ACCESS TO HEALTH AND SOCIAL SERVICES IN ENGLISH

The Access to Health and Social Services project was designed by the QCGN to help English-speaking Quebecers and the community’s organizations and institutions better understand how the right to access health and social services in English in Quebec operates.
With funding from the provincial Ministry of Health and Social Services, we have developed a series of information tools. These tools:

  • provide an overview of Quebec’s public health and social services;
  • explain how the right to access these services in English is structured; and
  • spell out the opportunities to participate in – and contribute to – the governance of the network.

As well, we have produced a series of short, informative video capsules: dedicated and seasoned volunteers from across our community share their perspectives and provide advice developed through their extensive experience and involvement. Each capsule also touches on how to pursue the right or opportunity discussed. Info sheets attached outline the basis in law, where this right exists, and spell out the practices in place in the public network and/or the English-speaking community. We have also prepared a lexicon of French terms, English equivalents, acronyms, and initialisms, as well as terminology used across the Quebec network.
It is essential that all English-speaking Quebecers better understand and thus are able to fully exercise their rights to access health and social services in our own language. We strongly encourage everyone to share these tools widely within your networks and communities.

The Right to Access Health and Social Services with Tania Callender

For members of the English-speaking community in Quebec, it is essential to be able to receive health and social services in our own language. The importance of this goes beyond simply language. “We … have found that culture plays a really important role as well,” Tania Callender explains. Service in English “is a right, and everyone who would like to have access to services in English has a right to do so,” adds Callender. She is Executive Director of the African Canadian Development and Prevention Network. Drawing on her extensive experience with community members seeking services in English, she notes that this is of even greater importance during crisis situations. She describes how our right to access to service in English works: In Quebec, “institutions that offer services are required to develop a program that ensures access to services in English.” Simply put, we have the right to know what services are available in English and where we can get them.

The Right to Service in English with Rachel Hunting

Our rights to receive health and social services in our own language across Quebec “are linked to something called an access program,” Rachel Hunting explains. “Depending on where you are in the province,” she adds, “the service level may be different.” These differences are largely determined by the organizational structure of each institution, as well as its human, material, and financial resources. Rachel Hunting is Executive Director of the Townshippers’ Association and also serves as an independent board member of the Centre Intégré de services de santé et services sociaux de l’Estrie-Centre hospitalier universitaire de Sherbrooke, which governs health services for the Eastern Townships region. For access programs to work properly, she emphasizes, “the really important part is to have community input.” This is how community members can aim the spotlight most effectively on “where the public health partner needs to focus,” in order to obtain the best results from an institution’s access program.

The Role of Regional Access Committees with Andrew Holman

Andrew Holman relates from personal experience how effective Regional Access Committees have proven in practice — both in designing access programs and then in making sure they are fine-tuned based on results and community feedback. “It’s incredibly rewarding to help shape the process” of how health and social services are delivered to members of the English-speaking community, adds Holman, president of the Regional Access Committee at the Centre intégré universitaire de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec. He is also the president of the Centre for Access to Services. “This is always a work in process,” Holman says. He provides an example that demonstrates the willingness of regional health-system administrators “to hear our concerns” and improve the system: “We feel very much heard, and understood. And our concerns have actually been addressed in our current version of the access plan. So we’re very happy with that.”

The Provincial Advisory Committee with Sara Saber-Freedman

“The right of access to English services is not an absolute right,” explains Sara Saber-Freedman, who has served as both chair and vice-chair of the Provincial Committee for the Provision of Health Services and Social Services in the English Language, commonly referred to as the Provincial Advisory Committee. The access program system is structured with one overall goal in mind: “What we are really aiming for here is comparable outcomes for English speakers and French speakers” across Quebec’s health and social services system. In practice, Saber-Freedman adds, this means that if a particular service in not available locally in English, your local institution needs “at a minimum to be able to refer you, and explain to you how you can go about getting that service in English, either in another institution in your region or, if you’re prepared to travel, at an institution in another region.” Ambulance services everywhere in Quebec remain in dire in need of access programs, she notes: “Not one single ambulance service is in an access plan.”

Your Right to Complain with Elizabeth Pusztai

Regardless of whether you are more comfortable speaking English or French, “every citizen has the right to get the care that they need from the health and social services sector,” counsels Elizabeth Pusztai. Don’t hesitate about asking for information and assistance to help you, family members, or friends you are accompanying navigate through a very complex and often confusing system, she adds. You can ask at any time for help from the institution’s Complaints Commissioner regarding aspects of services you did or did not receive, including whether these services are or were accessible in English, notes Pusztai. She is a former Quality and Complaints Commissioner at Batshaw Youth and Family Centres and at the Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal. Pusztai advises that this is a useful and readily available recourse – whether or not a particular institution is designated as bilingual: “The goal of this process is truly to find solutions.”

