Office of the Commissioner of Official Languages

Office of the Commissioner of Official Languages

July 12, 2007 08:25 ET

Commissioner of Official Languages Releases Heath Care Audit of Four Federal Institutions

OTTAWA, ONTARIO--(Marketwire - July 12, 2007) - The Commissioner of Official Languages, Graham Fraser, calls upon the federal government to provide health services in the official language of choice of patients in its care. He made this appeal today following the release of an audit that examines the extent to which four institutions-Health Canada, Veterans Affairs Canada, the Royal Canadian Mounted Police (RCMP) and Correctional Service Canada-comply with the Official Languages Act when they are required to provide health care directly to certain groups or communities.

"Our audit shows that the federal government must do more to ensure that it provides health services in the official language of choice of its clients, such as veterans, Aboriginal Canadians, inmates and RCMP cadets," said the Commissioner. "While it is difficult to find bilingual health care workers due to an overall shortage, this should not overshadow people's right to receive health services in their language of choice."

In order to help the institutions improve direct health care services in their clientele's language of choice, the Commissioner issued 30 recommendations, which address inconsistencies in service that are unique to each institution.

The audit report, the recommendations and the attached backgrounders are available on the Web site of the Office of the Commissioner of Official Languages at www.ocol-clo.gc.ca under "What's New?"


BACKGROUNDER

OFFICE OF THE COMMISSIONER OF OFFICIAL LANGUAGES' AUDIT OF DIRECT HEALTH CARE SERVICES

- HEALTH CANADA -

The Office of the Commissioner's audit was conducted at Health Canada's head office in the National Capital Region and at the Quebec regional office. We interviewed various managers and staff members at the head office and at the First Nations and Inuit Health Branch in Quebec, as well as persons responsible for official languages. Telephone calls were also made to the Quebec offices. We mainly reviewed the policies, directives, organizational structure, third party contribution agreements, contracts awarded to health professionals, institutional reports and other documents provided by the Department. We also reviewed relevant procedures and systems implemented by Health Canada.

In the Quebec region, the First Nations and Inuit Health Branch provides nursing care and oral health care. This care is provided on the reserves where there are no contribution agreements with the bands for managing these services. The First Nations and Inuit represent a restricted and identifiable clientele because they meet the criteria of paragraph 6(1)(a) of the Official Languages (Communications with and Services to the Public) Regulations and Treasury Board Directive C. As a result, Health Canada is required to provide bilingual services to the following communities:



Nursing care

a) Lac-Rapide
b) Winneway (Longue-Pointe First Nation)
c) Timiskaming (Notre-Dame-du-Nord)

Dental care

a) Gesgapegiag (Maria)
b) Listuguj (Restigouche)
c) Winneway (Longue-Pointe First Nation)
d) Timiskaming (Notre-Dame-du-Nord)


RESULTS

Strengths:

- Health Canada managers are determined to comply with their linguistic obligations in relation to health care services.

- The Department has appropriate official language policies in place and makes significant efforts to communicate them to managers.

- The Department complies with Treasury Board Directive C in identifying offices that must provide health care to a restricted and identifiable clientele.

Opportunities for improvement:

- The Department does not have appropriate monitoring mechanisms in place to ensure compliance with the Official Languages Act in relation to health care services.

- There are no mechanisms in place to assess language proficiency and the quality of services provided in both official languages by health professionals hired on contract.

- There is a lack of active offer in both official languages in person, on the telephone and on voice mail.

- The language level B that is currently required is too low, given the complexity of the issues handled by the nursing staff. These tasks instead require level C for oral interaction.

In order to ensure that adequate health care is provided to Health Canada's official language minority clientele in their language of choice, the Commissioner has made six recommendations:

- Recommendation: That Health Canada ensure its designated bilingual offices fully comply with the requirements of section 28 of the Official Languages Act concerning active offer in person, on the telephone and on voice mail.

- Recommendation: That Health Canada raise the linguistic profile of nursing positions for oral interaction and of non-insured health benefits eligibility officers who have an asymmetrical profile and review the number of bilingual positions required in these two job categories in the Quebec region.

- Recommendation: That Health Canada verify whether the incumbents of nursing positions and non-insured health benefits eligibility officer positions, whose linguistic profiles have been raised, meet these new requirements. In cases where the incumbents do not meet these new requirements, the Department must take measures to ensure equal health care in both official languages at all times.

- Recommendation: That Health Canada implement a monitoring mechanism to ensure compliance with its linguistic obligations in relation to the provision of health care services in Quebec.

- Recommendation: That Health Canada ensure health professionals hired on contract in Quebec have the required language skills.

- Recommendation: That Health Canada implement a monitoring mechanism to ensure the quality of services provided in both official languages by health professionals hired on contract in Quebec.


