The relationship between French Canadians and English people is represented in the novel by the relationship between Daniel and his British nurse, Jenny. The dynamic between the two characters illustrates the level of connection possible between two people that are externally very different. The language barrier between the nurse, who speaks English, and Daniel, who speaks French, is a metaphor for the differences between French Canadians and English-speaking Canadians.
The novel portrays French Canadian culture as a very austere and difficult world to live in. Certainly, the level of poverty informs the cultural differences. For example, Daniel's mother is unable or unwilling to buy him a tin flute that he wants. However, the nurses get it for him as he lays in his sick bed.
It's also important to note the symbolism of Daniel's situation. The women are responsible for controlling the situation, while gender roles amongst the French Canadians are the opposite. This is seen in the family dynamics of the French Canadians.