Health Care: A Community Concern?

By Anne Crichton; Ann Robertson et al. | Go to book overview

CHAPTER 16

Developing Provincial Policies and
Building Up Administrative Structures

When Canada decided to set up a welfare state or, rather, a whole range of welfare states in the provinces which had constitutional authority over social affairs, there were two problems: the first was to legitimate the idea of collectivism, the second to implement it (Hall et al. 1975). In both cases it was necessary to organize structural support for the change in policy. In this chapter the problems of implementation — the need to develop the provincial governments and their bureaucracies to manage the funding and organization of a collectivist approach to care — will be explored. It will trace the development of the formal power structures for controlling funding and management of the system


Development of Provincial Governments

Before the Second World War provincial governments were relatively small authorities. Although under the constitution they had power to regulate health, education and social services within their jurisdictions, they did not expect to be the funders, organizers or providers of services. This was perceived to be the responsibility of the municipalities, hospital boards, school boards, charities or private enterprise. A major exception was the mental health service which was funded and managed directly by provincial governments. Otherwise there were small departments for standard setting in public health, education and social services and very small provincial budgets. 1

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1
Guest (1980) has discussed a few other provincial activities but these were fairly minor.

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