TABLE OF CONTENTS

PREFACE 4

THE COMMITTEE MEMBERSHIP 5

ORDERS OF REFERENCE 7

ACRONYMS 10

NOTICE TO READERS 13

HIGHLIGHTS 14

RECOMMENDATIONS 16

INTRODUCTION 20

CHAPTER 1 – OVERVIEW OF THE SITUATION AND STAKEHOLDERS’ CONCERNS 22

Division of responsibilities 22

Language as a determinant of health 27

Equitable, safe and quality health care 28

Access difficulties faced by official language minority communities 29

Francophone communities outside Quebec 29

Anglophone communities in Quebec 30

Greater access difficulties faced by vulnerable communities 32

Gender and sex 32

Newcomers and racialized communities 33

Indigenous peoples 34

Challenges associated with the aging population 36

Home care 36

Long-term care 38

Family caregivers 39

Mental health 40

Better understanding of the populations being served 41

Data on official language minority communities and the language variable 42

Intersectionality 46

Support for research 47

Bilingual health care professionals 50

Initial training and skills upgrading 50

Language barriers to accessing the profession 52

Foreign credential recognition 54

Support for graduates 57

Hiring and retaining bilingual professionals 58

Language insecurity 59

Varying practices by profession and professionals’ mobility 60

Language concordance measures 62

Positions and institutions designated as bilingual 62

Interpretation services and translation of resources 64

Linguistic identification of patients 67

Inventory of available human resources or services 68

Linguistic challenges associated with new practices 69

Telemedicine, virtual care and artificial intelligence 69

Privatization of services 74

Essential collaboration among all partners 74

Essential support for community organizations 74

Essential support for post-secondary institutions 76

Interdepartmental coordination 78

Federal government’s leadership role 79

Language clauses 79

Active offer 82

National standards 84

CHAPTER 2 – BREAKING DOWN LANGUAGE BARRIERS IN HEALTH CARE 85

Revising the Canada Health Act 85

Defining language clauses 86

Enhancing direct funding for community organizations 87

Enhancing direct funding for post-secondary institutions 88

Attracting bilingual workers 89

Supporting the continuum of health care and services in the minority language 89

Accelerating language data collection and the sharing of disaggregated data 90

Supporting intersectional research and analyses 91

Supporting language concordance measures in collaboration with all partners 93

Striving for a standardized active offer practice 94

Ensuring that official languages are reflected in new practices 94

CONCLUSION 95

APPENDIX A – WITNESSES 97

APPENDIX B – BRIEFS AND OTHER DOCUMENTS 107