Children, Politics, and Medicare: Experiences in a Canadian Province

comparisons with other provinces (health and vital statistics), innovative approaches to health issues (e.g., technology, evaluation, etc.), and economic studies. At present, it is extremely difficult to obtain an overview of child/youth programs in the other provinces and territories. Regional comparisons with other countries would also be profitable. It will be interesting to observe whether the Children's Bureau accepts such a leadership role, or whether it confines its role to housekeeping activities.

The role of the provincial government entails a more direct involvement concerning needs, policy, planning, allocation of resources, and evaluation of programs for children and youth. The British Columbia Child and Youth Secretariat (Chapter 3) has been assigned the task of coordinating and implementing programs for children and youth for a three-year period. This function should be ongoing, because the needs of children and youth change over time, and public policies need to be altered and adapted to provide appropriate responses to current problems. There is also much to be gained by involving the paediatric community and non-governmental organizations concerned with child and family issues ( 40). The role of the Continuing Advisory Sub Committee (CASC) has not been a model of success.

In conclusion, we reiterate what one of us (GRFE) suggested forty years ago: "Children are our seed corn" ( 12). There is good evidence that prenatal and early life experiences play a key part in shaping the development of children and youth. There is evidence that the reproductive health of women can be improved by population-based prenatal care. It will be of great interest to follow the effectiveness of the British Columbia Maternal and Neonatal Care Program. When early experiences are negative, school failure, unemployment, and inappropriate behaviour are common outcomes. There is also evidence that these latter outcomes can be reversed by the introduction of appropriate replacement strategies. If Canada's Child Development Initiative can serve this need, it would be an enormous help to many people. Such an investment in children is both rational and just, and is the key to the building of healthy communities.

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