care for the English-speaking community,” it states.

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.

Advocates for access to health care in English reacted to the new directive with relief. “This directive is a complete rewrite; it answers a lot of the questions that people have had,” Townshippers’ executive director Denis Kotsoros said. “The question is now, ‘What language do health professionals decide to use with patients,’ not ‘What language are they required to use?’ Any directive that tries to finagle itself into that relationship is doomed to fail.”

“This was the right thing to do and we consider the matter closed,” Kotsoros said.

“The revised directives on language permissions go a long way toward assuaging the fears and concerns of the 1.3-million-member English-speaking community of Quebec,” said Eva Ludvig, president of the Quebec Community Groups Network. “They also more closely reflect the promises this and previous governments have made that changes to language legislation would not affect the availability of nor access to health and social services in English. Critically, they clearly confirm that the only card you need when you visit a doctor or go to the hospital

is a health card, not an identity card.”

“This basically puts the whole issue to rest,” said Jennifer Johnson of the Community Health and Social Services Network, which advocates for accessibility to health and social services in English in the regions. “The original document was really flawed, and thank goodness the efforts made by the community have had results.”

 “The client is the person who determines if they want to receive services in English, and then they ask for it. It’s also clear that if a client asks for services in Spanish or another language, the professional needs to do the best they can to provide those services to the patient,” Johnson noted. The directive states that health professionals can communicate directly in any language with a patient if they have the capacity, or use an interpretation service.

“Don’t be shy – ask for documentation in English, and ask for interpretation services if you need them,” Johnson said. “It’s not a common reflex for anglophones to ask for an interpreter, but we need to make sure people understand that they can.” In the event that no health professional is available to speak to you in your preferred language, she said, using an interpretation service is a better option than relying on family members or taking the risk that you won’t fully understand.

CIUSSS de l’Estrie-CHUS spokesperson Nancy Corriveau said the agency had received the directive but did not comment further. Despite the uncertainty surrounding the language directive over the past few months, Kotsoros said Townshippers’ had a “very, very good” working relationship with the CIUSSS, which was investing in programs to improve employees’ language skills and make it easier to spot bilingual employees in regional hospitals. “The CIUSSS has been very positive about providing services to the best of their ability … that is ingrained in the culture of the CIUSSS. We will stay aware of the situation and keep working with our partners.”