Canada - World Health Organization Regional Office for Europe

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.