History of medicine in Canada

Last updated

Hospitals in Canada were initially places which cared for the poor as those with higher socioeconomic status were cared for at home. In Quebec during the 18th century, a series of charitable institutions, many set up by Catholic religious orders, provided such care. [1]

Contents

The first medical schools were established in Lower Canada in the 1820s. These included the Montreal Medical Institution, which is the McGill University Faculty of Medicine today. In the mid-1870s, Sir William Osler changed the face of medical school instruction with the introduction of the hands-on approach. The College of Physicians and Surgeons of Upper Canada was established in 1839, and in 1869, it was permanently incorporated. In 1834, William Kelly, a surgeon with the Royal Navy, introduced the idea of preventing the spread of disease via sanitation measures following epidemics of cholera. In 1892, Dr. William Osler wrote the landmark text The Principles and Practice of Medicine , which dominated medical instruction in the West for the following half century. Around this time, a movement began that called for the improved healthcare for the poor, focusing mainly on sanitation and hygiene. This period saw important advances including the provision of safe drinking water to most of the population, public baths and beaches, and municipal garbage services to remove waste from the city. During this period, medical care was severely lacking for the poor and minorities such as First Nations. [2]

18th century

Hospitals were initially places which cared for the poor; Others were cared for at home. In Quebec (formerly known as Canada (New France) and then as Lower Canada), a series of charitable institutions, many set up by Catholic religious orders, provided such care. [3] As the country grew, hospitals grew with them. They tended to be not-for-profit, and were run by municipal governments, charitable organizations, and religious denominations (both Catholic and Protestant). [4] These organizations tended to be at arm's length from government; they received subsidies from provincial governments to admit and treat all patients, regardless of their ability to pay. Dr. David Parker of the Maritimes was the first to operate using anesthetic. One of the first "modern" operations, the removal of a tumor, was performed by William Fraser Tolmie in British Columbia.

19th century

The first medical schools were established in Lower Canada in the 1820s. These included the Montreal Medical Institution, which is the faculty of medicine at McGill University today; in the mid-1870s, Sir William Osler changed the face of medical school instruction throughout the West with the introduction of the hands-on approach and U.F.T.. The College of Physicians and Surgeons of Upper Canada was established in 1839 and in 1869 was permanently incorporated. In 1834, William Kelly, a surgeon with the Royal Navy, introduced the idea of preventing the spread of disease via sanitation measures following epidemics of cholera. In 1871, female physicians Emily Howard Stowe and Jennie Kidd Trout won the right for women to be admitted to medical schools and granted licences from the College of Physicians and Surgeons of Ontario. In 1883, Emily Stowe led the creation of the Ontario Medical College for Women, affiliated with the University of Toronto. In 1892, Dr. William Osler wrote the landmark text The Principles and Practice of Medicine , which dominated medical instruction in the West for the next 40 years. Around this time, a movement began that called for the improved health care for the poor, focusing mainly on sanitation and hygiene. This period saw important advances including the provision of safe drinking water to most of the population, public baths and beaches, and municipal garbage services to remove waste from the city. During this period, medical care was severely lacking for the poor and minorities such as First Nations [5]

20th century

The twentieth century saw the discovery of insulin by Frederick Banting and his colleagues, Charles Best, John Macleod, and James Collip, [6] in 1922. For this, Banting and Macleod of the University of Toronto won the 1923 Nobel Prize in Physiology and Medicine. [7] Dr. Wilder Penfield, who discovered a successful surgical treatment for epilepsy called the "Montreal procedure", founded the Montreal Neurological Institute in 1934.

The early 20th century saw the first widespread calls for increased government involvement and the idea of a national health insurance system had considerable popularity. During the Great Depression, calls for a public health system were widespread. Doctors who had long feared such an idea reconsidered hoping a government system could provide some stability as the depression had badly affected the medical community. However, governments had little money to enact the idea. In 1935, the United Farmers of Alberta passed a bill creating a provincial insurance program, but they lost office later that year and the Social Credit Party scrapped the plan due to the financial situation in the province. The next year a health insurance bill passed in British Columbia, but its implementation was halted over objections from doctors. William Lyon Mackenzie King promised to introduce such a scheme, but while he created the Department of Health he failed to introduce a national program.

