4.1: Introduction

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Page ID: 8924

Joan Wagner
University of Regina

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Learning Objectives

Review historical events related to Canadian health care and the role of early nurse leaders in those events.
Identify how health care responsibilities have been divided among federal, provincial, and territorial governments.
Describe how demographic forces and social forces impact nurse leadership within the Canadian health care system.

Nurses interact every day with Canadians seeking assistance to maintain and improve their health. As a result, nurses can identify trends in population and public health. They know the strengths and the weaknesses of Canada’s health system. They see, first hand, the issues related to accessibility of services. Nurses witness the need to integrate health services with other aspects of social development policy. They work with change in the form of emerging research, knowledge and new technology.

—CNA presentation to the Senate Standing Committee on Social Affairs, Science and Technology (Calnan & Lemire Rodger, 2002)

The World Health Organization (WHO) set 17 sustainable development goals (SDGs) for world health in 2015. These 17 SDGs include human activities across the economic, social, and environmental dimensions of health. Dr. Margaret Chan, Director-General of the WHO, stressed that universal health coverage (UHC) is the “linchpin of the health development agenda, not only underpinning a more sustainable approach to the achievement of the other health targets, but allowing for a balance between them” (WHO, 2015, p. iii). UHC is regarded, at an international level, as a “tested and proven” framework that guides progressive health care transformation within individual countries. Canada pioneered UHC for the world. This chapter will trace the role of nurse leaders in the development and provision of health care in Canada from the time of the first settlers through to the development, implementation, and ongoing refinement of UHC. The chapter will also include a brief overview of demographic and social forces that exerted a significant impact on both nursing leadership and the Canadian health care system.

Much of the historical information within this chapter is based upon the Canadian Nurses Association (CNA) history book, One Hundred Years of Service (CNA, 2013). For a more detailed account of the historical role of Canadian nurse leaders, you can access the full book here.