The Right to Serve: Community Representation in Network Governance with Judy Martin

“We need to have our voices heard” in order for the English-speaking community to continue to receive proper access to health and social services and ensure these services are provided in the language with which we are most comfortable, says Judy Martin. This is particularly important for our anglophone and allophone young people inside the youth-protection system who speak English at home, she adds. After several years as Board Chair at Batshaw Youth and Family Centres, Martin successfully applied through the Regional Access Committee to become an independent board member of the Centre intégré universitaire de services de santé et de services sociaux de l’Ouest-de-l’Île-de-Montréal: “Whenever you’re getting services … you want to make sure that you’re understanding everything that’s coming back at you from a professional. The right is there. And so we need to make sure that it stays. And that everybody understands that.”

The Role of Advisory Committees with Kimberly Buffitt

Isolation and relatively small concentrations of English-speakers in some of Quebec’s regions often present particular challenges when it comes to maintaining and on occasion improving delivery of health and social services in English. That’s even more the case when an integrated-services centre starts to tinker with overall policies and procedures. The Lower North Shore provides an example where the quiet work of an advisory committee has exerted a significant, very positive difference on the quality of services. “A small change can make a huge impact,” for instance with transportation policies, explains Kimberly Buffitt. Without citizen input and participation, she emphasizes, “little things get missed that are very important to us as a minority community.” Buffitt is president of the Advisory Committee for the Centre multiservices de santé et de services sociaux de la Basse-Côte-Nord of the Centre intégré de services de santé et de services sociaux de la Côte-Nord. The presence, role, and impact of the advisory committee is not always well understood by other organizations and individual citizens. However, because of its work the local English-speaking communities involved with a previously independent institution have been empowered to maintain their collective voice and policy-development influence. As Buffitt notes, “once policy is built, it’s very hard to change.”

The Role of the Users and Residents Committees with Mary Robertson

“It’s really important that everybody knows that there’s a group that is on their side that they can become involved with,” says Mary Robertson, president of the Jeffrey Hale – Saint Brigid’s Users’ Committee in Quebec City. She lays out the difference between users’ and residents’ committees, underscoring that both are representative groups. Each provides a properly structured path to speak up, raise concerns “if something is bothering them,” and work to resolve complaints. Robertson also reflects on one of the most important but poorly appreciated roles of such committees – to safeguard and protect “the individual identities and histories” of their individual institutions. Given “all this standardization” and the constant push for centralized management, the strengths provided by this heritage would otherwise be shunted aside. Rather, Robertson observes, “we want to keep the history.” With relentless standardization, she warns, “you also can lose the ownership that the community has” in each institution. After all, “it’s the community that provides the volunteers. Anglophone volunteers and francophone volunteers. It’s a real mélange. I think it’s really important to keep that identity.”

The Role of Foundations with Faye Dumont and Dr. Gerald Boos

Foundations serve an essential role in Quebec’s health and social services system. They enhance and supplement as well as protect services and the quality of life provided for residents in our public health-care institutions. “Our mission as a foundation is to make sure that the quality of care, which includes the service in English… remains exemplary, remains the way it was before” more centralized system management was introduced, explains Faye Dumont, treasurer of the Lachute Regional Residence Foundation. The Lachute seniors’ residence was founded to serve the English-speaking community across the region. “We have one mandate,” adds Dr. Gerald Boos, the foundation’s president: “Our responsibility is to the residents…. We raise money to pay for things that would not be paid for by the Ministry of Health.” As Dumont explains, “people, as they get older, their memory goes. But their mother tongue doesn’t go until the very end…. It’s a basic right for the English people to be served (in their mother tongue), especially at the end of their lives.”

Institutional Property Ownership with Dr. Abraham Fuks

“The right to function under Quebec law as a bilingual institution … is a very important provision” for the English-speaking community across many hospitals, clinics, rehabilitation centres, and other resources throughout Quebec’s health and social services sector, says Dr. Abraham Fuks. Many institutions were founded by – and remain profoundly rooted within – their communities. Their lands and their buildings were supplied using community funds, without financial support from the government of the day. “I always like to use the metaphor of a tree,” Dr. Fuks adds: “You want a tree with rich fruit, then you need a tree with deep roots…. that’s where you get your viability, that’s where you get identity, that’s where you get diversity.” A former Dean of the School of Medicine at McGill University, Dr. Fuks is now Chair of the Board of Governors of the Corporation of Centre Miriam. Such corporations and their boards represent the community’s interest, Dr. Fuks explains. Their responsibility is to ensure continuity, “maintain … integrity,” and thus safeguard “access to services that have to do with the cultural or linguistic characteristic of that institution.” They also have a veto right over any sale of an institution’s land and buildings, use of the proceeds, and any change to its linguistic mandate.