BACKGROUNDER

OFFICE OF THE COMMISSIONER OF OFFICIAL LANGUAGES' AUDIT OF DIRECT HEALTH CARE SERVICES

- ROYAL CANADIAN MOUNTED POLICE -

The Office of the Commissioner interviewed the managers in charge of the occupational health and safety sector at the Royal Canadian Mounted Police (RCMP) head office in the National Capital Region. An on-site audit was conducted in September 2005 at the Royal Canadian Mounted Police Academy (also called Depot Division) in Regina, Saskatchewan. We met with the staff of the Medical Treatment Centre and 20 Francophone cadets and reviewed the internal policies of the RCMP regarding the application of the Official Languages Act, organizational structure, agreements and other documents provided by the institution.

FINDINGS

Strengths:

- The RCMP complies with regulatory and administrative provisions in relation to identifying its clientele and measuring demand.

- The language requirements of the positions at the Regina Medical Treatment Centre are appropriate, and the language skills of all incumbents, with the exception of one, are sufficient.

Opportunities for improvement:

- Managers and employees are not sufficiently informed of their linguistic obligations, and there is no monitoring mechanism in place to ensure the provision of bilingual health care services.

- The language preference of cadets is not indicated in their medical records.

- The RCMP must give clear instructions and specific information to the Medical Treatment Centre staff concerning the concept of active offer of service.

- The Medical Treatment Centre must also insert a language clause in the service contracts that it signs with health professionals and create a bilingual human resources data bank for the health field in order to respect its patients' language of choice at all times.

In order to ensure the delivery of health care to the RCMP's official language minority clientele in their language of choice, the Commissioner has made six recommendations:

- Recommendation: That the RCMP take measures to distribute its official language policies and directives with regard to service to the public in both official languages to the manager and staff members of the Medical Treatment Centre at the Depot Division in Regina.

- Recommendation: That the RCMP ensure staff members at the Medical Treatment Centre fully comply with the requirements of section 28 of the Official Languages Act concerning active offer in person, on the telephone and on voice mail.

- Recommendation: That the RCMP indicate the preferred official language of cadets in their medical records.

- Recommendation: That the RCMP take the necessary measures to ensure that the psychological tests administered to cadets by the Regina Medical Treatment Centre are in the cadets' official language of choice.

- Recommendation: That the RCMP implement a monitoring mechanism to ensure that the Regina Medical Treatment Centre provides effective health care in both official languages.

- Recommendation: That the RCMP include a language clause in all of the Regina Medical Treatment Centre's service contracts with health professionals and create a bilingual human resources bank for the health field in order to ensure that the language rights of the Centre's patients are respected at all times.


BACKGROUNDER

OFFICE OF THE COMMISSIONER OF OFFICIAL LANGUAGES' AUDIT OF DIRECT HEALTH CARE SERVICES

- VETERANS AFFAIRS CANADA -

The Office of the Commissioner conducted several telephone interviews with the person responsible for official languages and various managers at the head office of the Department of Veterans Affairs Canada (VAC) located in Charlottetown, Prince Edward Island. An on-site audit was conducted at Sainte-Anne Hospital (SAH) located in Sainte-Anne-de-Bellevue on Montreal Island in Quebec. It is the only institution of the Department where there is significant demand for services pursuant to paragraph 6(1)(a) of the Official Languages (Communications with and Services to the Public) Regulations. We interviewed members of the Hospital's management team, representatives of the Nursing Branch and the Human Resources Branch, as well as the institution's ombudsman, and reviewed the policies and directives, organizational structure, professional service contracts, institutional transfer files and reports prepared by the Department. The procedures and systems in place at SAH were also reviewed.

FINDINGS

Strengths:

- Managers are well aware of the Department's linguistic obligations.

- VAC complies with Treasury Board Directive C in identifying significant demand from its restricted and identifiable clientele.

Opportunities for improvement:

- VAC needs to review the language requirements of positions that provide health care to hospital patients and evaluate the language skills of their incumbents.

- There is a lack of appropriate monitoring mechanisms to ensure compliance with linguistic obligations in relation to health care services by the staff and by health professionals hired on contract.

- In several reception areas of the SAH, there was no signage indicating the availability of services in both official languages.

In order to ensure that adequate health care is provided to VAC's official language minority clientele in their language of choice, the Commissioner made seven recommendations:

- Recommendation: That VAC display signage for active offer in all reception areas of Sainte-Anne Hospital informing patients of the availability of services in both official languages.

- Recommendation: That VAC raise the linguistic profile for oral interaction for bilingual orderly positions and various bilingual nursing positions at Sainte-Anne Hospital.

- Recommendation: That VAC verify whether the incumbents of bilingual orderly positions and various bilingual nursing positions at Sainte-Anne Hospital, whose language requirements have been raised, meet these new requirements. In cases where the incumbents do not meet these new requirements, the Department must take measures to ensure equal health care in both official languages at all times.