The beginning of coverage

Canadian health care spending for 1970 to 2007 compared with other nations Health care cost rise.svg
Canadian health care spending for 1970 to 2007 compared with other nations

It was not until 1947 [8] that the first Canadian province introduced near universal health coverage. Saskatchewan long had a shortage of doctors, leading to the creation of municipal doctor programs in the early twentieth century in which a town would subsidize a doctor to practice there. Soon after, groups of communities joined to open union hospitals under a similar model. There had thus been a long history of government involvement in Saskatchewan health care, and a significant section of it was already controlled and paid for by the government. In 1946, the Co-operative Commonwealth Federation government in Saskatchewan passed the Saskatchewan Hospitalization Act , which guaranteed free hospital care for much of the population. Tommy Douglas had hoped to provide universal health care, but the province did not have the money.

In 1950, Alberta's Social Credit Party also introduced a public health care plan. Alberta, however, created Medical Services (Alberta) Incorporated (MS(A)I) in 1948 to provide prepaid health services. This scheme eventually provided medical coverage to over 90% of the population. [9]

In 1957, the majority Liberal government under Louis St. Laurent passed the Hospital Insurance and Diagnostic Services Act [10] to fund 50% of the cost of such programs for any provincial government that adopted them. The HIDS Act outlined five conditions: public administration, comprehensiveness, universality, portability, and accessibility. These remain the pillars of the Canada Health Act .

By 1961, all ten provinces had agreed to start HIDS Act programs. In Saskatchewan, the act meant that half of their current program would now be paid for by the federal government. C.C.F. Premier Woodrow Lloyd decided to use this freed money to extend the health coverage to also include physicians. Despite the sharp disagreement of the Saskatchewan College of Physicians and Surgeons, Lloyd introduced the law in 1962 after defeating the Saskatchewan doctors' strike in July.

Medical Care Act

The programs in Saskatchewan and Alberta proved a success and the federal government of Lester B. Pearson introduced the Medical Care Act in 1966 that extended the HIDS Act cost-sharing to allow each province to establish a universal health care plan – an initiative that was drafted and initiated by the Liberal Party and supported by the New Democratic Party (NDP). It also set up the Medicare system. In 1984, the Canada Health Act was passed under a majority Liberal government, which prohibited user fees and extra billing by doctors. In 1999, Prime Minister Jean Chrétien and most premiers reaffirmed in the Social Union Framework Agreement that they are committed to health care that has "comprehensiveness, universality, portability, public administration and accessibility." [11]

See also

Related Research Articles

<span class="mw-page-title-main">Physician</span> Professional who practices medicine

A physician, medical practitioner, medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the study, diagnosis, prognosis and treatment of disease, injury, and other physical and mental impairments. Physicians may focus their practice on certain disease categories, types of patients, and methods of treatment—known as specialities—or they may assume responsibility for the provision of continuing and comprehensive medical care to individuals, families, and communities—known as general practice. Medical practice properly requires both a detailed knowledge of the academic disciplines, such as anatomy and physiology, underlying diseases and their treatment—the science of medicine—and also a decent competence in its applied practice—the art or craft of medicine.

<span class="mw-page-title-main">Medicare (Canada)</span> Canadas publicly funded, single-payer health care system

Medicare is an unofficial designation used to refer to the publicly funded single-payer healthcare system of Canada. Canada's health care system consists of 13 provincial and territorial health insurance plans, which provide universal healthcare coverage to Canadian citizens, permanent residents, and depending on the province or territory, certain temporary residents. The systems are individually administered on a provincial or territorial basis, within guidelines set by the federal government. The formal terminology for the insurance system is provided by the Canada Health Act and the health insurance legislation of the individual provinces and territories.

<i>Canada Health Act</i> Canadian federal law for health care funding

The Canada Health Act, adopted in 1984, is the federal legislation in Canada for publicly-funded health insurance, commonly called "medicare", and sets out the primary objective of Canadian healthcare policy.

