Health Care: A Community Concern?

By Anne Crichton; Ann Robertson et al. | Go to book overview
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The Health Care System
in the Welfare Society
The previous chapters have reviewed the literature which was available on community health services up to 1993 and it is now important to consider what conclusions can be drawn from these documents. The project was funded to examine organizational models for community health services, but we decided that it was not only necessary to look at community services but at health services as a whole within the welfare state in order to tease out why community services were not better funded and more effective. We took a historical approach.Organization theory indicated that we should look for three stages in the organizational development of a collectivist system of care:
1. The shift from an individualistic to a collectivist model of care delivery
2. The development of a collectivist model and, after a time, the questioning of this model (or first order change)
3. The proposed substitution of a new model after reviewing the mission (second order change)

Bartunek and Reis (1988) have first explained how new social organizations are formed. They have then discussed the first stages of a new organization's development. In the early stages of evolution of a new or merged organization, they said, the emphasis will be put upon gap filling and coordination. Then a second stage is likely to evolve. At this point the mission will be questioned and a new mission is likely to be substituted for the old. This revisitation of the mission will result in new objectives being set and will stir up the established patterns of doing things.

We found that there were three stages in the development of Canada's health care system which closely followed these ideas of the theorists despite


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Health Care: A Community Concern?
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