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> 37<br />
2011). Connected to this debate is the question of whether voluntary (or even<br />
compulsory) accreditation actually serves to improve health system quality<br />
and safety or whether it is a “sterile administrative ritual” (Lozeau, 1999). In<br />
a study comparing France, which has had a compulsory accreditation regime<br />
since 1996, and <strong>Canada</strong>, with its predominantly voluntary approach, Touati &<br />
Pomey (2009) found that both systems have contributed to quality and safety<br />
improvements although in very different ways.<br />
<strong>Health</strong> provider organizations, in particular physician organizations and,<br />
more recently, nurse organizations, have played a major role in shaping health<br />
care policy in <strong>Canada</strong> (see section 9.2.5). Other provider organizations including<br />
those representing dentists, optometrists, pharmacists, psychologists, medical<br />
technologists and many others are also more active in attempting to influence<br />
future health system re<strong>for</strong>ms.<br />
The Canadian Medical Association (CMA) is the umbrella national<br />
organization <strong>for</strong> physicians, including consultants – known as specialists in<br />
<strong>Canada</strong> – and general practitioners. In addition to lobbying <strong>for</strong> its members’<br />
interests, the CMA also conducts an active policy research agenda and publishes<br />
the biweekly CMAJ (Canadian Medication Association Journal) as well as six<br />
more specialized medical journals. The 12 P/T medical associations (Nunavut<br />
is not represented) are self-governing divisions within the CMA. These P/T<br />
bodies are responsible <strong>for</strong> negotiating physician remuneration and working<br />
conditions with P/T ministries of health, except in Quebec where negotiations<br />
are carried out by two bodies representing specialists and general practitioners.<br />
While the CMA is not involved directly in such bargaining, it does – when<br />
called upon – provide advice and expertise to the P/T associations.<br />
The role of the CMA and, in particular, its provincial divisions, must be<br />
separated from the regulatory role of the provincial colleges of physicians<br />
and surgeons. The latter are responsible <strong>for</strong> the licensing of physicians, the<br />
development and en<strong>for</strong>cement of standards of practice, investigation of patient<br />
complaints against members <strong>for</strong> alleged breaches of ethical or professional<br />
conduct and standards of practice as well as en<strong>for</strong>cement. As is the case<br />
with most professions in <strong>Canada</strong>, physicians are responsible <strong>for</strong> regulating<br />
themselves within the framework of provincial laws. A national body, the Royal<br />
College of Physicians and Surgeons of <strong>Canada</strong> (RCPSC), restricts its function<br />
to overseeing and regulating postgraduate medical education.