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A year after Quebec adopted the sweeping French-language law known as Bill 96, the Legault government’s proposed reform of the health system would further restrict access to medical services in English, according to a brief by an anglophone-rights organization.
Under Bill 15, the government would create a new agency, Santé Québec, with the goal of running the health system more efficiently. Critics, however, argue the legislation would give Santé Québec too much power and result in over-centralization in the management of health care.
And the Community Health and Social Services Network (CHSSN) contends Bill 15 would weaken so-called access programs for medical services in English. These programs ensure anglophones continue to receive health care in English in all regions across the province, taking into account the financial resources of local hospitals and other institutions.
At present, these programs are maintained and updated with input from the anglophone community. But Bill 15 would deprive the community of that input and let Santé Québec decide solely what’s good for anglophones, charged Jennifer Johnson, executive director of the CHSSN.
“The influence of the (anglophone) community is once again being eroded significantly for the institutions in Montreal and surrounding areas,” Johnson said in an interview.
“There’s been some terrible news stories of English-speaking patients being told, ‘I won’t serve you in English because that’s my right to do that,’” she added.
Following a 2015 reform by former Liberal health minister Gaétan Barrette, the government created regional authorities with boards of directors. Each board included an anglophone representative to safeguard access to health care in English.
But under Bill 15, these boards of directors would vanish, along with their anglophone representatives, Johnson noted.
“In the current system, there is a designated seat on every board for a representative of the English-speaking community,” she said. “That disappears absolutely in the new revision of the institutions.”
According to the brief submitted to the government by the CHSSN, “Bill 15 moves the legal requirement to develop an access program from the institutional level to the central body, Santé Québec. The effect may be access programs that are less connected to the institutional realities and the specific needs of the English-speaking population.
“Furthermore,” adds the brief, “Santé Québec will determine the regulations governing regional access committees, which (calls) into question the current provisions ensuring the participation of English-speaking representatives on committees, and their organizations in the nomination process.”
Health Minister Christian Dubé has said Bill 15 would “shake” the foundations of the health system, and suggested that Santé Québec would recruit “top guns” from the private sector to run the system. On Monday, Dubé’s press attaché said the government is taking the time to “read all the briefs submitted by the groups involved in our health-care network.”
Antoine de la Durantaye asserted that Section 16 of Bill 15 is “identical” to Section 16 of the Health and Social Services Act, which stipulates that “English-speaking persons are entitled to receive health services and social services in the English language.” But de la Durantaye did not address the concerns by the CHSSN about the lack of input by anglophones in the access plans.
“The aim of Bill 15 is to improve access to quality health care for all Quebecers, regardless of language,” de la Durantaye added.
The National Assembly has already voted in principle for Bill 15, which is now under detailed study by the Health and Social Services Commission. Dubé has said he hopes Bill 15 will become law before the summer break, but there are reports that the final adoption may be postponed until September.
The CHSSN is lobbying the government to make amendments to Bill 15 to make sure anglophones have a direct say in the access programs that would be managed by Santé Québec. The Gazette has learned that diplomatic efforts are also underway by other anglophone leaders to persuade Dubé to change Bill 15 to reflect their concerns.
Bill 15 follows provisions in Bill 96 that critics say limit health professionals in communicating in English to patients. Bill 96 requires all government workers — including those in hospitals and nursing homes — to use French exclusively in written and oral communications with their clients, with certain exceptions, like emergencies.
But Premier François Legault responded last year that “there is no need to worry about receiving health-care services in English for any Quebecers.”
Still, in January 2019, Legault said he would not reverse a decision to remove English from long-standing signs at a hospital in Lachute despite concerns raised by nine mayors in the lower Laurentians. The leader of the Coalition Avenir Québec government maintained that position even though a provincial government study the same year found that a significant number of English-speaking Quebecers “face language barriers in their daily lives” when it comes to accessing health care.
Research has shown that language barriers can result in poorer medical outcomes, with one study warning that “miscommunication in the health-care sector can be life-threatening.”
Yet even before the CAQ government was first elected in October 2018, the Gazette reported on complaints by the patient-rights group at Montreal’s St. Mary’s Hospital that the previous health minister, Barrette, tolerated changes to St. Mary’s signs, letterhead and other communications favouring French to the detriment of English.
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