Canada. Royal Commission on Health Services : The Royal Commission on Health Services was established under Order in Council P.C. 883, 20 June 1961, under Part I of the Inquiries Act (R.S.C., 1952, c.154) and on the recommendation of the prime minister. The Commission was mandated to inquire into and report upon the existing facilities and the future need for health services for the people of Canada and the resources to provide such services, and to recommend such measures, consistent with the constitutional division of legislative powers in Canada, as the Commissioners believe will ensure that the best possible health care is available to all Canadians, with specific reference to: (a) the existing facilities and methods for providing personal health services including prevention, diagnosis, treatment and rehabilitation; (b) methods of improving such existing health services; (c) the correlation of any new or improved programme with existing services; (d) the present and future requirements of personnel to provide health services; (e) methods of providing adequate personnel with the best possible training and qualifications for such services; (f) the present physical facilities and the future requirements for the provision of adequate health services; (g) the estimated cost of health services now being rendered to Canadians, with projected costs of any changes that may be recommended; (h) the methods of financing health care services; (i) the methods of financing any new or extended programmes which may be recommended; (j) the relationship of existing and any recommended health care programmes with medical research and the means of encouraging a high rate of scientific development in the field of medicine in Canada; (k) the feasibility and desirability of priorities in the development of health care services; and (l) such other matters as the Commissioners deem appropriate for the improvement of health services. The commissioners were Emmett Matthew Hall, Chairman; Alice Girard, David M. Baltzan, O. John Firestone, Cecil Leslie Strachan, Arthur F. Van Wart and Malcolm Wallace McCutcheon. On 9 August 1962, McCutcheon resigned from the commission because of his appointment to the Senate and to the federal cabinet. The secretary was N. Lafrance.
The Federal-Provincial Conference of 1955 held discussions concerning the introduction of a comprehensive health insurance program in Canada. The decision to proceed with a national hospital insurance plan reflected a realization that of all health services, hospital care was the most expensive one. As a result of these discussions, and subsequent negotiations, the Hospital Insurance and Diagnostic Services Act (5-6 Eliz. II, c.28, 1956-1957; amended by 7 Eliz. II, c-6, 1958) was implemented on 1 July 1958 with five provinces participating. It authorized federal payments toward the cost of supporting certain hospital services provided by the provinces under provincially administered health insurance programs. By 1 January 1961, all 10 provinces were providing federally assisted hospital insurance.
The Report of the Royal Commission on Health Services said the reaction to the national hospital insurance program was favourable:
"The representations from hospital associations, medical associations, provincial governments, and consumer groups together with our own investigations, make it clear that, by and large, the basic foundations of the programme are sound, that it has financed hospital operations that could not otherwise have been made possible, enabled people to obtain care that they would not otherwise have received, and prevented, for many individuals and families, a substantial part of the financially crippling blows of prolonged illness."
By the 1960's, it appeared that Canadians enjoyed a comparatively high level of medical care. The public hospital insurance plan was firmly in place and because of that the private purchase of hospital insurance was no longer necessary. Consequently, insurance firms began to offer Canadians protection against the costs incurred from possible illness or injury and other types of health insurance.
Despite the availability of various types of health insurance, the Royal Commission on Health Services observed:
"This does not, however, mean that health services are universal or comprehensive. Half of our population still lacks adequate medical insurance. Moreover, medical and hospital care, being mainly curative and diagnostic, represent only part of the whole spectrum of hospital services."
In 1960, the Canadian Medical Association, which supported the principal that insurance to prepay the costs of medical services should be available to all Canadians regardless of age, state of health, or financial status, called upon the federal government to appoint an independent inquiry on health services. It wanted an objective study carried out in order to avoid the kind of political dispute which was taking place in the Province of Saskatchewan.
In Saskatchewan, the committment of the provincial government to the introduction of a compulsory province wide medical care insurance plan was strongly opposed by the Saskatchewan College of Physicians and Surgeons. The College declared its support for "the extension of health and sickness benefits through indemnity and service plans" and medicare became one of the main issues of the provincial election of June 1960. The dispute between the provincial government and the doctors continued long after that time because the College, even though many doctors went out on strike, was unable to prevent the government's medical care insurance plan from coming into effect on 1 July 1962.
Because of the controversy in Saskatchewan, the Council of the Canadian Medical Association, at a meeting held in 1960, decided to have the CMA Executive:
"Approach the Federal Government to ask them to establish a committee to study the existing and projected health needs and health resources of Canada; and to study methods of ensuring the highest standard of health care for all citizens of Canada..."
This resolution was forwarded to Prime Minister Diefenbaker on 12 December 1960. On 21 December, the Prime Minister responded by promising that a royal commission on health services would be appointed. Six months went by, however, before the government passed an Order in Council formally establishing the federal inquiry. (See Malcolm G. Taylor, Health Insurance and Canadian Public Policy: The Seven Decisions that Created the Canadian Health Insurance System,( Montreal: McGill-Queens University Press, 1978), pp. 331-337 and Royal Commission on Health Services, 1964, Vol. 1, pp. 381-422).
Hearings of the commission were held in St. John's, Halifax, Charlottetown, Fredericton, Quebec City, Montreal, Toronto, Ottawa, Winnipeg, Regina, Edmonton, Vancouver, Victoria and Whitehorse from 27 September 1961 to 11 March 1963. Representatives of the commission also visited the United Kingdom, France, Holland, Sweden, Switzerland, Austria, Italy, the United States, the Union of Soviet Socialist Republics, Australia and New Zealand. The commission received 406 submissions. RG33-78 General Inventory
