Saskatchewan pioneered two distinct and innovative programs for financing the construction, maintenance, and administration of hospital facilities and the services they provided: Union Hospital Districts (UHDs) and municipal hospital care plans. In 1916 legislation was introduced to permit the formation of UHDs. These arrangements empowered rural municipalities, villages and towns to form local authorities and pool their limited resources to establish and maintain hospitals. Although UHDs were formed in Alberta and Manitoba, it was in Saskatchewan that municipal hospitals grew to provide the bulk of hospital accommodation. Municipal hospitals were a response to local needs, and seem to have been the first in North America. Saskatchewan lacked the wealthy philanthropists who financed and controlled many of the hospitals elsewhere in Canada. Municipal hospital care plans provided payment for the hospital services obtained by residents of a municipality from general revenues and, later, personal taxes. Both UHDs and municipal hospital plans appear to have originated in the town of Lloydminster along the Saskatchewan-Alberta border. In 1913 the local hospital in Lloydminster, which had closed in 1912 for financial reasons, was reopened as a union hospital and provided hospital care to all residents. In 1916 both Saskatchewan and Alberta passed legislation to legalize this experiment in both the maintenance and administration of hospital facilities and pre-paid hospital care financed from general revenues. In 1917 Saskatchewan passed a more general Union Hospital Act to facilitate the establishment of similar pre-paid hospital service plans. By 1942, 100 municipalities provided their residents with hospital services. Municipal hospital care plans were superseded by the introduction of a provincewide hospital service plan in 1947. The provision of hospital grants by the T.C. Douglas government facilitated the continued growth of UHDs. When national hospital insurance was introduced in 1957, Saskatchewan had 119 municipal hospitals with 64% of the province’s hospital beds.
Gordon S. Lawson