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Devolution to democratic health authorities in Saskatchewan: an interim report.
S J Lewis1, D Kouri, C A Estabrooks
1HEALNet Regionalization Research Centre, Saskatoon, Sask.
Summary
Saskatchewan health board members supported reforms and devolution, seeing improved local control and decision quality. However, unresolved tensions regarding authority and representation persist despite general satisfaction with changes.
Area of Science:
- Health Services Research
- Public Health Policy
- Health Care Administration
Background:
- Saskatchewan implemented a district health board structure in 1995, with elected and appointed members.
- This governance model aimed to decentralize authority from the province to local health districts.
Purpose of the Study:
- To examine district health board members' opinions on health care reform in Saskatchewan.
- To assess perceptions of devolved authority and its impact on local control and decision-making.
Main Methods:
- A survey was administered to all 357 members of Saskatchewan district health boards in 1997.
- Response rate was 77% (275 members); analysis compared elected vs. appointed members and provider vs. non-provider members.
Main Results:
- Most members perceived increased local control and better decision quality post-devolution.
- A majority supported extensive reforms and recent changes, believing reform prioritized health over spending.
- Significant concerns were raised about unclear system vision, legal responsibility without control, and provincial government restrictions.
Conclusions:
- District health board members largely supported health care reform goals and recent changes.
- Few significant differences in opinion existed between elected/appointed or provider/non-provider members.
- Key challenges remain in resolving tensions related to governance authority and representation.