Quebec backtracks on English eligibility certificate for health care

Responding to an outcry from the anglophone community, Quebec’s Health Ministry has issued a new directive stating explicitly that people in the province can receive medical and social services in English without a certificate, replacing controversial rules from July that appeared to restrict access to such services in languages other than French.

The new rules no longer require of “historic anglophones” an eligibility certificate from the Education Ministry to obtain health care in English exclusively. The new directive — streamlined to 10 pages from the original 31 — stipulates in bold in three places that “no validation of the user’s identity is required to access these services in English or any other language.”

In a statement on Monday morning, Health Minister Christian Dubé reiterated that there will be no eligibility certificate requirement. The Education Ministry produces the certificates for the children of anglophone parents seeking to attend English primary and secondary schools, and those documents have not been made available to adults.

“As we had pledged to the groups that we met a few weeks ago, we have rewritten the directive,” Dubé declared in a post on X. “Let’s be clear: There will be no verification of a citizen’s status for access to health and social services in English.

“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,” he added.

“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.”

The Coalition Avenir Québec government had introduced the eligibility certificate requirement on July 18 following the adoption of Bill 96, the CAQ’s overhaul of the French Language Charter, two years ago. But the eligibility requirement and other aspects in the directive sparked outrage in the anglophone community, and raised concerns by the federal government that the rules may have been in conflict with the accessibility principle enshrined in the Canada Health Act.

In addition to the revised directive, the Health Ministry has made public a two-page “checklist” in English, stating it “is intended as a summary of situations in which a language other than French may be used with users of health and social services. It is intended for use by institutions in the health and social services network (RSSS).”

Reaction to the updated directive was largely positive, although anglo leaders still have some concerns.

“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 (QCGN).

“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. They heard what we said.”

However, Sylvia Martin-Laforge, director general of the QCGN, cautioned there are still some issues that are unresolved.

“We understand there may be more details to come on the administrative side of the directives, with which we might not find favour,” Martin-Laforge said.

“We will address any further concerns with … Dubé because, as we have maintained since this issue arose in July, we believe it is first and foremost a health issue, not a language issue. We are always ready to work co-operatively and in good faith.”

Although the QCGN was made aware late last week that an announcement about the new directive was imminent, its release online at 6:06 a.m. Monday caught the organization by surprise. The Gazette started making inquiries about the new directive on Friday before its contents were leaked to the CBC, which posted a report at 6 a.m.

The Gazette has learned that three bilingual health organizations with anglophone roots had sent a letter to the government last week demanding that the reworked directive include a clause that it’s up to the patient — and not the institution — to decide what language they can use when seeking health care. Although the new directive does not contain such a clause, it nonetheless repeats in several places “the right of English-speaking people to receive health and social services in English to the extent provided by (English-language) access programs.”

Montreal lawyer Eric Maldoff, chair of the Coalition for Quality Health and Social Services, noted that among the unresolved issues are contracts, research, websites and signage.

“I would have hoped that they would have added something that says that institutions that have bilingual requirements would be able to staff themselves accordingly, and that’s not there,” Maldoff said, adding, however, that overall “I feel (the new directive) is a positive development.”

The new rules would appear to suggest the right of anglophones to file a complaint if health and social services are not available in English, among other problems. “Any user … who believes that his or her rights have not been respected, or who is dissatisfied with the services he or she has received, may lodge a complaint.” It adds that the grievance can even be filed “in another language if they are unable to do so in French.”

In an interview with CJAD radio talk show host Aaron Rand on Aug. 9, French Language Minister Jean-François Roberge confirmed that anglophones could file a complaint with a hospital ombudsperson if they are denied health care in their mother tongue. Although the July 18 directive did contain a section on complaints, it emphasized the French Language Charter.

In addition to English-speaking Quebecers, the new directive specifies that health care can be delivered in Italian and other languages in institutions that have bilingual status under Article 29.1 of the French Language Charter. What’s more, exceptions can be made for health workers to speak in languages other than French for the following reasons:

In a letter sent by email to all health and social services institutions on Monday, deputy minister Daniel Paré confirmed that a “second volume” of language rules would be forthcoming.

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