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French-Language Services: A Matter Of Language, Equity and Health - The Montfort Hospital Experience



I Introduction



I had planned another text for this issue of Bloc-Notes, but having just got back from Health Promotion Summer School 2004, where I spent two days immersed in French in the company of extraordinary participants and speakers, the desire to share Gisèle Lalonde's speech with you took precedence. What a wonderful example! After hearing her, there is no difficulty understanding why she is being showered with honours of all kinds. Gisèle Lalonde is someone who has a positive view of the future of Ontario's francophone community. Her enthusiasm is infectious and she is stimulating civic involvement in French Ontario like no-one else. This is the full text of her speech at Health Promotion Summer School 2004.



--Hélène Roussel, joint editor, Le Bloc-Notes

II Dear friends of francophonie and health care professionals



I stand before you today with a great deal of pride and humility. I am proud, first of all, to have the privilege of speaking with you and sharing my vision of a health care system that meets our collective expectations, and I am deeply proud to be associated with the Franco-Ontarian people, which I have been for many years, well before the Montfort Saga. A determined people, who are claiming social justice and the defence of their rights. A people who stand up for themselves! I am humble, too, before you, health care professionals who know your profession and your environment better than anyone. But there is a great deal more to take into consideration beyond your profession in the planning and implementation of French-language health care services.



In this sense, I hope to be the source of inspiration, to kindle the flame burning inside you that will give you a better understanding and appreciation of the vitality of a community working for a hospital or any other health care organization. Beyond the bricks and mortar that shape the facades of our hospitals, there are thousands of individuals, members of our community, who are laying claim to quality French-language health care services that measure up to their collective and individual expectations. I am with you today to pass on my experience and my vision of the development and expansion of your own health care environment.



But before I go any further, I would like to take a few moments to talk to you about SOS Montfort -- a success story I have been in charge of since 1997 and that ended in a resounding victory for our entire community -- because it was the SOS Montfort adventure that gave rise to my awareness of the importance of community involvement in the implementation and shaping of our institutions that are responsible for the delivery of services.



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III A fight to the finish against intolerance



SOS Montfort is the greatest indicator of success for a community. But beyond the saving of Montfort Hospital, there is a battle worth being put in perspective. For the real battle, the battle that really counts, the battle we should all be concerned with, is the one we must fight unrelentingly against intolerance. No self-respecting county, no country that hopes to have a great future, can be built on intolerance. Modern politics is such that this intolerance is not always readily discernible for. With disconcerting nonchalance, some governments breed confusion, claiming to act for the public good when in fact they are blithely crushing the weakest and most vulnerable, usually for financial reasons or to streamline available resources. In the history of the world, not one country has survived this intolerance. And I am telling you, I swear to you, that not until I have drawn my last breath will I let any government authority destroy the dream all of us cherish of living together in tolerance and harmony. I realize that it doesn't take much for me to become very passionate on this subject, as you can tell, but I have deep-seated convictions that will accompany me and will guide all of my actions, for the well-being of our community.



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IV The epic battle of SOS Montfort



Well, to get back to the story of SOS Montfort and Montfort Hospital, the epic battle that lasted more than five years. You are doubtless aware that the print and electronic media devoted hundreds of articles, news stories, commentaries and editorials to this daily struggle of a people's quest for justice and the protection of its rights. A book by Michel Gratton, entitled Montfort: La lutte d'un peuple (Montfort: A People's Struggle), has even been written on the story. There is no need to remind you of the importance of this struggle. The facts speak for themselves!



Without reiterating an exhaustive chronology of this historic battle, I'll just remind you that on February 24, 1997, the Ontario Health Services Restructuring Commission, created by the Government of Ontario, announced the closure of the only French-language teaching hospital in Ontario: Montfort. Within 24 hours, the Franco-Ontarian community had united to create SOS Montfort, the movement of which I have been president since February 25, 1997. After discussions with the Restructuring Commission proved futile, SOS Montfort turned to the courts in late July 1998. The case was heard in April 1999. In late November 1999, the Ontario Divisional Court handed down its unanimous decision striking down the Commission's directions recommending the closure of Montfort.



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V An initial victory



The Court found that Montfort was an institution essential to the growth and vitality of the Franco-Ontarian community and that consequently, the Commission's recommendations violated the unwritten constitutional principle of respect for the protection of minorities. The government, unwilling to accept this loss, appealed the case before the Court of Appeal of Ontario. After all of the parties in the case had presented their arguments before the Court of Appeal, on December 7, 2001, Montfort won another historic and legal victory.



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VI Another victory



I would like to remind you that submissions in our favour from the Commissioner of Official Languages, the Attorney General of Canada and representatives of the Fédération des communautés francophones et acadienne du Canada and the ACFO head office bolstered our position. And speaking of community, the community had grown tremendously with support of this nature. At the Ontario Court of Appeal, the three judges handed down a unanimous ruling stating that Montfort was protected by the Canadian Constitution because it was essential to the survival of the Franco-Ontarian community. But our fate remained uncertain because the government still had the option of taking the case to the Supreme Court of Canada. Notwithstanding our celebrations, we were on tenterhooks, dreading the need to carry on the battle. On February 1, 2002, however, Tony Clement, Ontario's Minister of Health and Long-Term Care, announced that his government would not be requesting permission to appeal from the highest court in the land.