Universal health care is a health care system in which all residents of a particular country or region are assured access to health care. It is generally organized around providing either all residents or only those who cannot afford on their own, with either health services or the means to acquire them, with the end goal of improving health outcomes.

<span class="mw-page-title-main">Healthcare in Canada</span> Overview of healthcare

Healthcare in Canada is delivered through the provincial and territorial systems of publicly funded health care, informally called Medicare. It is guided by the provisions of the Canada Health Act of 1984, and is universal. The 2002 Royal Commission, known as the Romanow Report, revealed that Canadians consider universal access to publicly funded health services as a "fundamental value that ensures national health care insurance for everyone wherever they live in the country."

Single-payer healthcare is a type of universal healthcare in which the costs of essential healthcare for all residents are covered by a single public system.

<span class="mw-page-title-main">Paramedics in Canada</span> Overview of paramedics in Canada

A paramedic is a healthcare professional, providing pre-hospital assessment and medical care to people with acute illnesses or injuries. In Canada, the title paramedic generally refers to those who work on land ambulances or air ambulances providing paramedic services. Paramedics are increasingly being utilized in hospitals, emergency rooms, clinics and community health care services by providing care in collaboration with registered nurses, registered/licensed practical nurses and registered respiratory therapists.

<span class="mw-page-title-main">McGill University Faculty of Medicine and Health Sciences</span> Medical school in Canada

The Faculty of Medicine and Health Sciences is one of the constituent faculties of McGill University. It was established in 1829 after the Montreal Medical Institution was incorporated into McGill College as the college's first faculty; it was the first medical faculty to be established in Canada. The Faculty awarded McGill's first degree, and Canada's first medical degree to William Leslie Logie in 1833.

A public hospital, or government hospital, is a hospital which is government owned and is fully funded by the government and operates solely off the money that is collected from taxpayers to fund healthcare initiatives. In some countries, this type of hospital provides medical care free of charge to patients, covering expenses and wages by government reimbursement.

<span class="mw-page-title-main">Emergency medical services in Canada</span> Overview of emergency medical services in Canada

Emergency medical services in Canada are the responsibility of each Canadian province or territory. The services, including both ambulance and paramedic services, may be provided directly by the province, contracted to a private provider, or delegated to local governments, which may in turn create service delivery arrangements with municipal departments, hospitals or private providers. The approach, and the standards, vary considerably between provinces and territories.

<span class="mw-page-title-main">Brian Day</span> English-Canadian surgeon

Brian Day, is an orthopedic surgeon and health researcher in Canada, a past president of the Canadian Medical Association, and a prominent sometimes controversial advocate for privatization of Canada's health system.

The Saskatchewan doctors' strike was a 23-day labour action exercised by medical doctors in 1962 in the Canadian province of Saskatchewan in an attempt to force the Co-operative Commonwealth Federation government of Saskatchewan to drop its program of universal medical insurance. The strike was from July 1, the day the Saskatchewan Medical Care Insurance Act took force, to July 23.

<span class="mw-page-title-main">Healthcare in Thailand</span>

Healthcare in Thailand is overseen by the Ministry of Public Health (MOPH), along with several other non-ministerial government agencies. Thailand's network of public hospitals provide universal healthcare to all Thai nationals through three government schemes. Private hospitals help complement the system, especially in Bangkok and large urban areas, and Thailand is among the world's leading medical tourism destinations. However, access to medical care in rural areas still lags far behind that in the cities.

<span class="mw-page-title-main">Nursing in Canada</span> Overview of nursing in Canada

Nurses in Canada practise in a wide variety of settings, with various levels of training and experience. They provide evidence-based care and educate their patients about health and disease.

Albert Ernest Joseph Mark Archer was a Canadian physician and political activist. He is best known for his early efforts to promote national and provincial public health care systems. Some have argued that he deserves as much recognition as Tommy Douglas for the establishment of medicare in Canada.

