University of Calgary Press

University of Calgary Press www.uofcpress.com HEALTH CARE: A COMMUNITY CONCERN? by Anne Crichton, Ann Robertson, Christine Gordon, and Wendy Farrant ISBN 978-1-55238-572-2 THIS BOOK IS AN OPEN ACCESS E-BOOK. It is an electronic version of a book that can be purchased in physical form through any bookseller or on-line retailer, or from our distributors. Please support this open access publication by requesting that your university purchase a print copy of this book, or by purchasing a copy yourself. If you have any questions, please contact us at ucpress@ucalgary.ca Cover Art: The artwork on the cover of this book is not open access and falls under traditional copyright provisions; it cannot be reproduced in any way without written permission of the artists and their agents. The cover can be displayed as a complete cover image for the purposes of publicizing this work, but the artwork cannot be extracted from the context of the cover of this specific work without breaching the artist s copyright. COPYRIGHT NOTICE: This open-access work is published under a Creative Commons licence. This means that you are free to copy, distribute, display or perform the work as long as you clearly attribute the work to its authors and publisher, that you do not use this work for any commercial gain in any form, and that you in no way alter, transform, or build on the work outside of its use in normal academic scholarship without our express permission. If you want to reuse or distribute the work, you must inform its new audience of the licence terms of this work. For more information, see details of the Creative Commons licence at: http://creativecommons.org/licenses/by-nc-nd/3.0/ UNDER THE CREATIVE COMMONS LICENCE YOU MAY: read and store this document free of charge; distribute it for personal use free of charge; print sections of the work for personal use; read or perform parts of the work in a context where no financial transactions take place. UNDER THE CREATIVE COMMONS LICENCE YOU MAY NOT: gain financially from the work in any way; sell the work or seek monies in relation to the distribution of the work; use the work in any commercial activity of any kind; profit a third party indirectly via use or distribution of the work; distribute in or through a commercial body (with the exception of academic usage within educational institutions such as schools and universities); reproduce, distribute, or store the cover image outside of its function as a cover of this work; alter or build on the work outside of normal academic scholarship. Acknowledgement: We acknowledge the wording around open access used by Australian publisher, re.press, and thank them for giving us permission to adapt their wording to our policy http://www.re-press.org/content/view/17/33/

APPENDIX B A Chart of Important Dates in the Development of Canada's Community Health Care Organization 1867 Federation of colonies: British North America Act Provincial governments take responsibility for mental health Federal and municipal governments take responsibility for public health 1930-39 Great Depression 1932 Regina Manifesto published by Cooperative Commonwealth Federation 1939-45 World War II 1940 Report of the Royal Commission on Dominion-Provincial Relations (Rowell-Sirois) 1943 Federal Report on Social Security (Marsh) Federal Report on Health Insurance (Heagarty) 1944 CCF party elected to power in Saskatchewan. Reviews by Health Survey Commission 1945-46 Dominion-Provincial Conference on Social Reconstruction 1946 Saskatchewan introduces Hospital Insurance Act 1948 Federal offer of National Health Grants for planning, hospital construction and demonstrations in public and mental health 1951 Pilot projects on regionalization defeated in Saskatchewan 1957 Federal Hospital Insurance and Diagnostic Services Act 1959 Death of Premier Duplessis of Quebec thus freeing up the province to begin the Quiet Revolution 1962 Saskatchewan introduces medical care insurance legislation. Doctor's strike 333

