Canada - World Health Organization Regional Office for Europe

5. Provision of services
Although it is difficult to generalize given the decentralized nature of
health services administration and delivery in Canada, the typical
patient pathway starts with a visit to a family physician, who then
determines the course of basic treatment, if any. Family physicians act as
gatekeepers: they decide whether their patients should obtain diagnostic tests,
prescription drug therapies or be referred to medical specialists. However,
provincial ministries of health have renewed efforts to reform primary care
in the last decade. Many of these reform efforts focus on moving from the
traditional physician-only practice to interprofessional primary care teams that
provide a broader range of primary health care services on a 24-hour, 7-day-aweek
basis. In cases where the patient does not have a regular family physician
or needs help after regular clinic hours, the first point of contact may be a
walk-in medical clinic or a hospital emergency department.
Illness prevention services including disease screening may be provided
by a family physician, a public health office or within a dedicated screening
programme. All provincial and territorial governments have public health
and health promotion initiatives. They also conduct health surveillance and
manage epidemic response. While PHAC develops and manages programmes
supporting public health throughout Canada, most day-to-day public health
activities and supporting infrastructure remains with the provincial and
territorial governments.
Almost all acute care is provided in public or non-profit-making private
hospitals in Canada, although some specialized ambulatory and advanced
diagnostic services may be provided in private profit-making clinics. Most
hospitals have an emergency department that is fed by independent emergency
medical service units providing first response care to patients while being
transported to emergency departments.
5. Provision of services