Methodology
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Our audit was conducted between May 2005 and May 2006 in four federal institutions that provide health care to a restricted and identifiable clientele: Health Canada (HC), Veterans Affairs Canada (VAC), the Royal Canadian Mounted Police (RCMP) and Correctional Service Canada (CSC). Taking into consideration our limited access to some of the clientele or their health status, our audit focused more on the infrastructure established by each of these institutions in order to fulfil their obligations in relation to bilingual health care services.
We conducted interviews with representatives from the headquarters of the four institutions concerned and with managers, health professionals and some recipients in their designated bilingual offices. The selected offices were as follows:
- at HC, the Quebec regional office in Montréal;
- at VAC, the Sainte-Anne Hospital in Sainte-Anne-de-Bellevue, Quebec;
- at the RCMP, its academy in Regina;
- at CSC, 14 correctional institutions and the regional offices in Quebec and New Brunswick.
We also reviewed and analyzed policies, operational guidelines, procedures, documentation on organizational structure, third party contribution agreements, health care institution transfer records, contracts concluded with health professionals and reports produced by the institutions.
Legislative and Administrative Framework
Part IV of the Official Languages Act deals with service to the public and states that federal institutions must ensure that any member of the public can communicate with them and obtain available services from their head office in English and French within the National Capital Region or where there is significant demand or service is justified by the nature of the office. To this end, federal institutions are obliged to designate offices that must provide services in both official languages in accordance with the Official Languages (Communications with and Services to the Public) Regulations. The audited institutions are covered by the following sections of the Act and Regulations:
- section 22 of the Act states that federal institutions must ensure the delivery of services in either official language where there is significant demand for that language;
- section 25 of the Act as well as Appendix C of the Treasury Board Policy on Alternative Service Delivery sets out the federal government’s duties when transferring its responsibilities to third parties acting on its behalf in order to comply with the provisions of Part IV of the Act in relation to service to the public;
- section 27 of the Act sets out the duty to use both official languages in oral and written communications and services; and
- section 28 of the Act specifies that federal institutions that provide communications and services in both official languages must make this known to the public by ensuring an active offer of service.
Paragraph 6(1)(a) of the Official Languages (Communications with and Services to the Public) Regulations defines the concept of significant demand in the case of a restricted and identifiable clientele as being a demand for services in English or French that is at least 5% of the total volume of the demand for service over a period of one year.
“Restricted clientele” refers to the clientele of an office that provides services to a specific group or category of clients. The institution must be able to show that the services in question are for a stable clientele whose composition can be clearly specified. The term “identifiable” means that it is possible to determine both the name of each client and the official language in which the client wishes to receive services. Institutions must take a census of the clientele of those offices that are subject to the provisions regarding a restricted clientele in order to determine the official language in which clients wish to receive their services. Treasury Board Directive C, which provides an operational definition of the concept of restricted and identifiable clientele, can be found in Appendix F of this report.