VII Victory, the ultimate victory, was at hand!



February 1, 2002 therefore marks the date of our great collective victory, which will make itself felt far beyond Ottawa. Montfort Hospital and SOS Montfort had just written another page in the history books which will set out for evermore the scope and application of the principle of respect for and protection of minorities, and the obligations this principle imposes on the state.



To summarize the Montfort story, I would like to use the words of Pierre Bergeron, the editor of Ottawa's Le Droit newspaper, who wrote in March 2002, "Much more than a victory over the intolerable, Montfort is a guiding light for future generations and a conclusive statement in the development of our French-language communities across Canada." (unofficial translation)



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VIII A community working for an institution



I know you will agree with me that the fierce struggle that was the Montfort story emphasizes the importance of a community working for an institution. Well beyond such battles, communities can also be useful in the development and expansion of the health care structures to be delivered to the members of our respective communities. Without claiming to get involved in administrative interference, I fully believe that the community has a role to play in the planning, implementation and evaluation of health care programs. But before this can happen, community members must become active in health care administration. Whether it be on the boards of directors in the various health care sectorsareas, such as hospitals, district health councils or community health care centres, we must join in and get involved.



Instead of giving you theoretical arguments for getting actively involved in such planning, I'm going to allow myself to be swayed by my own experience and the guidelines established by Montfort Hospital for promoting this kind of relationship, a relationship, might I add, that guarantees success and prosperity.



Montfort equipped itself with a model of governance by and for the community. Consequently, the ultimate decision-making structure is based on the members of the Board of Governors, who are derived in large part from the community representatives. These members, who are an even mix of representatives of the business, cultural, political and social sectors, and form an equal balance of men and women, are there to oversee sound and holistic administration and to work together to identify and assess new prevention and treatment programs. Who better than the patient to determine what is appropriate and satisfactory for him or her? As I have already said, there is no attempt to take over the administrator's role, but to make suggestions based on what we see, hear and observe. As an example, during the SOS Montfort battle, I met with numerous social and community groups and was able to observe certain deficiencies in services. Believe me, I passed on my observations to the Montfort administration!



I became especially aware of the weakness of our women's services programs. Not just the lack of specific services, but the lack of cohesion between the various bodies responsible for the delivery of direct services. I took it on myself to discuss the matter with members of the Board of Governors, and with the administration, and I can tell you that my words did not fall on deaf ears. Not just because I am Gisèle Lalonde, but because I was expressing a point of view shared by many.



But beyond a structure that is responsive to ad hoc needs, health care centres, hospitals and community agencies need to equip themselves with mechanisms that can effectively respond to potential deficiencies and close gaps in service delivery and continuity. When I talk about structures, I don't mean cumbersome committees or expert analyses that endlessly analyze and remodel everything in a different way! I'm talking about a structure in which everyone has an opportunity to have his or her their say and assert his or her their rights.



At Montfort, meetings with users, or patients, take place at least twice a year. Patients meet with professionals and share their experiences. In return, the professionals and administrators take the opportunity to identify potential solutions for continual improvement to the delivery and quality of our services.



We need to equip ourselves with communication and evaluation tools that are adapted to modern realities and the dynamics of our respective environments. We must be proactive, instead of just reacting to the slightest fluctuation. Where French-language services and the importance of delivering them in your clients' usual language are concerned, I cannot begin to emphasize their importance enough. Even the Court recognized it! And although I am aware and convinced that French-language services are important to you, the very fact that you are here today, at the University of Toronto, is clear and palpable proof.



I see before me leaders, individuals who can make a difference for future generations. People who are bound to maintain and even expand the delivery of French-language services. It is more than a matter of language and equity. It is a matter of health.



I would also like to thank Suzanne Jackson, director of the program in which you are taking part, Denise Hébert, chair of the francophone sub-committee, and Lisa Weintraub, coordinator of the Summer School, who believe in making this kind of program happen and in the importance of French-language services.



These kinds of initiatives inspire communities to outdo themselves and to provide themselves with health care workers who are attuned to the realities of the people who shape our social fabric. As I said to you when I began my talk, these simple words and ideas are offered in all humility. They must be adapted to your own realities.



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IX Conclusion



In closing, I would like to leave you with this message: don't be afraid to stand up for yourself. Never give up. Striving, devoting yourself to building a better world is never easy, but it is a great, noble and satisfying cause. Stay calm and content in the face of adversity, for battle and combat make us grow in stature. They make you -us- people whom all others envy. People who make a difference. Essentially, all I did, all we did, was to obstinately refuse to retreat, while continuing to advance. Take heart. Our cause is just.