Allison Hanes: Quebec health directive 2.0? There should never have been a 1.0

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English-speaking Quebecers with upcoming medical appointments will no longer have to worry about whether they have an eligibility certificate.

The Quebec government of Premier François Legault on Monday made good on a promise to rewrite a controversial directive issued this summer suggesting health services in English would only be dispensed to so-called “historic anglophones” who qualify for education in English. Although the government repeatedly denied this was the case, French Language Minister Jean-François Roberge finally conceded the policy needed to be clarified.

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And it was left to Health Minister Christian Dubé to clear the air, unveiling regulations that should leave little room for doubt among health providers and patients alike about when services can be offered in English — or any other language, for that matter — under Bill 96.

“Let’s be clear: There will be no verification of a citizen’s status for access to health and social services in English,” Dubé tweeted. “The changes to the directive are simply to ensure that the text reflects the government’s intentions and that it is easier for our employees and the public to understand.

“There has never been any question of restricting access to health and social services on the basis of a linguistic criterion. We will treat you, no matter your language.”

Well, that’s a relief.

Simpler yet would have been no regulations at all, because, as former Parti Québécois premier Lucien Bouchard once famously said, Quebecers shouldn’t need a language test when they go for a blood test. Alas, 10 crisp, succinct pages were sorely needed to counter the 31 pages of doublespeak that did so much damage to the already strained relations between the Legault government and the English-speaking community.

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There is also a handy two-page cheat sheet to dispel any lingering doubts. To sum up: Anyone who wants health care in French will be served in French. Anyone who wants it in English can have it in English at any of the institutions designated as bilingual where it was previously available. There are also lots of bolded lines, bullet points and highlighted boxes that emphasize no certificates, documentation or proof will be required to obtain health care in English.

To the government’s credit, the new version is more than a mere clarification. It reads like a complete repudiation of the previous effort.

The preamble of the 2.0 directive explicitly mentions, in the second paragraph, that under Quebec’s law on health and social services, English-speaking Quebecers have the right to care in their language, through access programs that accord bilingual status to hospitals. The previous version began with a long preamble about how the Charter of the French Language establishes French as the only official language of Quebec.

“Only French has this status,” it said; only French can be used “systematically” in the health-care system, with specific exemptions for offering services in other languages, which it went on to describe in painstaking detail.

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Many other differences

That’s the first notable difference when comparing the tone and contents of the two documents. But there are many others.

The fact that Dubé was responsible for issuing the new rules instead of Roberge is in itself reassuring. Dubé has a reputation in the Legault government as a Mr. Fix-It and is seen as a voice of reason in cabinet. When the first contradictory version emerged over the summer, concerned groups sought a meeting with Dubé, since he is in charge of health care. But Roberge remained on the file, to their chagrin. His deking and skating did little to allay fears. Although he did finally admit the rules needed to be revised, he insisted the dubious policy would remain in effect in the interim.

So providing health care in English is now back in the hands of the health minister — where it belongs.

The troublesome definition of an anglophone has been excised completely from the glossary in the new document. The problematic original defined “a recognized English speaker” as “a person declared eligible for English education in Quebec.” We’re back to being “people” and “users” again, part of broader, universal categories that don’t single out anyone’s linguistic background.

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There is no mention anywhere of the words “eligibility certificate,” which were sprinkled throughout the previous copy. The National Assembly did, after all, adopt a unanimous motion put forward by Liberal MNA André Fortin, stating that anglophones do not need their proof of eligibility for English education to receive English health care.

It never made any sense that the Education Ministry would be in charge of determining who qualifies for health care in English. Besides, many patients, especially seniors, don’t have the papers, having graduated from school before Bill 101 — adopted in the 1970s — made them a prerequisite. And the Education Ministry only allots them to school-age children.

But just in case, the new guidelines repeatedly state: “No validation of the identity of the user is required to access services in English.”

The phrases “health and social services in English” and “services in English” are specifically highlighted. The previous document in many cases referred more vaguely to “a language other than French,” as if English was a dirty word. And anglophones who are denied service in English even have grounds to file a complaint. Is it an olive branch or a safeguard?

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New guidelines gutted of language scenarios

The guidelines actually state that no documentary proof is needed to receive care in any other tongue, either, whether that’s Italian at Santa Cabrini Hospital or Yiddish at the Jewish General, which are among the public institutions allowed to communicate with patients in a third language. This also apparently applies to obtaining translation services or situations in which a care provider is able to communicate in the patient’s mother tongue.

The new guidelines have been gutted of all the examples of when or under what circumstances care may be offered in a language other than French. The original was like a game of snakes and ladders, with pedantic (and frankly insulting) scenarios, like doctors in an emergency room being permitted to communicate with the anglophone parent of a French-speaking child to explain a diagnosis, or staff in a clinic being authorized to detail post-procedure care to the person accompanying a 14-year-old seeking an abortion.

Instead, the new regulations state that “a language other than French may be utilized once the user or their representative requests it, expresses that they don’t understand or seems not to comprehend French or” — and this is crucial — “according to the judgment of the care provider.”

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Yes, please, let’s respect the common sense of health professionals, rather than constrain them from delivering the best care or, worse, causing them to fear sanctions for communicating in the wrong language.

The revised guidelines are more open-ended, saying health care can be provided in other tongues in “all situations or circumstances, physical, mental (or) psychosocial … in which the user requires a continuum of services … must give consent, or must participate in care decisions that affect their health, well-being or security.”

It also adds: “It is understood that care must be offered in a manner that is scientific, humane … personalized and safe, with respect to the laws, the ethics code and the clinical judgment of every caregiver.”

This should go without saying. But it’s necessary to state the obvious in light of the Kafkaesque turmoil of the past few months.

Before we move on from this unfortunate episode, however, there are some nagging questions that cannot be so easily swept under the rug.

Like, how did this happen in the first place? And why? Was this bureaucracy run amok? Was this overreach? Was this bad faith, despite the fact Roberge previously promised “good faith” was all that would be needed for Quebecers to receive health services in English? Was this fiasco a symptom of a government that fails to understand the needs and rights of the community because only one per cent of the civil service identifies as anglophone, a proportion that hasn’t budged in 50 years? Was this the left hand not knowing what the right hand was doing?

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And why was it such a struggle to get the offending policy revised, riddled as it was with contradictions? Why were there so many disingenuous denials and so much blatant gaslighting that there was nothing to worry about, when clearly there was?

English-speaking Quebecers are often told we’re the most coddled minority in the world and prone to hysteria.

But if my colleague Aaron Derfel hadn’t exposed the directive that was quietly disseminated in the middle of the summer, if The Gazette hadn’t stood its ground against accusations that our reporting was off-base, if community organizations hadn’t pushed back against this stealth infringement, if ordinary anglophones hadn’t protested or printed up stickers, access to health care in English may well have been compromised.

Good sense has (mostly) prevailed. But rather than breathing easy, most anglophones have been conditioned to wait for the other shoe to drop.

Given that deputy health minister Daniel Paré said Monday there is a “second volume” of language rules coming soon, we shouldn’t let our guard down.

ahanes@postmedia.com

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