334 / Health Care: A Community Concern? 1963 Fulton-Favreau agreement between Ottawa and Quebec on grant aid 1961-{;4 Royal Commission on Health Services 1965 Canada and Quebec pension plans introduced 1966 Canada Assistance Plan enacted 1966 Federal Medical Care Insurance Act passed 1968 Trudeau's proposal for a charter of rights 1970 Task Force on the Cost of Health Services Report 1968-71 Castonguay-Nepveu Committee Report on Quebec's health and welfare services 1971 Quebec introduces new health structures and programs 1972-73 Report of the National Community Health Centres Committee 1972 Science Council report on need for research on health care system 1973 Ontario sets up first District Health Council 1974 A New Perspective on the Health of Canadians 1974 Rejection of Orange Paper on guaranteed annual income by federal cabinet 1977 Established Programs Financing Act legislation 1977 Human Rights Act, revised 1983 1978 Alma Ata Conference on Primary Health Care 1980 OECD Conference on "Crisis in the Welfare State" 1981 International Year of Disabled Persons 1982 Constitution Act, Charter of Rights and Freedoms 1984 Canada Health Act 1984 Liberal government in Ottawa replaced by Progressive Conservatives 1984-91 Provincial Public Inquiries into Health Care Organization (see List of Provincial Commissions and Government Responses, Appendix B). Proposals for regionalization 1985 Canada job strategy introduced 1985 Report of Royal Commission on Economic Union and Development Prospects 1986 Achieving Health for All: A Framework for Health Promotion 1988 Canada-United States Free Trade Agreement, which agreed on a "harmonized" system of taxes 1993 PC government in Ottawa replaced by Liberals

Appendix B / 335 Legislative Milestones in the Development of the Social Security System Year Act 1914 Ontario Workmen's Compensation Act Saskatchewan Municipal Medical Scheme introduced 1916 Manitoba Mothers' Pension Act Saskatchewan Union Hospital Act 1927 Federal Old Age Pensions Act 1930 Federal War Veterans' Allowances Act 1935 Federal Employment and Social Insurance Act (ruled ultra vires by courts) 1940 Federal Unemployment Insurance Act (major reforms in 1955 and 1971) 1944 Family Allowances Act 1946 Saskatchewan Hospital Insurance Act 1951 Federal Old Age Assistance Act and Old Age Security Act (replaced Old Age Pensions Act) Federal Blind Persons Act 1954 Federal Disabled Persons Act 1956 Federal Unemployment Assistance Act 1957 Federal Hospital Insurance and Diagnostic Services Act 1961 Quebec School Allowances Act 1962 Saskatchewan Medical Care Insurance Act 1964 Federal Youth Allowances Act 1965 Federal Canada Pension Plan Act/Quebec Pension Plan 1966 Federal Canada Assistance Plan Act (replaces earlier assistance.legislation for the blind, disabled, elderly and unemployed which was repealed) 1966 Federal Medical Care Act - implemented by 1970 1967 Federal Guaranteed Income Supplement to Old Age Security Act 1973 New federal Family Allowances Act (replaced old act of same name and Youth Allowances Act) 1977 Federal Extended Health Care Services Program implemented in Federal-Provincial Arrangements and Established Programs Financing Act

336 / Health Care: A Community Concern? 1978 Federal Child Tax Credit introduced to Income Tax Act 1984 Federal Canada Health Act (replaced Hospital Insurance and Diagnostic Services Act and Medical Care Act) 1992 Federal Child Tax Benefit introduced to Income Tax Act (Child Tax Credit deleted and Family Allowances Act repealed) Source: Canada Year Book 1994

Alberta Alberta. Minister for Special Projects. Caring and Responsibility. Edmonton: Government Printer, 1988. Alberta. Premier's Committee on Future Health Care for Albertans. Interim Report: Caring and Commitment. Edmonton: Government of Alberta, 1988. Alberta. Advisory Committee on the Utilization of Medical Services. An Agenda for Action. Report of the Advisory Committee on the Utilization of Medical Services. Edmonton: Government of Alberta, 1989. Alberta. Premier's Committee on Future Health Care for Albertans. The Rainbow Report: Our Vision for Health. Report of the Premier's Committee on Future Health Care for Albertans. Edmonton: Government of Alberta, 1989. Alberta. Premier's Committee on Future Health Care for Albertans. What You've Said. Newsletter special edition. Edmonton: Government of Alberta, 1989. Alberta. Partners in Health. Edmonton: Government of Alberta, 1991. British Columbia British Columbia. Royal Commission on Health Care and Costs. Closer to Home. 3 vols. Victoria: Government Printer, 1991. British Columbia. Department of Health. New Directions in Health Care. Victoria: Government Printer, 1992. Manitoba Manitoba. Mental Health Working Group. Mental Health Services in Manitoba: A Report and Recommendations. Winnipeg: Government Printer, 1983. Manitoba. Health Services Review Committee. Report of the Health Services Review Committee, vol. 3. Winnipeg: Government of Manitoba, 1985. Roch, Denis J., Robert G. Evans, and David W. Pascoe. Manitoba and Medicare: 1971 to the Present. Winnipeg: Manitoba Health, 1985. Manitoba. Manitoba Health Advisory Network. "Manitoba Health." Manitoba Health Advisory Network Newsletter, nos. 1-3. (1989-90). Manitoba. Manitoba Health. Quality Health for Manitobans: The Action Plan. Winnipeg: Government Publisher, 1992. Appendix B / 337 List of Provincial Commissions of Inquiry and Government Responses 1984-92

