Canada - World Health Organization Regional Office for Europe

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Health systems in transition Canada
The Canadian Nurses Association (CNA) is a federation of 11 P/T registered
nurses (RN) organizations with approximately 144 000 members as of 2011. 3
Some of the provincial organizations such as the Registered Nurses Association
of Ontario (RNAO) carry considerable political influence within their respective
jurisdictions. The CNA and its provincial affiliates have also played a major
role in carving out a larger role for nurse practitioners in Canada. P/T nurses
associations are not involved in collective bargaining with the provinces. This is
the function of the various unions in the provinces and territories representing
RNs and licensed practical nurses (LPNs). The Canadian Federation of Nurses
Unions (CFNU) is an umbrella organization for all provincial and territorial
nurses’ unions with the exception of Quebec.
There are numerous civil society groups at the pan-Canadian level with
the chief objective being to mobilize support and funding for both general and
specific health care causes (see section 9.26). Some examples of organizations
with a more general policy advocacy role, sometimes combined with a
research mandate, include the Canadian Healthcare Association (formerly the
Canadian Hospital Association), the Canadian Health Coalition, the Canadian
Public Health Association (CPHA), the Canadian Women’s Health Network,
the Canadian Home Care Association and the Canadian Hospice Palliative
Care Association among many others. Other charitable organizations promote
a greater public focus on particular diseases or health conditions through
advocacy, information and advice for affected individuals and their caregivers.
Many of these organizations have charitable status and provide funding for
research in their respective areas. Some of the larger of these pan-Canadian
charities are identified in section 9.2.6.
Finally, there are industry associations that represent profit-making interests
in health care. These include organizations such as the Canadian Generic
Pharmaceuticals Association, Canada’s Research-Based Pharmaceutical
Companies, and the Canadian Life and Health Insurance Association.
2.4 Decentralization and centralization
While Canada is a highly decentralized federation with a mixed model of public
and private health delivery, the administration of health care has become more
centralized as a result of large-scale administrative reforms enacted by P/T
governments during the past two decades. When regionalization first occurred,
3 The association of nurses of Quebec (Ordre des infirmières et infirmiers du Québec – OIIQ) is not a member of the
CNA, while there is a single association for nurses in Nunavut and the Northwest Territories.