Canada - World Health Organization Regional Office for Europe

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36 Health systems in transition Canada While CBS’s board members are nominated by P/T ministers of health, civil servants are not permitted on the board. Quebec is not a participating member of CBS and instead has it own blood products and services agency – Héma-Québec. F/P/T governments collaborate extensively with civil society partners in a number of other pan-Canadian health initiatives, including the Canadian Partnership Against Cancer Corporation and the Pan-Canadian Public Health Network. Through the Council of the Federation, provincial and territorial governments recently created a Health Care Innovation Working Group made up of all P/T ministers of health. In 2012, this Working Group was mandated to examine human resources management, provider scope of practice and clinical practice guidelines in order to identify and learn from innovative initiatives in Canada. 2.3.4 Nongovernmental national agencies and associations Canadian health care programmes and policies are highly influenced by a number of nongovernmental organizations including health services associations, professional organizations such as regulatory bodies, protective associations, trade unions, industry associations, and patient and disease advocacy associations. Many are organized as provincial associations – one study found that there were 244 such organizations operating in Ontario alone (Wiktorowicz et al., 2003). A number of these provincial bodies have national umbrella organizations that play an important role in facilitating and coordinating the memberships’ pan-Canadian initiatives. Some of the larger or more influential of these national organizations are described below. Accreditation Canada is a voluntary, nongovernmental organization that accredits hospitals, health facilities and RHAs. Funded by the organizations it accredits, Accreditation Canada also conducts reviews and assessments of health facilities and regional health systems with recommendations for improvements. First established in 1958, Accreditation Canada has expanded its mandate beyond acute care hospitals to psychiatric facilities (1964), long-term care institutions (1978), rehabilitation facilities (1985), community-based health services (1995) and home care services (1996). 2 There has been some debate in Canada as to whether accreditation should be made compulsory, and two provinces – Quebec and Alberta – have moved to mandatory accreditation with a third – Manitoba – considering a similar change (Nicklin, 2 Accreditation Canada’s name changes reflect its expanding mandate: in 1958, it was first incorporated as the Canadian Council on Hospital Accreditation; 30 years later (1988), the name was changed to the Canadian Council on Health Facilities Accreditation; in 1995, it was reincorporated as the Canadian Council on Health Services Accreditation; and finally, in 2008, it became Accreditation Canada.
Health systems in transition Canada 37 2011). Connected to this debate is the question of whether voluntary (or even compulsory) accreditation actually serves to improve health system quality and safety or whether it is a “sterile administrative ritual” (Lozeau, 1999). In a study comparing France, which has had a compulsory accreditation regime since 1996, and Canada, with its predominantly voluntary approach, Touati & Pomey (2009) found that both systems have contributed to quality and safety improvements although in very different ways. Health provider organizations, in particular physician organizations and, more recently, nurse organizations, have played a major role in shaping health care policy in Canada (see section 9.2.5). Other provider organizations including those representing dentists, optometrists, pharmacists, psychologists, medical technologists and many others are also more active in attempting to influence future health system reforms. The Canadian Medical Association (CMA) is the umbrella national organization for physicians, including consultants – known as specialists in Canada – and general practitioners. In addition to lobbying for its members’ interests, the CMA also conducts an active policy research agenda and publishes the biweekly CMAJ (Canadian Medication Association Journal) as well as six more specialized medical journals. The 12 P/T medical associations (Nunavut is not represented) are self-governing divisions within the CMA. These P/T bodies are responsible for negotiating physician remuneration and working conditions with P/T ministries of health, except in Quebec where negotiations are carried out by two bodies representing specialists and general practitioners. While the CMA is not involved directly in such bargaining, it does – when called upon – provide advice and expertise to the P/T associations. The role of the CMA and, in particular, its provincial divisions, must be separated from the regulatory role of the provincial colleges of physicians and surgeons. The latter are responsible for the licensing of physicians, the development and enforcement of standards of practice, investigation of patient complaints against members for alleged breaches of ethical or professional conduct and standards of practice as well as enforcement. As is the case with most professions in Canada, physicians are responsible for regulating themselves within the framework of provincial laws. A national body, the Royal College of Physicians and Surgeons of Canada (RCPSC), restricts its function to overseeing and regulating postgraduate medical education.
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Health Systems in Transition Vol. 1
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Health Systems in Transition Gregor
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Contents Preface . . . . . . . . .
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Preface The Health Systems in Trans
Page 9 and 10: Acknowledgements The HiT on Canada
Page 11 and 12: List of abbreviations Abbreviations
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Page 15: Abstract Canada is a high-income co
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The European Observatory on Health
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Canada - World Health Organization Regional Office for Europe

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