Improving health care for anglos

Mark Reynolds | The Faculty of Arts held a launch for an $11.5 million project that will have McGill professors and researchers developing strategies to improve English-language health services in Quebec.

Hélène Riel-Salvatore and Estelle Hopmeyer present the outline of the THRDP
Owen Egan

"As far as I can tell, it's the newest and biggest project in the Faculty of Arts," said sociology professor Uli Locher, the principal investigator of the Training and Human Resources Development Project (THRDP).

Funded by Health Canada, the four-year project will attempt to improve English-language instruction for front-line health service providers in those areas of Quebec with anglophone communities. In addition, it will look into ways to recruit and retain English speakers in those communities. The goal, explained Locher, is to ensure equal access to health services in Quebec.

"If you can't communicate, you're not going to get good services, so it's important to have English-provided services. It doesn't have to be by anglophones, but the range of services is important."

Getting health professionals to live and work outside of urban areas is a challenge all across Canada. But the problem is particularly acute for English communities in Quebec outside of Montreal. There are English pockets in all of Quebec's 16 health regions, from the Gaspé, to the Eastern Townships, to the Saguenay—Lac Saint Jean region.

"Outside of Montreal, the populations are changing. There's a depopulation of the young — the population is increasingly old and in greater need of health services. At the same time, older English speakers are the ones who have not been to French school and have lived their lives in their English-speaking enclaves and so really don't get along in French at all," said Locher.

The THRDP had its genesis in the work of the Community Health and Social Services Network, a group of affiliated anglophone social services groups that include, among others, the YMCA, the Batshaw Centre and the McGill School of Social Work. Social work professor Estelle Hopmeyer is also a researcher on the THRDP.

Jim Carter of the Community Health and Social Services Network said that the THRDP came about through a Health Canada Consultative Committee for English-Speaking Minority Communities report, which identified language training for health a social workers as an important factor in the long-term survival of English-speaking communities.

It was Carter and the Community Health and Social Services Network that took this identified need and brought the project to McGill to explore collaborative opportunities.

"Our belief is that this project will have two main outcomes," said Carter. "The first is to support francophone professionals who serve English-speaking communities by giving them resources to improve their ability to deliver services in English," said Carter.

"The second outcome has to do with supporting the vitality of our communities. These measures are to retain and support English-speaking professionals in the regions; to ensure that those students who leave the regions to get professional training in English will return to their regions to serve their communities."

Language training for front-line workers — anyone from doctors to receptionists — is the first priority. This will include training in English for francophones and in French for anglophones. Hélène Riel-Salvatore of the English and French Language Centre said that there are a number of tactics the project will explore to accomplish this.

"Information is the key. We are working with regional agencies, heath and social services institutions, communities and instructional institutions to do a needs analysis," she said.

Part of the project will be to determine how to best accommodate the health professionals' schedules. Arranging for replacements while doctors or nurses are in class is one approach. Collaborating with instructional facilities already in the area will be the first option.

Riel-Salvatore said that follow-up is also important. To that end, the project would establish networks wherein health practitioners can get the information and support they need during and after their formal language training. On-going evaluation of the project will be carried out to determine how effective the measures are.

The project will also look at using language instruction as an incentive for professionals to stay in the target areas. This will include providing French-language instruction and support to anglophones.

Locher said that previous incentive programs to keep professionals in far-flung communities have not always had to undergo the rigorous evaluation that is required to determine their effectiveness.

"We want to set up pilot projects on recruitment and retention of personnel. We want to find out what works. One thing that is very clear is that governments don't know what works," he said, adding that too often, governments simply throw money at the problem.

"There are other things that may be important. For instance, doctors do not want to practice in outlying areas because that cuts them off from cutting-edge medicine. If you can set up some kind of interactive hook-up, it may well be that doctors in outlying areas can receive all the necessary training, specialization and participation in cutting-edge medicine that they would actually get in Montreal."

For her part, Riel-Salvatore is excited by the learning potential for the university that this project represents.

"What does the Quebec population know about the regions, Monsieur Tout-le-monde? If you say that the francophone community is homogeneous, we know that's not true. But the same could be said of the English community in the regions. We need to understand how these communities exist — how they survive and thrive. In getting different expertise together, we're getting a good, positive and efficient way to provide solutions," she said.