In June 2000, Kenneth J. Fyke was commissioned by the Saskatchewan government under Roy J. Romanow “to identify the key challenges … in reforming and improving medicare,” and “to recommend an action plan for delivery of health services … that embodies the core values of medicare.”
Following an interim report in October 2000, the final report, Caring for Medicare: Sustaining a Quality System, was presented in April 2001 to Romanow’s successor, Lorne Calvert.
The Commission occurred at an important juncture in the ongoing evolution of Canada’s health care system. In the midst of reduced federal transfers, significant technological and medical innovation, and increasing pressure to balance their budgets, provincial governments were struggling to deal with the mounting costs and declining public confidence in the system. Hence the Fyke Report was preceded by the Clair Report in Quebec and followed by the Mazankowski Report in Alberta. Shortly after Fyke completed his work, Romanow himself headed up the federally appointed Commission on the Future of Health Care in Canada.
The Fyke Report insisted that the measure of the system’s success be its ability to provide high-quality services in a sustainable manner. Without significant reform, Fyke warned, the quality of the services would continue to decline. The report laid out a detailed plan for the reorganization of health services in the province, beginning with integrated primary health care teams at the local level, increasingly sophisticated services at the regional level, and high-end diagnostic, complex and tertiary care in Regina, Saskatoon and Prince Albert.
Although the government’s response was muted at first, it did eventually follow through on some of Fyke’s recommendations. In 2002–03, the Health Services Utilization and Research Commission (HSURC) was divided into the Saskatchewan Health Research Foundation (SHRF) and the Health Quality Council, a body designed to assess the system’s performance and to recommend further changes as needed. The province’s thirty-three health districts were also amalgamated into twelve health authorities in order to better coordinate service delivery on a regional basis. But many of Fyke’s more sweeping recommendations for a new approach to primary health care and service integration have yet to be realized. However, Fyke’s model of “putting quality first” remains an important benchmark for measuring the success of health care reform in Saskatchewan and in the nation.