338 / Health Care: A Community Concern? New Brunswick New Brunswick. Report of the Task Force on New Brunswick Health Care. Fredericton: Government Printer, 1978. New Brunswick. Nurses' Resources Advisory Committee. Action Plan on Quality of Worklife Issues of Nurses in New Brunswick. Fredericton: Government Printer, 1988. New Brunswick. Commission on Selected Health Care Programs. Report of the Commission on Selected Health Care Programs. Fredericton: Government Printer, 1989. New Brunswick. Department of Health and Community Services. Toward a Comprehensive Health Strategy. Fredericton: Government Printer, 1991. New Brunswick. A Health and Community Services Plan for New Brunswick. Fredericton: Government Printer, 1992. Newfoundland Newfoundland. Royal Commission on Hospital and Nursing Home Costs. Report of the Royal Commission on Hospital and Nursing Home Costs to the Government ofnewfoundland and Labrador. St. John's: Government of Newfoundland and Labrador, 1984. Newfoundland. A Green Paper on Our Health Care System Expenditures and Funding [Collins and Twomey]. St. John's: Government of Newfoundland and Labrador, 1986. Newfoundland. Advisory Committee on Nursing Workforce. Report of the Advisory Committee on Nursing Workforce. St. John's: Government of Newfoundland and Labrador, 1988. Nova Scotia Nova Scotia. Legislative Select Committee on Health. Report ofthe Legislative Select Committee on Health. Halifax: Government Printer, 1984. Nova Scotia. Issues and Concerns: Summary ofpublic Hearings and Submissions. Halifax: Government Printer, 1988. Nova Scotia. Royal Commission on Health Care. Report of the Nova Scotia Royal Commission on Health Care: Towards a New Strategy. Halifax: Government Printer, 1989. Nova Scotia. Ministry of Health. Health Strategy for the Nineties: Managing Better Health. Halifax: Government Printer, 1990. Ontario Ontario. Minister for Senior Citizens' Affairs. A New Agenda: Health and Social Services Strategies for Ontario Seniors. Toronto: Government Printer, 1986. Ontario. Health Review Panel. Report of the Task Force on Midwifery in Ontario. Toronto: Government Printer, 1987.