- Recommendation: That VAC implement a monitoring mechanism to ensure compliance with its linguistic obligations in relation to the provision of health care services at Sainte-Anne Hospital.

- Recommendation: That VAC ensure health professionals hired on contract by Sainte-Anne Hospital have the required language skills.

- Recommendation: That VAC implement a monitoring mechanism to ensure the quality of services provided in both official languages by health professionals hired on contract at Sainte-Anne Hospital.

- Recommendation: That VAC review its 12 operating agreements with provincial health services and health institutions signed prior to 1993 to determine whether, when they are renewed, they should include a language clause in accordance with the obligations set out in section 25 of the Official Languages Act and paragraph 6(1)(a) of the Regulations.


BACKGROUNDER

OFFICE OF THE COMMISSIONER OF OFFICIAL LANGUAGES' AUDIT OF DIRECT HEALTH CARE SERVICES

- CORRECTIONAL SERVICES CANADA -

The Office of the Commissioner's audit was conducted at the head office of Correctional Service Canada (CSC) in the National Capital Region, and telephone interviews were conducted at 14 designated bilingual institutions in Quebec and New Brunswick, and at the Quebec and Atlantic regional offices. The relevant policies and operational directives were reviewed, as well as the organizational structure, the professional service contracts and a third party operating agreement in Quebec.

CSC complies with the operational definition of the concept of restricted clientele. At this time, only those institutions located in Quebec and New Brunswick have been designated bilingual:



PROVINCE BILINGUAL INSTITUTIONS
------------------------------------------------------------
Quebec Archambault Institution
Cowansville Institution
Donnaconna Institution
Drummond Institution
Joliette Institution
La Macaza Institution
Leclerc Institution
Montee Saint-Francois Institution
Port-Cartier Institution
Sainte-Anne-des-Plaines Institution


New Brunswick Atlantic Institution
Dorchester Penitentiary
Shepody Institution
Westmorland Institution


FINDINGS

Strengths:

- Managers are well aware of their linguistic obligations.

- The Department has policies and an administrative directive concerning official languages.

- It is possible to identify offenders' preferred language using the Offender Management System database.

Opportunities for improvement:

- There are shortcomings in the process of identifying the clientele's preferred language.

- There are no effective monitoring mechanisms for ensuring compliance with the Official Languages Act in relation to health care.

- There is no active offer of service in both official languages at a number of institutions.

- There is a need to raise the linguistic profile of positions to ensure equal health care in both official languages.

- There is a lack of positions designated bilingual to provide services in both official languages at all times in the institutions' health sector.

- Many contractual agreements signed with health professionals do not contain a language clause.

- Most of the institutions do not have mechanisms to assess the language skills of contract health professionals and the quality of services provided by them in both official languages.

In order to ensure that health care is provided to CSC's official language minority clientele in their official language of choice, the Commissioner has made 11 recommendations:

- Recommendation: That CSC review its procedures for admitting offenders in the Regional Reception Centres and other institutions performing this function, in order to provide this service in both official languages, in accordance with the Official Languages Act and the Regulations.

- Recommendation: That CSC ensure its bilingual institutions fully comply with the requirements of section 28 of the Official Languages Act concerning active offer in person, on the telephone and on voice mail.

- Recommendation: That CSC indicate offenders' preferred official language in their medical records in order to ensure better health care services in their language of choice.

- Recommendation: That CSC develop and implement a strategy for recruiting more bilingual health care professionals for institutions in Quebec and New Brunswick.

- Recommendation: That CSC raise the linguistic designation of bilingual health professional positions, especially for oral interaction, for institutions in Quebec and New Brunswick.

- Recommendation: That CSC verify whether the incumbents of bilingual health professional positions in institutions in Quebec and New Brunswick, whose language requirements have been raised, meet these new requirements. In cases where the incumbents do not meet these new requirements, the Department must take measures to ensure equal health care in both official languages at all times.

- Recommendation: That CSC include a reference to complaints concerning official languages in its directive on offender complaints and grievances.

- Recommendation: That CSC implement a monitoring mechanism to ensure compliance with its linguistic obligations in relation to health care services.

- Recommendation: That CSC review its contractual agreements with health professionals to include an appropriate language clause in order to ensure health services in both official languages to the offenders in bilingual institutions.

- Recommendation: That CSC ensure health professionals hired on contract at its bilingual institutions have the required language skills.

- Recommendation: That CSC implement a monitoring mechanism to ensure the quality of services delivered in both official languages by contract health professionals at its bilingual institutions.

Contact Information

  • Office of the Commissioner of Official Languages
    Robin Cantin
    Manager, Media Relations
    613-995-0374
    Cellular: 613-324-0999 / Toll-free: 1-877-996-6368
    robin.cantin@ocol-clo.gc.ca