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> 31<br />
Table 2.3<br />
<strong>Regional</strong>ization in the provinces and territories<br />
RHAs first established<br />
(year)<br />
Number of RHAs when<br />
first established<br />
Number of RHAs<br />
in 2011<br />
British Columbia 1997 52 5<br />
Alberta 1994 17 1<br />
Saskatchewan 1992 32 13<br />
Manitoba 1997 12 11<br />
Ontario 2005 14 14<br />
Quebec 1989 18 18<br />
New Brunswick 1992 8 2<br />
Nova Scotia 1996 4 9<br />
Prince Edward Island 1993 6 1<br />
Newfoundland and Labrador 1994 6 6<br />
Northwest Territories 1997 8 8<br />
Sources: Axelsson, Marchildon & Repullo-Labrador (2007) and current provincial and territorial ministry websites consulted<br />
in November 2011 (see section 9.2).<br />
Notes: Year of RHA establishment based on calendar year in which law establishing regionalization was passed; jurisdictions with<br />
one RHA have separated RHA governance and mandate from ministry of health governance and mandate, similar to other<br />
regionalized jurisdictions.<br />
While the provinces have the primary governance responsibility <strong>for</strong> most<br />
public health care services, the federal government plays a key role in setting<br />
pan-Canadian standards <strong>for</strong> hospital, diagnostic and medical care services<br />
through the <strong>Canada</strong> <strong>Health</strong> Act and the <strong>Canada</strong> <strong>Health</strong> Transfer (see section<br />
3.3.3). The federal department of health – <strong>Health</strong> <strong>Canada</strong> – is responsible <strong>for</strong><br />
ensuring that the provincial and territorial governments are adhering to the<br />
five criteria of the <strong>Canada</strong> <strong>Health</strong> Act. Although conditional transfers are a<br />
common policy tool in most federations, the use of the federal spending power<br />
in health care has been more controversial in <strong>Canada</strong>, in large part because of<br />
the desire of some provincial governments and policy advocates <strong>for</strong> an even<br />
greater degree of fiscal and administrative decentralization (Marchildon, 2004;<br />
Boessenkool, 2010).<br />
While provincial and territorial governments must provide universally<br />
insured services to all registered Indians and recognized Inuit residents, the<br />
First Nations and Inuit <strong>Health</strong> Branch of <strong>Health</strong> <strong>Canada</strong> provides these citizens<br />
supplemental coverage <strong>for</strong> “non-insured health benefits” (NIHB) such as<br />
prescription drugs, dental care and vision care as well as medical transportation<br />
to access medicare services not provided on-reserve or in the community of<br />
residence. In addition, <strong>Health</strong> <strong>Canada</strong> and the PHAC provide a number of<br />
population health and community health programmes in First Nation and Inuit<br />
communities. <strong>Health</strong> <strong>Canada</strong> is also responsible <strong>for</strong> regulating the safety and<br />
efficacy of therapeutic products, including medical devices, pharmaceuticals