The Alberta Health Insurance Act was an act passed by the Alberta Legislature in February 1935. It was the first Canadian health insurance act to provide some public funding for medical services, and as such is considered to be an early step toward the provision of medicare in Canada.

This article provides a brief overview of the health care systems of the world, sorted by continent.

<i>Hospital Insurance and Diagnostic Services Act</i> Repealed Canadian legislation for health care funding

The Hospital Insurance and Diagnostic Services Act (HIDS) is a statute passed by the Parliament of Canada in 1957 that reimbursed one-half of provincial and territorial costs for hospital and diagnostic services administered under provincial and territorial health insurance programs. Originally implemented on July 1, 1958, with five participating provinces, by January 1, 1961, all ten provinces were enlisted. The federal funding was coupled with terms and conditions borrowed from the Saskatchewan Hospital Services Plan, introduced in 1947 as the first universal hospital insurance program in North America. In order to receive funding, services had to be universal, comprehensive, accessible and portable. This stipulation was dropped in 1977 with the Established Programs Financing Act and then reinstated in 1984 in the Canada Health Act. Widely acknowledged as the foundation for future developments in the Canadian health care system, the HIDS Act was a landmark example of federal-provincial cooperation in post-war Canada.

<span class="mw-page-title-main">Physicians in Canada</span> Canadian physician

Physicians and surgeons play an important role in the provision of health care in Canada. They are responsible for the promotion, maintenance, and restoration of health through the study, diagnosis, prognosis, and treatment of disease, injury, and other physical and mental impairments. As Canadian medical schools solely offer the Doctor of Medicine (M.D.) or Doctor of Medicine and Master of Surgery degrees, these represent the degrees held by the vast majority of physicians and surgeons in Canada, though some have a Doctor of Osteopathic Medicine (D.O.) from the United States or Bachelor of Medicine, Bachelor of Surgery from Europe.

References

  1. ↑ Shah, Chandrakant P (2003). Public health and preventive medicine in Canada (5th ed.). Toronto: Elsevier Canada.
  2. ↑ Warren, P. (2008). "Physician advocacy essential for Canada's First Nations". Canadian Medical Association Journal. 179 (7): 728. doi:10.1503/cmaj.081290. PMC   2535741 . PMID   18809906 . Retrieved 2011-02-10.
  3. ↑ Shah, Chandrakant P (2003). Public health and preventive medicine in Canada (5th ed.). Toronto: Elsevier Canada.
  4. ↑ [Marchildon GP. Health Systems in Transition: Canada. Copenhagen, WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies. Downloaded from "Archived copy" (PDF). Archived from the original (PDF) on 2008-02-27. Retrieved 2008-01-07.{{cite web}}: CS1 maint: archived copy as title (link)].
  5. ↑ Warren, P. (2008). "Physician advocacy essential for Canada's First Nations". Canadian Medical Association Journal. 179 (7): 728. doi:10.1503/cmaj.081290. PMC   2535741 . PMID   18809906 . Retrieved 2011-02-10.
  6. ↑ The Discovery of Insulin, 25th Anniversary Edition, by Michael Bliss, Chicago, ISBN   978-0-226-05899-3
  7. ↑ "The Nobel Prize in Physiology or Medicine 1923". Nobelprize.org. Retrieved 2011-02-10.
  8. ↑ Directorate, Government of Canada, Health Canada, Strategic Policy Branch, Health Care Policy (26 May 2011). "Canada's Health Care System [Health Canada, 2011]".{{cite web}}: |first= has generic name (help)
  9. ↑ "History". Alberta Medical Association. Archived from the original on 2010-11-14. Retrieved 2011-02-10.
  10. ↑ Turner, J. G. (1958). "The Hospital Insurance and Diagnostic Services Act: Its Impact on Hospital Administration". Canadian Medical Association Journal. 78 (10): 768–70. PMC   1829926 . PMID   13523526.
  11. ↑ Government of Canada, Social Union, News Release, "A Framework to Improve the Social Union for Canadians: An Agreement between the Government of Canada and the Governments of the Provinces and Territories, February 4, 1999." Retrieved December 20, 2006.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.