eVisitNB investigations reveal ‘serious' breaches of languages act

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New Brunswick’s official languages commissioner is sounding the alarm after she found seven francophone eVisitNB patients couldn’t receive taxpayer-funded service in their language of choice, contrary to the province’s Official Languages Act.

In four of those cases, virtual health-care providers used the same blanket statement to tell French-speaking patients that they couldn’t “understand your request well enough to provide treatment.” In two other cases, patients also didn’t receive service after talking to a provider due to a language barrier, while another patient received a message that they may face a longer wait time if they set their preferred language to French on the eVisitNB mobile app.

“In the seven complaints investigated, none of the complainants were able to receive the services they requested in the official language of their choice, French,” commissioner Shirley MacLean wrote in a March 20 report released publicly Wednesday.

“There have been serious breaches of the Official Languages Act.”

Both the Department of Health and eVisitNB have indicated to MacLean they’re working to address the issues raised in the seven complaints filed with her office between October 2022 and February 2023. Those complaints resulted in two separate investigations undertaken by the commissioner.

As a result of those investigations, MacLean has made 12 recommendations to the Department of Health, including that it take “immediate steps” to ensure eVisitNB patients have timely access to service no matter their language preference and that there’s “adequate staffing” to meet the Official Languages Act obligations.

“The department has already implemented several of the recommendations made by the Commissioner of Official Languages for New Brunswick,” government spokesperson Sean Hatchard said in an email Wednesday. “It will continue working with the contractor to implement the remaining recommendations and will continue to monitor progress.”

Under the Official Languages Act, New Brunswick government departments and Crown corporations have an obligation to communicate and provide services in both English and French. As for third-party service providers like eVisitNB, either the department or Crown corporation doing business with them has a duty to ensure these linguistic obligations are being met.

In this case, the Department of Health has that responsibility because since January 2022, it has contracted eVisitNB to provide virtual health-care services to Medicare cardholders. That contract requires eVisitNB to be compliant with the Official Languages Act.

In a response to the complaints, eVisitNB – through the Department of Health – acknowledged there had been cases where its health-care providers had responded in English to French-speaking patients that they couldn’t understand their requests.

The company policy is that providers are supposed to send clients messages back “in the language they are attempting to access services in.”

Patients are supposed to be matched with providers based on their selected language preference, but in cases where there’s a mismatch, the patient has the choice of waiting in the cue for an appropriate provider, proceeding in a different language or updating their language preference and re-registering for care, according to eVisitNB.

In cases where patients haven’t selected the appropriate language preference for them, providers have “scripts with direction to assist the patient to amend their registration information.”

“eVisitNB takes these situations very seriously and responds to each and every one with a communication to the provider to reinforce eVisitNB’s procedure in this instance, provide counselling and coaching on how to correct the error, and if provider-specific non-compliance is trending, to remediate individually,” the response reads.

In the wake of these complaints, eVisitNB has reviewed the policy and process with “all providers and disciplinary action could result from non-compliance up to and including termination.”

Commissioner makes series of recommendations

In its own response dated back in October, the Department of Health reported that it was working with eVisitNB to address language issues on both the company’s website and app, including ensuring “simplified directions on selecting language of choice.”

But MacLean said she remains concerned that patients are still required to choose their own language settings on both web and mobile apps against the principle of active offer of service.

That offer means “informing the public, at the first point of contact, that services are available in both official languages,” according to the government website.

MacLean also raised concerns that the Department of Health doesn’t have more data from eVisitNB to ensure the Official Languages Act standards are being met.

Many New Brunswickers use this system to access primary health care and my office continues to receive complaints about eVisitNB to this day.

Shirley MacLean

The department initially told the commissioner it didn’t have “access to the linguistic profile or other information” about eVisitNB health-care providers. However, it later reported back the company had 26 bilingual nurse practitioners, with an average of 13 of those online on any given day.

“As this does not guarantee coverage in French on every work shift, the Department of Health works with the provider to ensure compliance with the Official Languages Act,” it said in its response at the time of the investigation.

On Wednesday, Hatchard said the province has “worked with the vendor to ensure it has staffing capacity in both official languages for each shift.”

About 280,000 virtual health-care visits were provided to New Brunswickers by eVisitNB in the 2023-24 fiscal year, according to the health department. The service is offered seven days a week from 8 a.m. to 8 p.m. daily.

“Many New Brunswickers use this system to access primary health care and my office continues to receive complaints about eVisitNB to this day,” MacLean said in a release accompanying her findings. “It is crucial that the department resolve these issues to ensure that no member of the public is at a disadvantage because of their official language of choice.”

Brunswick News requested comment from eVisitNB Wednesday. The company referred the newspaper back to the provincial government.