Research on Organization Theory and
its Relevance for Canadian Health
The decision of the Canadian federal and provincial governments to establish collectivist social policies was made without realizing the structural implications of such a decision. The framework of analysis presented in Chart 1.1 gives some indication of the complexity of the organization of the welfare states which would have to be set up. Not only was there a variety of social programs to be brought in, but there were a number of different levels of government involved in their funding and delivery. The need for coordinating policy making, service delivery, administration and research was barely understood. And it might have been easier to start from scratch, but some professional and social services were already being provided under the individualistic system of care which existed in Canada in the 1930s. As well the postwar reconstruction plans for a collectivist system of care were introduced in a piecemeal manner as, and when, they could get political support.
The chapter which follows outlines the theory of reconstructing organizations and should enable the reader to see what might be expected in moving first from an individualistic system of health care to a collectivist biomedical model and then, after a review of the mission, to a social model of care. No one seems to have seen the whole picture or understood the adjustments that would have to be made in moving from one model to another as the existing subgroups were brought into one larger new organization. And they were resistant to making the necessary changes for the system to be optimally successful.