Appendix B / 339 Ontario. Health Review Panel. Toward a Shared Direction for Health in Ontario [Evans Report to the Premier}. Toronto: Government Printer, 1987. Ontario. Ministers' Advisory Group on Health Promotion. Health Promotion Matters in Ontario [PodborskiJ. Toronto: Ministry of Health, 1987. Ontario. Panel on Health Goals for Ontario. Health for All Ontario [Spasoff ReportJ. Toronto: Government Publisher, 1987. Ontario. Provincial Community Mental Health Committee. Building Community Support for People: A Plan for Mental Health in Ontario [Graham Committee]. Toronto: Government Printer, 1988. Ontario. Task Force on the Use and Provision of Medical Services. Report of the Conjoint Review Committee on the 23 Hospital Operational Reviews. Toronto: Government Printer, 1987. Ontario. Task Force on the Use and Provision of Medical Services. Report of the Task Force on the Use and Provision of Medical Services. Toronto: Government Printer, 1987. Ontario. Hospital Association. The Future Role of Hospitals in Providing Care: Issues to Consider. Don Mills: Ontario Hospital Association, 1989. Ontario. The Independent Health Facilities Act, 1989. Ontario. Ministry of Health. Deciding the Future of Our Health Care. Toronto: Ontario Ministry of Health, 1989. Ontario. Ministry of Health. Striking a New Balance: A Blueprint for the Regulation of Ontario's Health Professions. Toronto: Ontario Ministry of Health, 1989. Ontario. Premier's Council on Health Strategy. From Vision to Action: Report of the Health Care System Committee. Toronto: Premier's Council on Health Strategy, 1989. Ontario. Premier's Council on Health Strategy. Funding and Incentives Study [Stevenson Kellogg Ernst and WhinneyJ. Toronto: Premier's Council on Health Strategy, 1989. Ontario. Premier's Council on Health Strategy. A Vision ofhealth: Health Goals for Ontario. Toronto: Premier's Council on Health Strategy, 1989. Ontario. Health Professions Act, 1991. Ontario. Steering Committee Public Hospitals Act Review. Into the 21st Century: Ontario Public Hospitals. Toronto: Queen's Printer, 1992. Prince Edward Island Prince Edward Island. Advisory Committee on the Status of Women. Health Survey for PEI. Charlottetown: Government Printer, 1988. Prince Edward Island. Comprehensive Health. Charlottetown: Government Printer, 1988.

340 / Health Care: A Community Concern? Quebec Quebec. Ministry of Social Affairs. Quebec's System of Health and Social Services. Quebec: Gouvemement du Quebec, 1985. Quebec. Comite d'etude sur la promotion de la sante. Objectif: Sante. Rapport du comite sur la promotion de la sante. Quebec: Gouvemement du Quebec, 1984. Translated by Mercedes Sandra Gayk under the title Objective: A Health Concept in Quebec. Ottawa: Canadian Hospital Association,1986. Quebec. Groupe du travail sur Ie revision des fonctions et des organisations gouvemementales. Rapports Quebec [Comite de Sages]. Rapports Quebec (Quebec: La Groupe du Travail, 1986. Quebec. Comite de la politique de sante mentale. Pour un partenariat enlargi: Projet de politique de sante mentale pour Ie Quebec [Harnois]. Quebec: Gouvemement du Quebec, 1987. Quebec. Comite d'etude sur la main-d'oeuvre en soins infirmiers au Quebec. Rapport du comite d'etude sur la main-d'oeuvre en soins infirmiers. Quebec: Gouvemement du Quebec, 1987. Quiviger, Claude. Centres communautaires locaux de services sociaux et de sante: Etude cooperative Quebec-Ontario. Quebec: Les Publications du Quebec, 1987. Brunet, Jacques. Analyse des activites des CLSCs. Quebec: Les Publications du Quebec, 1987. Quebec. Commission d'enquete sur les services de sante et les services sociaux. Rapport de la commission d'enquete sur les services de sante et les services sociaux. Quebec: Gouvemement du Quebec, 1988. Montambault, Pierre. Rapport du comite de travail sur les nouvelles technologies de reproduction humaine. Quebec, Gouvemement du Quebec, 1988. Quebec. Ministere de la sante et des services sociaux. Improving Health and Well-Being in Quebec: Orientations. Quebec: Gouvemement du Quebec, 1989. Quebec. An Act Respecting Health Services and Social Services and Amending Legislation (Bill 120). Quebec: Official Publisher, 1990. Quebec. Ministere de la sante et des services sociaux. Une reforme axee sur Ie citoyen. Quebec: Gouvemement du Quebec, 1990. Saskatchewan Saskatchewan. Commission on Directions in Health Care. Future Directions for Health Care in Saskatchewan. Regina: Queen's Printer, 1990. Saskatchewan. Saskatchewan Health. A Saskatchewan Vision for Health. Regina: Saskatchewan Health, 1992.