Week 1 - History of Healthcare in Canada Flashcards
who established the first health care systems in Canada? what happend?
- indigenous peoples developed healthcare practices hundreds of years prior to the arrival of settlers
- european settlers depended on indigenous people for health issues and traditional medicines and practice
- this was until settlers imposed their own healthcare practices and policies, so western healthcare overtook indigenous practices
what is the British North America (BNA) Act?
- created in 1867
- renamed to the Constitution Act in 1982
- outlined provincial and federal governments shared responsibility for health care
what responsibilities did the federal and provincial government take on after the BNA?
provincial:
- responsible for establishing and managing hospitals, asylums, charities, and charitable institutions.
- responsibilities regarding health care (social welfare, health and public health matters) were assumed by default since they were not clearly outlined as federal responsibility
federal:
- responsible for the establishment and maintenance of marine hospitals, the care of Indigenous populations and the management of quarantine
when was the Department of Health created? what was its role?
- in 1919, the federal government established a department of health
- it would take on healthcare related responsibilities, including collaborating with provinces and territories
- in 1928, it became known as the Department of Pensions and National Health.
- in 1944, the name changed to Department of National Health and Welfare. federal responsibilities expanded to include food and drug control, the development of public health programs, health care for members of the civil service, and the operation of the Laboratory of Hygiene
- in 1993, the department was renamed Health Canada.
who were the first healthcare providers in Canada?
- a combination of civilian and military physicians who came with the arrival of European settlers
- these doctors cared for their patients in their homes until hospitals were built
- only wealthier settlers were able to afford medical attention from a doctor and to seek care in a hospital when required.
- others received care through religious and other charitable organizations or from family and friends who provided in-home care using botanical remedies and other natural medicines handed down to them by family or shared with them by Indigenous people
when/where was the first hospital opened?
- in 1639 in Québec City
- called the the Hôtel-Dieu de Québec
- Augustinian nuns from France who worked as “nursing sisters” opened the hospital
what were hospitals like in the 1800’s?
- they were very crowded places focused that primarily treated infectious diseases
- people of poorer classes who could not afford private care mostly attended the hospital
- in contrast, the wealthier segment of the population avoided hospitals by hiring doctors who would visit patients’ homes to provide treatment
- this changed when anaesthesia, aseptic technique, and improved surgical procedure were developed so the use of hospital facilities increased
what volunteer organizations played a role in early healthcare? why?
- in the eighteenth and early nineteenth centuries, Canadians’ health care needs were attended to largely by volunteer organizations
- they heavily relied on them to raise funds for health care because there was little or no funding provided by the government or any other agency
- the order of st john
- the canadian red cross society
- canadian blood services
- victorian order of nurses
- childrens aid society
when/where was the first nursing school established?
- 1873 at Mack’s General and Marine Hospital
- St Catherines, Ontario
- the first university to offer a nursing degree was in 1919 at the University of British Columbia
when/where was the first medical school established?
- 1825
- Montreal, Quebec
what was the pre-contact era?
the thousands of years before indigenous people came into contact with outsiders
what were early indigenous health practices like?
- most cultural practices were rooted in holistic and spiritual beliefs, and a relationship with nature
- knowledge about healing ceremonies and health practices was passed down from one generation to another by healers, both orally and through “hands-on” experiences
- the few illnesses that Indigenous people had were sometimes attributed to evil spirits, or to an imbalance or disharmony between such entities as the body, mind, community, and nature.
- indigenous healers had their own traditions, an understanding of healing, and the use of herbal medicines.
- a variety of rituals, ceremonies, and spiritual practices were used to treat some disorders whereas other were treated with an assortment of plants, herbs, roots, and fungi
how were indigenous practices affected by colonization?
