RT Journal Article
SR Electronic
T1 Devolution to democratic health authorities in Saskatchewan: an interim report
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 343
OP 347
VO 164
IS 3
A1 Steven J. Lewis
A1 Denise Kouri
A1 Carole A. Estabrooks
A1 Harley Dickinson
A1 Jacqueline J. Dutchak
A1 J. Ivan Williams
A1 Cameron Mustard
A1 Jeremiah Hurley
YR 2001
UL http://www.cmaj.ca/content/164/3/343.abstract
AB Methods: All 357 members of Saskatchewan district health boards were surveyed in 1997; 275 (77%) responded. Analyses included comparisons between elected and appointed members and between members with experience as health care providers and those without such experience, as well as comparisons with hypotheses about how devolution would develop, which were advanced in a 1997 report by another group. Results: Most respondents felt that devolution had resulted in increased local control and better quality of decisions. Ninety-two percent of respondents believed extensive reforms were necessary and 83% that changes made in the previous 5 years had been for the best. However, 56% agreed that there was no clear vision of the reformed system. A small majority (59%) perceived health care reform as having been designed to improve health rather than reduce spending, contrary to a previous hypothesis. Many respondents (76%) thought that boards were legally responsible for things over which they had insufficient control, and 63% perceived that they were too restricted by rules laid down by the provincial government, findings that confirm the expectation of tensions surrounding the division of authority. Respondents with current or former experience as health care providers were less likely than nonprovider respondents to believe that nonphysician health care providers support decisions made by the regional health boards (45% v. 63%, p = 0.02), a result that confirmed the contention that the role of health care providers on the boards would be a source of tension. Interpretation: Members of Saskatchewan district health boards supported the general goals of health care reform and believed that changes already undertaken had been positive. There were few major differences in views between appointed and elected members and between provider and nonprovider members. However, tensions related to authority and representation will require resolution.