Position Paper on Bilateral Agreements in Health – The Principle of Equitable Access: Definition, Discussion and Implementation

27 Oct, 2025 | Articles & Press Releases, By Santé en français, Studies and Documents

View the full Position Paper.

View the one-pager of the Position Paper.

Context

  • On February 14, 2024, the governments of Canada and Manitoba announced more than $633 million in funding to improve health care in Manitoba.
  • Through the Working Together agreement, the Government of Canada will provide nearly $434 million to support Manitoba’s three-year Action plan to improve health care.
  • The federal government will also provide approximately $199 million through the Aging with Dignity agreement, to support Manitoba’s five-year Action plan to improve home, community and long-term care for seniors.
  • These agreements contain statements of principle that governments commit to uphold, including “equity of access for under-served groups and individuals, including those in official language minority communities. »
  • The agreements also contain commitments regarding official language minority communities, namely:
    o “implement measures that also meet the needs of underserved and/or disadvantaged populations”
    o “Share available disaggregated data with CIHI [Canadian Institute for Health Information] and work with CIHI to improve availability of disaggregated data for existing and new common indicators to enable reporting on progress for underserved and/or disadvantaged populations”
    o “improving access to services in French. Consideration will be given to bilingual employee needs as a component of future health human resources planning and strategies as a part of efforts to increase the representation of Francophone and French-speaking health care providers.”

Why is the principle of equity of access important?

  • More than one million people in Canada have French as their first official language spoken and live in a minority setting.
  • The 2021 census shows that Manitoba has 112,115 French-speaking people spread across the province. This includes:
    • 74,215 people in the Winnipeg Health Region
    • 21,330 people in the Southern Health region
    • 7,575 people in the Interlake-Eastern Health Region
    • 1,835 people in the Northern region
  • Although the demographic weight of French is declining in Canada, which requires targeted interventions by all pillars of government, the absolute number of Francophones is growing in Manitoba, thanks in part to immigration and the growing demand for French immersion school programs, among others.
  • The most recent consultations indicate that two-thirds of Francophones in minority communities have inadequate access to quality health services in French.1
  • When language barriers exist, the quality and safety of health services decreases significantly. This has been demonstrated by research on numerous occasions.2
  • The consequences of language barriers can be serious, in some cases leading to death. Here are a few examples:
    o In 2024, an Ottawa man hospitalized with dementia is unable to communicate with health care providers in English and continues to be served in English by the vast majority of staff, despite numerous complaints from his family.
    o Following a misunderstanding due to linguistic discrepancy, a Francophone in Northern Ontario is amputated on the wrong leg.
    o Following a hospital stay for serious mental health reasons, a French-speaking immigrant is released from a hospital in Saskatchewan without any follow-up or information for his loved ones or community. Alone and isolated, he ends his life shortly afterwards.
    o During a health incident in Alberta, a doctor mistook the inability of a French-speaking senior to express himself in English for confusion, further complicating the situation.
  • According to a July 2022 study by the Canadian Medical Association Journal, the mortality rate is reduced by 24% when Francophones in Ontario receive care in their mother tongue.

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