- western medicine and knowledge soon overtook the traditional ceremonies and practices of Indigenous populations, invalidating much of their knowledge and traditional ceremonies
- the inability of Indigenous healers to successfully treat the newly introduced diseases (TB, flu, smallpox) allowed non-Indigenous people to discredit traditional healing ceremonies and the legitimacy of traditional healer
- The British North American Act (1867) and the Indian Act (1876) welcomed assimilation of Indigenous people, applying numerous restrictions to their practices and way of life
- Indigenous people in Canada suffered greatly, particularly from the unspeakable and tragic abuses and atrocities they experienced at residential schools
what is the indigenous medicine wheel?
a holistic approach to health and wellness that considers the mental, physical, cultural, and spiritual well-being of not only the individual person but also the entire community
when was publicly funded healthcare first introduced?
- in 1957, the Hospital Insurance and Diagnostic Services Act was introduced
- was done by the federal government under John Diefenbaker
- it proposed that any provinces and territories willing to implement a comprehensive hospital insurance plan will have 50% of their cost covered by the federal government
- 5 provinces (and Northwest Territories and Yukon) bought into the plan
what did the Hospital Insurance and Diagnostic Services Act provide?
- all residents of a province or territory were entitled to receive insured health care services upon uniform terms and conditions
- the Act provided residents with full care in an acute care hospital for as long as the physician felt necessary
- It also included care provided in outpatient clinics (not in tuberculosis sanitariums, mental institutions, or long-term care facilities)
- services for some allied health workers (i.e physiotherapy) and other non-medical professionals, as well as diagnostic procedures, were covered by provincial and territorial health insurance plans only if the care was provided in a hospital setting and under the direction of a physician
who is tommy douglas?
- known as the “father of medicare”
- was the premier of Saskatchewan from 1944 to 196
- he campaigned to integrate a publicly funded, comprehensive hospital and medical insurance plan that everyone could access
- lead to the passing of the Saskatchewan Medical Care Insurance Act in 1961
what legislations/report played a role in the passage of the Canada Health Act?
- The Hall Report
- The Medical Care Act
- The Established Programs and Financing Act
the Hall report
- 1960
- known as the Royal Commission on Health Services
- it supported a national Medicare program
- recommended that the number of physicians be doubled by 1990 to meet demands of a growing and aging population
the Medical Care Act
- 1968
- allowed all jurisdictions to administer the plan as they saw fit
- in order to receive funds, provincial and territorial health plans had to meet four criteria:
1) universality
3) portability
3) comprehensive coverage
4) public administration
The Established Programs and Financing (EPF) Act
- 1977
- introduced a a new funding mechanism to allocate money for health care based on block payments (one payment to cover all services) to provinces and territories
- replaced the previous 50/50 sharing formula
Canada Health Act
- became law in 1984 under Prime Minister Pierre Trudeau’s Liberal government
- is still in place today, governing and guiding the health care delivery system in Canada
what is the goal of the Canada Health Act?
- is to provide equal, prepaid, and accessible health care to eligible Canadians and thereby meet the objectives of Canadian health care policy
- established criteria and conditions for the delivery of health care
- to qualify for federal payments, the provinces and territories must adhere to the 5 criteria and to 2 additional conditions
what are the 5 criteria of the Canada Health Act?
1) Public Administration
- managed by provincial plans (not a private company) on a not-for-profit basis
2) Comprehensive coverage
- allows patients access to prepaid, medically necessary services, in particular, physician and hospital services
- available to all insured residents with equal opportunity
- procedures that are considered cosmetic are usually not covered, unless the procedure is required for a medical reason
3) Universality
- every resident is entitled to, and must have equal, insured coverage without discrimination.
4) Portability
- citizens must wait no longer than three months if moving provinces to gain access to the provincial health care system (under the Reciprocal Agreement); in the meantime their home province pays for their care
- canadians who leave the country will continue to be insured for health services for varying periods of time
5) Accessibility
- reasonable access to services when and where they are available.
- if a person lives far from a service, they must be granted access to the service in the closest location where it is offered
