Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
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<strong>Health</strong> systems in transition <strong>Canada</strong><br />
Strategy following the 10-Year Plan agreed to by first ministers in 2004,<br />
there has been little progress on a pan-Canadian catastrophic drug coverage<br />
programme.<br />
Rehabilitation and long-term care policies and services, including home<br />
and community care, palliative care and support <strong>for</strong> in<strong>for</strong>mal carers, vary<br />
considerably among provinces and territories. Until the 1960s, the locus of<br />
most mental health care was in large, provincially run psychiatric hospitals.<br />
Since deinstitutionalization, individuals with mental illnesses are diagnosed<br />
and treated by psychiatrists on an outpatient basis even though they may spend<br />
periods of time in the psychiatric wards of hospitals. Family physicians provide<br />
the majority of primary mental health care.<br />
Unlike long-term care and mental health, almost all dental care is privately<br />
funded in <strong>Canada</strong>. As a consequence of access being largely based on income,<br />
outcomes are highly inequitable. Complementary and alternative medicine<br />
(CAM) is, with a few exceptions (e.g. chiropractors in some provinces) also<br />
privately funded and delivered.<br />
Due to the disparities in health outcomes <strong>for</strong> Aboriginal peoples, as well as<br />
the historical challenge of servicing some of the most remote communities in<br />
<strong>Canada</strong>, F/P/T governments have established a number of targeted programmes<br />
and services. While Aboriginal health status has improved in the postwar period,<br />
a large gap in health status continues to separate the Aboriginal population from<br />
most other Canadians.<br />
Principal health re<strong>for</strong>ms<br />
Since 2005, when the first edition of this study was published, there have been<br />
no major pan-Canadian health re<strong>for</strong>m initiatives. However, individual provincial<br />
and territorial ministries of health have concentrated on two categories of<br />
re<strong>for</strong>m, one involving the reorganization or fine tuning of their regional health<br />
systems, and the second linked to improving the quality, timeliness and patient<br />
experience of primary, acute and chronic care.<br />
The main purpose of regionalization (i.e. the introduction of RHAs to<br />
manage services as purchasers or purchaser–providers) was to gain the benefits<br />
of vertical integration by managing facilities and providers across a broad<br />
continuum of health services, in particular to improve the coordination of<br />
“downstream” curative services with more “upstream” public health and illness<br />
prevention services and interventions. In the last ten years, in an attempt to